Article Figures & Data
Figures
- Fig 1.
Sagittal T2-weighted spinal MR imaging of a 36-year-old woman with LETM. The lesion extends beyond the imaginary line (dashed line) connecting the inferior cortex of the C1 anterior and posterior arches. Cervicomedullary junction involvement is present.
- Fig 2.
Sagittal T2-weighted spinal MR imaging of a 43-year-old man with LETM. Cord expansion ratio is measured as the anteroposterior diameter of the most swollen spinal cord segment (solid line) to the anteroposterior diameter of the noninvolved spinal cord in the cranial direction (dotted line). Two independent readers measured the cord expansion ratio as 1.65 and 1.71.
- Fig 3.
Two examples of bright spotty lesions (white arrows) in axial T2-weighted spinal MR imaging. Two independent readers judged the lesions as positive.
Tables
Characteristic AQP4 Antibody–Positive Group (n = 15) AQP4 Antibody–Negative Group (n = 26) Age (mean) (yr) 48 ± 13 42 ± 12 Female 13 (87%) 5 (19%) Ethnicity Asian (100%) Asian (100%) Time interval from first attack to MRI study (median) (interquartile range) (days) 10 (3–21) 14 (5–30) 1–15 days 10 (67%) 14 (54%) 16–30 days 3 (20%) 6 (23%) 31–60 days 1 (1%) 2 (8%) >60 days 1 (1%) 4 (15%) Brain involvement 8 (53%) 10 (38%) Preceding optic neuritis 4 (27%) 1 (4%) ↵a Data are number and percentage unless otherwise indicated.
Imaging Features AQP4 Antibody–Positive Group (n = 15) AQP4 Antibody–Negative Group (n = 26) Cervicomedullary junction involvement 9 (60%) 6 (23%) Medulla oblongata involvement 4 (27%) 1 (4%) Cord expansion ratio (mean) (onset ≤2 months)b 1.35 ± 0.15 1.24 ± 0.15 Cord expansion ratio (mean) (onset ≤15 days)c 1.34 ± 0.17 1.24 ± 0.17 Bright spotty lesion Negative 1 (7%) 18 (69%) Positive 14 (93%) 8 (31%) Involved segment Cervical 5 (33%) 7 (27%) Cervicothoracic 8 (53%) 5 (19%) Thoracic 2 (13%) 10 (38%) Thoracolumbar 0 (0%) 1 (4%) Holocord 0 (0%) 3 (12%) No. of segments involved (mean) 9 ± 4 7 ± 4 Axial distribution Central 10 (67%) 21 (81%) Peripheral 4 (27%) 4 (15%) Both 1 (7%) 1 (4%) >Half of the cord area 12 (80%) 24 (92%) Enhancement No enhancement 4 (27%) 6 (23%) <50% enhancement 9 (60%) 17 (65%) >50% enhancement 0 (0%) 0 (0%) Not available 2 (13%) 3 (12%) Variable OR (95% CI) P Value Sex Male Reference Female 3.3 (1.5–5.1) <.001 Cervicomedullary involvement Absent Reference Present 1.6 (0.2–3.0) .02 Bright spotty lesion Negative Reference Positive 3.4 (1.3–5.6) .002 Cord expansion ratio ≤1.4 Reference >1.4 2.1 (0.5–3.7) .01 Parameters Points Sex Male 0 Female 1 Cervicomedullary involvement Absent 0 Present 1 Medulla oblongata involvement +1 = 2 Bright spotty lesion Absent or suspicious 0 Definite 1 Cord expansion ratio for acute or early-stage MRI ≤1.4 0 >1.4 1
