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AJNR - American Journal of Neuroradiology

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Peripheral Third Cranial Nerve Enhancement in Multiple Sclerosis

M. Tariq Bhatti^a,b, Ilona M. Schmalfuss^c, Lorna S. Williams^d and Ronald G. Quisling^c

^a Department of Ophthalmology, University of Florida College of Medicine, Gainesville, FL
^b Department of Neurology, University of Florida College of Medicine, Gainesville, FL
^c Department of Radiology, University of Florida College of Medicine, Gainesville, FL
^d Department of Radiology, JFK Medical Center, Atlantis, FL

View larger version (107K): [in a new window]   FIG 1. Coronal gadolinium-enhanced T1-weighted images (TR/TE, 600/14) through the cerebral peduncle and cisternal course of cranial nerve III (A) demonstrate marked enhancement and subtle enlargement of cranial nerve III on the left side (white arrows in A). Notice the normal appearance of cranial nerve III on the right (arrowheads in A). There is also subtle enhancement at the cranial nerve III exit zone on the left side (black arrows in A and B), which is better appreciated on the axial gadolinium-enhanced T1-weighted image (B) performed with the same imaging parameters.

View larger version (126K): [in a new window]   FIG 2. Axial fluid-attenuated inversion recovery (FLAIR) image (TR/TE, 9500/110) through the midbrain (A) demonstrates a subtle area of increased signal intensity (arrows) along the medial margin of the cerebral peduncle on the left side. No enhancement is seen on the axial gadolinium-enhanced T1-weighted image (600/17) (B) in this region. The coronal gadolinium-enhanced T1-weighted images (600/14) through the cisternal course of cranial nerve III (C) demonstrate subtle enhancement of the cranial nerve III on the left side (arrows in C). Notice the normal appearance of cranial nerve III on the right (arrowheads in C).

View larger version (91K): [in a new window]   FIG 3. Coronal FLAIR-weighted image (TR/TE, 10,002/168) obtained at the level of the anterior horns of the lateral ventricles shows a focal area of increased signal intensity (arrows) in the subcortical white matter of the inferior frontal lobe on the left side.

View larger version (91K): [in a new window]   FIG 4. Coronal gadolinium-enhanced T1-weighted image (TRTE, 882/14) obtained at the level of the anterior horns of the lateral ventricles shows multiple enhancing white matter lesions (arrows). There is also a nonenhancing lesion in the corpus callosum in midline (arrowhead).