Article Figures & Data
Figures
- fig 1.
Bielschowsky's silver impregnation shows axonal density in the normal periplaque white matter (patient 1) (A), a reduction by 45% (patient 3) (B), and a reduction by 75% (patient 1) (C) within the plaques (magnification for all, ×166). Prominent protoplasmic gliosis with large astrocytes (D) is seen by immunocytochemistry for GFAP (patient 1). Numerous GFAP-positive cell processes (E) indicate fibrillary gliosis (patient 3). Immunocytochemistry for MOG (F) shows an early active demyelinating lesion (patient 2). Macrophages carry MOG-positive degradation products in their cytoplasm. Dense macrophage infiltrate (G) is seen in the same lesion as shown in F (immunocytochemistry for Ki-MlP)
- fig 2.
T1-weighted gradient-echo MR images (3D fast low-angle shot, 4-mm partitions, 15/6 TR/TE, 20° flip angle) of patient 1 indicating VOIs selected for MRS.
A, Transverse section with VOIs centered at the left parieto-occipital lesion (20 × 20 × 20 mm3) and in a contralateral control region (16 × 30 × 16 mm3).
B, Sagittal section with a smaller VOI (16 × 16 × 16 mm3) encompassing the same lesion (note small defect in the skull and corresponding biopsy canal),
C, Coronal section depicting an ipsilateral VOI (20 × 20 × 20 mm3) in left frontoparietal cortex unsuspicious at MR imaging.
- fig 3.
Localized proton MR spectra (stimulated-echo acquisition mode, 3000/20/30 [TR/TE/TM]) of patient 1 from locations indicated in figure 2. Left occipitoparietal lesion (top) image using a 4-mL VOI and (second row) 8-mL VOI, an ipsilateral 8-mL VOI in unsuspicious left frontoparietal cortex (third row), and contralateral control (bottom). Major resonances are due to N-acetylaspartate (NAA), creatine and phosphocreatine (Cr), choline-containing compounds (Cho), myo-inositol (Ins), and lactate (Lac). Spectra are normalized for comparison
Tables
- Table 2:
Lesion histopathology and corresponding proton MRS-detected metabolic alterations. Absolute metabolite levels (mM;shL VOI) derived from proton MR spectra (STEAM, TR;shTE;shTM = 3000;sh20;sh30 ms) of biopsied lesions of patients ;ns1 to ;ns3
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