Tumefactive demyelinating lesions of 15 patients: Clinico-radiological features, management and review of the literature.

Sánchez, Pedro; Meca-Lallana, Virginia; Barbosa, Antônio Vinícius Corrêa; Manzanares, Rafael; Palmí, Itziar; Vivancos, José

doi:10.1016/j.jns.2017.08.005

Cited by 39 publications

(50 citation statements)

References 35 publications

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“…In Asian MS patients, tumefactive MS may be more frequent, with an occurrence of 6.3% versus 0.1–1.4% in Western MS patients [33–35]. The development of tumefactive demyelinating lesions is attributed to the failure of focal immune-regulation against inflammatory insults that underlie MS lesion formation [36].…”

Section: Discussionmentioning

confidence: 99%

A comparison of brain magnetic resonance imaging lesions in multiple sclerosis by race with reference to disability progression

Nakamura

Gaetano

Matsushita

et al. 2018

J Neuroinflammation

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BackgroundWe compared the magnetic resonance imaging (MRI) features between Japanese and Caucasian patients with multiple sclerosis (MS), and identified the relationships between MRI features and disability.MethodsFrom the baseline data of phase II fingolimod trials, 95 Japanese and 246 Caucasian relapsing-remitting MS patients were enrolled. The number, volume, and distribution of brain MRI lesions were evaluated using T2-weighted (T2W) images. Cross-sectional total normalized brain volume (NBV), normalized cortical gray matter volume, normalized deep gray matter volume (NDGMV), normalized white matter volume (NWMV), and normalized thalamic volume were measured.ResultsJapanese patients had significantly lower Expanded Disability Status Scale (EDSS) scores than Caucasian patients (mean 2.0 vs. 2.3, p = 0.008), despite a similar disease duration. Japanese patients showed a trend towards fewer T2W-lesions (median 50 vs. 65, p = 0.08) and significantly lower frequencies of cerebellar and parietal lobe lesions (p = 0.02 for both) than Caucasian patients. There were no differences in T2W-lesion volume between races, whereas Japanese patients had a significantly larger T2W-lesion volume per lesion compared with Caucasian patients (median 140 mm3 vs. 85 mm3, p < 0.0001). T2W-lesion volumes were positively correlated with EDSS scores in Japanese patients (p < 0.0001). In both races, NBV, normalized cortical gray matter volume, NDGMV, and thalamic volume were negatively correlated with disease duration and EDSS scores (p < 0.01 for all). NWMV was negatively correlated with disease duration and EDSS scores only in Caucasian patients (p = 0.03 and p = 0.004, respectively). NBV, NDGMV, NWMV, and thalamic volume were consistently smaller in Japanese compared with Caucasian patients throughout the entire examined disease duration (p = 0.046, p = 0.01, p = 0.005, and p = 0.04, respectively). Japanese patients had a significantly faster reduction in NDGMV (p = 0.001), particularly for thalamic volume (p = 0.001), with disease duration compared with Caucasian patients.ConclusionsGray matter atrophy is a common denominator for disability in Japanese and Caucasian patients. Additional contributory factors for disability include T2W-lesion volume in Japanese patients and white matter atrophy in Caucasian patients. Less frequent parietal and cerebellar involvement with fewer T2W-lesions may underlie milder disability in Japanese patients.

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Section: Discussionmentioning

confidence: 99%

A comparison of brain magnetic resonance imaging lesions in multiple sclerosis by race with reference to disability progression

Nakamura

Gaetano

Matsushita

et al. 2018

J Neuroinflammation

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“…Several characteristic conventional MR imaging findings and advanced MR imaging techniques have been introduced for the diagnosis of TDLs. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Conventional MR imaging findings, 23 including open ring or incomplete rim enhancement, a T2 hypointense rim, absent or mild mass effect, and absent or mild perilesional edema, demonstrate variable frequencies. In addition, 1 review article classified TDLs into 4 different subtypes based on the most prominent conventional MR imaging characteristics as follows: megacystic, Balò -like, infiltrative, and ringlike.…”

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confidence: 99%

“…24 Several studies have reported the use of advanced MR imaging techniques, including diffusion-weighted imaging, dynamic susceptibility-weighted contrast-enhanced imaging (DSC), MR spectroscopy, and diffusion tensor imaging. 5,8,10,12,14,15,18,19 To our knowledge, the MR imaging findings of TDLs and their diagnostic performance for differentiating TDLs from primary brain tumors have not yet been systematically reviewed. Therefore, we aimed to evaluate conventional and advanced MR imaging findings of TDLs and to determine the diagnostic performance of MR imaging for differentiating TDL from primary brain tumor.…”

mentioning

confidence: 99%

MRI Findings in Tumefactive Demyelinating Lesions: A Systematic Review and Meta-Analysis

Suh

Kim

Jung

et al. 2018

AJNR Am J Neuroradiol

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“…which is usually associated with to multiple sclerosis. 5 Recent studies have shown the anti-MOG antibody-positive cases presented supratentorial TDL, 6,7 or cortical lesions 8 but not in the brainstem.…”

Section: Discussionmentioning

confidence: 99%

“…The anti‐MOG antibody is related to various inflammatory CNS diseases such as optic neuritis, myelitis, acute disseminated encephalomyelitis, and NMOSD . TDL is defined radiologically as tumor‐ or mass‐like white matter dominant lesions exceeding 2 cm in size, which is usually associated with to multiple sclerosis . Recent studies have shown the anti‐MOG antibody‐positive cases presented supratentorial TDL, or cortical lesions but not in the brainstem.…”

Section: Discussionmentioning

confidence: 99%

A unique case with positive anti‐myelin oligodendrocyte glycoprotein antibody presenting multiple brain lesions

Matsumoto

Sato

Hishikawa

et al. 2020

Neurology & Clinical Neurosc

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The accurate diagnosis of anti‐myelin oligodendrocyte glycoprotein (MOG) antibody‐associated diseases is sometimes challenging due to its various central nervous system (CNS) lesions. Here, we report a 22‐year‐old man with positive anti‐MOG antibody presenting multiple brain lesions including a brainstem tumefactive demyelinating lesion (TDL), cortical edematous lesions, and a periventricular white matter lesion. These variety of lesions made the diagnosis challenging, especially because TDL is quite rare among MOG antibody‐associated disease patients. The present case suggests the importance to check anti‐MOG antibody for patients presenting atypical multiple CNS lesions.

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Tumefactive demyelinating lesions of 15 patients: Clinico-radiological features, management and review of the literature.

Cited by 39 publications

References 35 publications

A comparison of brain magnetic resonance imaging lesions in multiple sclerosis by race with reference to disability progression

A comparison of brain magnetic resonance imaging lesions in multiple sclerosis by race with reference to disability progression

MRI Findings in Tumefactive Demyelinating Lesions: A Systematic Review and Meta-Analysis

A unique case with positive anti‐myelin oligodendrocyte glycoprotein antibody presenting multiple brain lesions

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