Which findings on MRI are characteristic of optic neuritis?

Updated: Feb 25, 2016
  • Author: Pil (Peter) S Kang, MD; Chief Editor: James G Smirniotopoulos, MD  more...
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Answer

Answer

MRI characteristics of optic neuropathy are demonstrated in the images below.

A 43-year-old woman with acute vision loss and eye A 43-year-old woman with acute vision loss and eye pain. No prior neurologic symptoms were noted. Axial, fat-suppressed, postgadolinium, T1-weighted image through the orbit reveals an intensely enhancing segment of the distal left optic nerve.
A 43-year-old woman with acute vision loss and eye A 43-year-old woman with acute vision loss and eye pain. No prior neurologic symptoms were noted. Coronal, fat-suppressed, postgadolinium, T1-weighted image demonstrates intense enhancement within the optic nerve. No significant nerve expansion or enhancement of the adjacent tissues is seen. Note the normal right optic nerve for comparison.
A 35-year-old woman with acute onset of left-eye p A 35-year-old woman with acute onset of left-eye pain and vision decline. Axial, fat-suppressed, postcontrast, T1-weighted image demonstrates enhancement in the intracanalicular portion of the left optic nerve.
A 35-year-old woman with acute onset of left-eye p A 35-year-old woman with acute onset of left-eye pain and vision decline. Axial, fluid-attenuated inversion recovery (FLAIR) image demonstrates bilateral periventricular white matter lesions. Several additional and similar lesions were seen in other locations (not shown). No history of prior neurologic illness was noted in the patient, but in the setting of acute optic neuritis, the multiple white matter lesions in a number and pattern atypical for the patient's age were considered to be supportive of the diagnosis of multiple sclerosis.

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