|
Demyelination
(Functional MRI Study) |
|
Jonathan
S. Lewin, M.D. |
| ----Clinical
History: Forty-eight year old with numbness of right arm and leg. |
|
|
|
| ----Procedure:
Following acquisition of a 3D volume T1-weighted gradient echo study
of the brain, a se- |
| ries
of 10 axial slices parallel to the anterior-posterior commisural line
were obtained using a suscep- |
| tibility/sensitive
sequence during rest and during self-paced rapid alternative finger
motion bilaterally. |
|
The two sets of images were subsequently post-processed using a nonparametric
Mann-Whitney |
| pixel-by-pixel
algorithm and centroid linkage to provide statistical maps of activated
cortex. A single |
| slice
was similarly obtained during face movement. The data were color coded
and overlayed on T1- |
| weighted
images. |
| ----Radiologic
Findings: Functional data generated during bilateral hand motion demonstrates
pronnu- |
| nced activation
on both sides of the central sulcus, more prominent on the left. This
is consistent with |
| the expected
location of primary motor and primary sensory cortex. Minimal activation
is also noted |
| within
the left parietal lobes. Activation tracking within the central sulcus
is noted extending towards |
| the vertex,
consistent with the draining veins of the adjacent cortex. A parenchymal
lesion suspicious |
| for a focus
of demyelination was noted on T2-weighted images (not shown) in the
left frontal lobe app- |
| roximately
two centimeters anterior to this region of motor activation. |
| ----Diagnosis:
Demyelination |
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|
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K.
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|
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BR.
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|
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|
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|
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|
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|
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|
|
Submitted
by:
Jonathan S. Lewin, M.D.
Magnetic Resonance Imaging |
|
|
