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FIG 1. A, Coronal T2-weighted image (4000/90/2 [TR/TE/excitations]) at the level of the crus cerebri nicely shows heterogeneous left MDJ lesion with extensive edema, sparing the red nucleus.
B, Coronal noncontrast T1-weighted image (300/15/3) at the same level as A reveals a hemorrhagic focus in the lesion.
C, Coronal T2-weighted image (4000/90/2) posterior to A shows extension of perilesional edema caudally to the superior cerebellar peduncle and pontine tegmentum, and upward to the white matter of the temporal lobe, external capsule, and thalamus.
D, Caudal extension of the edema toward the pontine tegmentum is seen on axial T2-weighted image (4000/90/1).
E, Two years later, after another relapse of the disease, coronal T2-weighted image (4000/90/1) reveals a contralateral MDJ lesion. The left-sided lesion now has shrunk to a small hypointense area.
F, Contrast-enhanced T1-weighted image (660/17/1) shows enhancement of the new right MDJ lesion.
G and H, Similar extension of edema as observed in C and D is seen in the right mesencephalopontine region of the brain stem on T2-weighted images (4000/90/1).
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