T1 post-gad T1 post-gad 5 years later T2 5 years later

Diagnosis: Multiple sclerosis

Multiple sclerosis is believed to be due to an autoimmune mediated demyelination and is the most common demyelinating disease other than demyelination produced by small vessel ischemic changes of aging. Two-thirds of patients are women and the onset is usually between 20 and 40 years of age. The classic appearance of MS lesions is that of an oval shaped periventricular focus which is hypointense on T1 and bright on T2. The lesions may or may not enhance depending on their chronicity with acute lesions often enhancing while chronic ones do not. Another finding described in multiple sclerosis and seen here is decreased T2 signal in the basal ganglia and thalami on T2 which is believed to be due to abnormal iron accumulation. This patient was severely disabled by his MS with a chronic seizure disorder and quadriplegia. Related Cases

Drayer B, Burger P, Hurwitz B, et al. Reduced signal intensity on MR images of thalamus and putamen in multiple sclerosis: increased iron content? AJR, Aug 1987; 149(2):p357- 63.

Multiple sclerosis Multiple sclerosis HIV encephalopathy