Mri atlas of ms lesions 1st ed.2008

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MRI Atlas of MS Lesions

M. A. Sahraian, E.-W. Radue

MRI Atlas of MS Lesions
With the collaboration of A. Gass, S. Haller, L. Kappos, J. Kesselring, J.-I. Kira, K. Weier


Prof. Dr. med. Mohammad Ali Sahraian Assistant Professor of Neurology Department of Neurology Tehran University of Medical Sciences Hassan Abad Square Sina Hospital Tehran-Iran

Prof.Dr. med. Ernst-Wilhelm Radue Head of Department of Neuroradiology University Hospital Basel Petersgraben 4 4031 Basel Switzerland

Library of Congress Control Number: 2007927652 ISBN 978-3-540-71371-5 Springer Berlin Heidelberg New York This work is subject to copyright. All rights reserved, whether the whole or part of the material is concerned, specifically the rights oftranslation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilm or in any other way, and storage in databanks. Duplication of this publication or parts thereof is permitted only under the provisions of the German Copyright Law of September, 9, 1965, in its current version, and permission for use must always be obtained from Springer-Verlag. Violations are liable forprosecution under the German Copyright Law. Springer is a part of Springer Science + Business Media © Springer-Verlag Berlin Heidelberg 2008 The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore freefor general use. Product liability: The publisher cannot guarantee the accuracy of any information about dosage and application contained in this book. In every individual case the user must check such information by consulting the relevant literature. Editors: Dr. Ute Heilmann/Annette Hinze, Heidelberg, Germany Desk editor: Meike Stoeck, Heidelberg, Germany Cover design: Frido Steinen-Broo,eStudio Calamar, Spain Production & Typesetting: LE-TEX Jelonek, Schmidt & Vöckler GbR, Leipzig, Germany Printed on acid-free paper 21/3180/YL – 5 4 3 2 1 0

To our wives Barbara and Niloofar and our children Pascal, Geraldine and Amir hossien



Magnetic resonance imaging (MRI) has greatly increased our understanding about multiple sclerosis (MS) during the last two decades, and isnow considered to be the imaging of choice for diagnosis and in vivo monitoring of the disease. New diagnostic criteria allow us to demonstrate dissemination of MS pathology in space and time by MRI, thus making early diagnosis and treatment possible. Exclusion of other possible pathologies is a main step in MS diagnosis. Also in this context, MRI plays an important role. Despite its highsensitivity, MRI is not a specific tool for diagnosing MS, and almost any alteration in cerebral white matter may change the signal intensity on T2-weighted images. Nevertheless, understanding MS lesion characteristics, patterns on different sequences, and topography of lesions in the central nervous system help to determine if MS is the best diagnosis for a patient who has presented with signs andsymptoms of white matter involvement.

The present book aims at demonstrating MS lesions in different sequences of conventional MRI, and shows examples of typical and atypical lesions. The main idea for collecting the images in this atlas is to show the diversity of MS lesions in different sequences of conventional MRI. There is a summarized introduction at the beginning of each chapter, followed byselected images in different sequences demonstrating MS lesions in different shapes, sizes, and locations. A teaching point has been added to the images as a “Note” in order to increase the information resulting from them. Revised McDonald criteria and some of the most important differential diagnoses have been discussed in two separate chapters. The images have been selected out of thousands of...
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