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Physiologic MRI of a tumefactive multiple sclerosis lesion
1Department of Radiology, Harbor-UCLA Medical Center, Torrance, CA 90502, USA.
Neurology
|November 18, 1998
Summary
A large lesion in multiple sclerosis (MS) mimicking a tumor was diagnosed using advanced MRI. Physiologic MRI findings confirmed it as a tumefactive MS plaque, leading to successful steroid treatment.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Multiple sclerosis (MS) can present with large lesions that mimic neoplasms.
- Differentiating tumefactive MS plaques from brain tumors is crucial for appropriate treatment.
Observation:
- A patient with MS presented with subacute left hemiparesis and a large, ring-enhancing brain lesion with mass effect on MRI.
- Initial differential diagnoses included neoplasm versus a large MS plaque.
Findings:
- Physiologic MRI revealed reduced blood flow and magnetization transfer, alongside increased diffusion, within the lesion.
- These advanced imaging findings supported a diagnosis of tumefactive MS plaque over a neoplastic process.
Implications:
- Physiologic MRI parameters can aid in distinguishing tumefactive MS plaques from brain tumors.
- Prompt diagnosis and steroid treatment for MS exacerbation led to significant clinical and radiological improvement.