Article Figures & Data
Figures
- Fig 1.
Flow chart of patients who met the inclusion/exclusion criteria for the study population.
- Fig 2.
Spine MR images of a 13-year-old female patient with monophasic idiopathic transverse myelitis. The sagittal T2-weighted image (A) shows a longitudinally extensive, minimally expansile hyperintense lesion at the distal spinal cord. The axial T2-weighted (B) and postcontrast T1-weighted (C) images show central involvement with the owl's eyes sign (arrows in B) and no discernible contrast enhancement of the lesion.
- Fig 3.
Spine MR images of a 29-year-old female patient with recurrent transverse myelitis. The sagittal T2-weighted image (A) shows a longitudinally extensive, expansile hyperintense lesion at the cervical spine. The axial T2-weighted (B) and postcontrast T1-weighted (C) images show gray and white matter involvement with bright spotty lesions (arrows in B) and ring enhancement of the lesion. The patient was diagnosed with NMOSD later at follow-up.
Tables
Sequence TR/TI (ms) TE (ms) Matrix Size FOV (mm) Section Thickness/Spacing (mm) T1WI sagittal 397–562 8.7–11 256–384 × 256–288 25–32 × 35.3–45.2 3–3.5/3.3–4.3 T2WI sagittal 2340–4070 96–109 256–384 × 256–288 25–32 × 35.3–45.2 3–3.5/3.3–4.3 STIR sagittal 3210–4610/150–220 42–79 256–384 × 256–288 25–32 × 35.3–45.2 3–3.5/3.3–4.3 T2WI axial 2874–4100 98–109 256–320 × 192–280 18–20 × 25.4–28.3 3–4/3.3–5 T1WI axial 400–654 8.4–9.7 256–320 × 192–280 18–20 × 25.4–28.3 3–4/3.3–5 - Table 2:
The clinical characteristics of 77 patients who presented with acute transverse myelitis
Characteristics Monophasic (n = 50) Recurrent (n = 27) P Values Age at initial manifestation (mean) (yr) 34.2 ± 20.6 40.4 ± 18.5 .196 Female (n) (%) 25 (50%) 21 (77.8%) .033 Ethnicity .020 African American (n) (%) 10 (20%) 10 (37%) Caucasian (n) (%) 38 (76%) 12 (44.4%) Asian American (n) (%) 1 (2%) 3 (11%) Hispanic (n) (%) 1 (2%) 2 (7.4%) Seropositivity for anti-AQP4 Ab 1 (2%) 8 (29.6%) .003 Mean follow-up time (yr) 2.4 ± 1.7 3.8 ± 3.8 .023 Mean EDSS score 4.2 ± 2.1 3.3 ± 1.8 .064 Patients with follow-up spine MRIs (n) (%) 16 (32%) 27 (100%) <.001 Use of immunosuppressive/immunomodulatory treatment (n) (%) 9 (18%) 18 (66.7%) <.001 Note:—AQP4 Ab indicates aquaporin 4 antibody.
- Table 3:
The frequencies of spinal MRI findings and associations with monophasic/relapsing disease
MRI Findings Monophasic Disease (n = 50) (n) (%) Recurrent Disease (n = 27) (n) (%) P Value Unadjusted OR (95% CI) LETM (n = 42) (54.5%) 22 (44%) 20 (74.1%) .022a 3.63 (1.30–10.14) Multifocal lesions (n = 16) (22.5%) 9/44 (20.5%) 7 (25.9%) .808 1.36 (0.44–4.21) Distribution .304 Cervical (n = 21) (27.3%) 14 (28%) 7 (25.9%) Cervicothoracic (n = 14) (18.2%) 6 (12%) 8 (29.6%) Thoracic (n = 35) (45.5%) 25 (50%) 10 (37%) Holocord (n = 7) (9.1%) 5 (10%) 2 (7.4%) Brain stem extension (n = 5) (6.5%) 1/46 (2.2%) 4/25 (16%) .049a 8.57 (0.90–81.46) Location .521 Gray matter (n = 3) (3.9%) 3 (6%) 0 Gray + white matter (n = 65) (84.4%) 42 (84%) 23 (85.2%) White matter (n = 9) (11.7%) 5 (10%) 4 (14.8%) >1/2 of the cord area (n = 55) (71.4%) 33 (66%) 22 (81.5%) .242 2.26 (0.73–7.04) Cord expansion (n = 48) (62.3%) 26 (52%) 22 (81.5%) .021a 4.06 (1.32–12.42) T1 hypointensity (n = 23) (30.3%) 11/49 (22.4%) 12 (44.4%) .089 2.76 (1.01–7.61) BSLs (n = 27) (35.1%) 12 (24%) 15 (55.6%) .012a 3.95 (1.45–10.74) Owl's eyes sign (n = 2) (2.6%) 2 (4%) 0 .539 0.58 (0.06–5.88) Enhancement (n = 48) (62.3%) 26 (52%) 22/26 (84.6%) .011a 5.07 (1.52–16.87) Brain involvement (n = 17) (27%) 11/43 (25.6%) 6/20 (30%) .950 1.24 (0.38–4.04) ↵a Significant.
Variable Adjusted ORs P Value 95% Cl Cord expansion 5.30 .018 1.33–21.11 BSLs 3.63 .040 1.06–12.43 Enhancement 5.05 .023 1.25–20.34 Age 1.03 .084 0.99–1.061 Constant 0.01 .00
