Evolution of Lesions in Susac Syndrome at Serial MR Imaging with Diffusion-Weighted Imaging and Apparent Diffusion Coefficient Values
Matthew L. Whitea,
Yan Zhanga and
Wendy R. K. Smokera
a From the Department of Radiology, University of Iowa College of Medicine, Iowa City
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FIG 1. Patient 1. Initial MR examination at 2 weeks from the onset of symptoms.
A and B, Axial T2-weighted images show multiple hyperintense lesions involving the corpus callosum and cerebral white matter.
C and D, Axial FLAIR images at almost the same levels as in A and B show hyperintense lesions not only in the corpus callosum and cerebral white matter but also in the cerebral cortex (arrows).
E, Contrast-enhanced axial T1-weighted image shows diffuse leptomeningeal enhancement.
F, Axial DWI shows several hyperintense lesions in the cerebral white matter (arrows), with a cluster of lesions in the corpus callosum.
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FIG 2. Patient 1. Second MR examination shortly after relapse of the symptoms (8 weeks from initial onset).
A and B, Axial FLAIR images show that the lesions in the corpus callosum have decreased in size and number compared with those in Figure 1. However, new punctate hyperintense lesions appeared in the cerebral cortex (arrows).
C, Axial DWI also reveals the scattered hyperintense lesions in the cerebral cortex (arrows).
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FIG 3. Patient 1. Third MR examination at 2 weeks following relapse of the symptoms (10 weeks from initial onset).
A and B, Axial FLAIR images show multiple hyperintense lesions in the basal ganglia and thalami bilaterally, as well as in the left cerebellar peduncle and left dentate nucleus. A questionable small lesion is seen in the cortex (arrow in A).
C, Axial DWI shows a hyperintense lesion in the right caudate head (arrow), which was not depicted by either FLAIR or T2-weighted images (not shown).
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FIG 4. Patient 1. Fourth MR examination at 8 months from the onset of symptoms. Axial FLAIR image shows diffuse, bilateral, confluent increased signal intensity in the deep white matter. Note the enlarged ventricles and mildly prominent sulci; this is consistent with cerebral atrophy.
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AJNR - American Journal of Neuroradiology