Magnetic resonance imaging of the optic nerve in optic neuritis

Abstract

Magnetic resonance imaging (MRI) of the optic nerves using the STIR (short inversion time inversion recovery) sequence was performed in 37 adult patients with a recent or past attack of optic neuritis. MRI revealed high-signal regions in 84% of symptomatic and 20% of asymptomatic nerves. The mean longitudinal extent of lesions was 1 cm. Slow or poor visual recovery was associated with more extensive lesions, or lesions within the optic canal. Disk swelling was usually associated with anterior lesions but also occurred with lesions in the canal. Visual evoked potentials were even more sensitive than MRI in detecting lesions and are still the investigation of choice in suspected demyelinating disease involving the optic nerve.

The investigation of acute optic neuritis: a review and proposed protocol

“…More-extensive optic nerve lesions are associated with poor clinical outcomes such as slow and incomplete recovery. 81,82 Depending on the severity of inflammation, contrast enhancement can be observed on (fat-suppressed) T1-weighted images in about 94% of patients with acute optic neuritis. In established optic atrophy from previous damage, T2 high signal changes will also be seen, but these changes are associated with thinning of the nerve and do not change over time.…”

A case of isolated acute optic neuritis

“…(Miller et al 1988;Frederiksen et al 1989: Morrissey et al 1995Optic Neuritis Study Group 1997;Jacobs et al 1991Jacobs et al , 1997. All these studies agree that MRI clearly offers prognostic information regarding the chances of developing further neurological events of MS.…”

Quantitative Evaluation of Signal Intensity of Magnetic Resonance Images in Optic Neuritis

“…There have been improvements in the MRI techniques to detect optic nerve lesions in patients with acute optic neuritis since Johnson et al [1] introduced the excellent results with the MR STIR method. Evaluations were based on signal abnormalities, such as the signal intensity [3], the enlargement of the nerve width [11], the length and the position of the lesion [3,6,[12][13][14]. The precise measurement of the size and length of optic nerve lesions is considered unreliable because of the oblique placement of the optic nerve in the coronal plane.…”

“…Such unreliability of the MR images of optic nerve lesions was partly overcome by STIR [1,3], orbital fat suppression [2,7], and the T2-weighted method [6]. Among these, the T2-weighted images can detect the edema of acute lesions and the gliosis and demyelination of chronic lesions.…”

“…With the technical advancement of MRI, there have been a number of studies that have not only demonstrated the usefulness of MRI but also shown an improvement in the certainty of the diagnosis [2][3][4][5][6][7][8][9].…”