Multiple sclerosis - marked brain volume loss

Case contributed by Dr Bruno Di Muzio

Presentation

Known long date history of a demyelinating condition.

Patient Data

Age: 45-year-old
Gender: Female
MRI

MRI Brain

Multiple white matter T2/FLAIR hyperintense regions are noted, in keeping with the known diagnosis of multiple sclerosis. These have remained stable in appearance and number, with no definite new lesions identified, and no abnormal restricted diffusion. No intra or extra-axial collection or mass.

Brain volume is globally reduced.

Case Discussion

This case illustrates a routine MRI brain follow-up study in a patient with a long-term history of multiple sclerosis. The aim is to identify disease progression. 

In our institution, this protocol is performed without post contrast sequences. New lesions can be spotted by comparison of the volumetric FLAIR sequences from the current and previous studies. 

Additionally, a MIP axial FLAIR is created as a fast track comparison of gross white matter lesion changes. The colourful sagittal volumetric acquisition represents the standard deviations of the volume of different cerebral regions compared to a control group in the same age range. It is a simple way to spot the diffuse and marked global brain atrophy in this patient. 

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Case information

rID: 45014
Case created: 12th May 2016
Last edited: 3rd Jun 2016
Tag: rmh
Inclusion in quiz mode: Included

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