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Research ArticleHead and Neck Imaging

The Central Bright Spot Sign: A Potential New MR Imaging Sign for the Early Diagnosis of Anterior Ischemic Optic Neuropathy due to Giant Cell Arteritis

P. Remond, A. Attyé, A. Lecler, L. Lamalle, N. Boudiaf, F. Aptel, A. Krainik and C. Chiquet
American Journal of Neuroradiology July 2017, 38 (7) 1411-1415; DOI: https://doi.org/10.3174/ajnr.A5205
P. Remond
aFrom the Department of Neuroradiology and MRI (P.R., A.A., A.K.), SFR RMN Neurosciences
bDepartment of Ophthalmology (P.R., F.A., C.C.), University Hospital of Grenoble, Grenoble, France
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  • ORCID record for P. Remond
A. Attyé
aFrom the Department of Neuroradiology and MRI (P.R., A.A., A.K.), SFR RMN Neurosciences
cUniversity Grenoble Alpes (A.A., L.L., N.B., A.K.), IRMaGe, Grenoble, France
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A. Lecler
dDepartment of Neuroradiology (A.L.), Rothschild Foundation, Paris, France.
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L. Lamalle
cUniversity Grenoble Alpes (A.A., L.L., N.B., A.K.), IRMaGe, Grenoble, France
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N. Boudiaf
cUniversity Grenoble Alpes (A.A., L.L., N.B., A.K.), IRMaGe, Grenoble, France
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F. Aptel
bDepartment of Ophthalmology (P.R., F.A., C.C.), University Hospital of Grenoble, Grenoble, France
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A. Krainik
aFrom the Department of Neuroradiology and MRI (P.R., A.A., A.K.), SFR RMN Neurosciences
cUniversity Grenoble Alpes (A.A., L.L., N.B., A.K.), IRMaGe, Grenoble, France
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C. Chiquet
bDepartment of Ophthalmology (P.R., F.A., C.C.), University Hospital of Grenoble, Grenoble, France
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    Fig 1.

    High-resolution T1 sequences in the axial plane showing the bright spot sign ranking score. A, The first patient was referred with right nonarteritic AION and a score of 1, with no optic nerve head intravitreal protrusion but local enhancement (white arrow). B, The second patient was referred with left GCA-related AION and both protrusion and local enhancement, defined as score 2 (white arrow).

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    Table 1:

    Number of patients with the bright spot sign for each reader

    ReaderHealthy Subjects (n = 15)NA-AION (n = 15)GCA-AION (n = 15)
    Reader 10/157/1515/15
    Reader 20/156/1515/15
    Reader 30/156/1515/15
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    Table 2:

    Sensitivity, specificity, positive/negative predictive values, and positive/negative likelihood ratios of the MR imaging bright spot sign in healthy subjects and patients with GCA-AION or NA-AION

    No. of ParticipantsTP ResultsTN ResultsFP ResultsFN ResultsSensitivity (%)Specificity (%)PPV (%)NPV (%)PLRNLR
    NA-AION vs GCA-AION
        Observer 1301587010053.368.21002.10
        Observer 230159601006071.41003.50
        Observer 330159601006071.41003.50
    NA-AION vs healthy subjects
        Observer 1307150846.710010065.20.5
        Observer 230615094010010062.50.6
        Observer 330615094010010062.50.6
    GCA-AION vs healthy subjects
        Observer 1301515001001001001000
        Observer 2301515001001001001000
        Observer 3301515001001001001000
    • Note:—FN indicates false-negative; FP, false-positive; PLR, positive likelihood ratio; NLR, negative likelihood ratio; NPV, negative predictive value; PPV, positive predictive value; TN, true-negative; TP, true-positive.

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American Journal of Neuroradiology: 38 (7)
American Journal of Neuroradiology
Vol. 38, Issue 7
1 Jul 2017
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Cite this article
P. Remond, A. Attyé, A. Lecler, L. Lamalle, N. Boudiaf, F. Aptel, A. Krainik, C. Chiquet
The Central Bright Spot Sign: A Potential New MR Imaging Sign for the Early Diagnosis of Anterior Ischemic Optic Neuropathy due to Giant Cell Arteritis
American Journal of Neuroradiology Jul 2017, 38 (7) 1411-1415; DOI: 10.3174/ajnr.A5205

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The Central Bright Spot Sign: A Potential New MR Imaging Sign for the Early Diagnosis of Anterior Ischemic Optic Neuropathy due to Giant Cell Arteritis
P. Remond, A. Attyé, A. Lecler, L. Lamalle, N. Boudiaf, F. Aptel, A. Krainik, C. Chiquet
American Journal of Neuroradiology Jul 2017, 38 (7) 1411-1415; DOI: 10.3174/ajnr.A5205
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