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Multiple Sclerosis International
Volume 2014, Article ID 986923, 5 pages
Research Article

Periventricular Lesions Help Differentiate Neuromyelitis Optica Spectrum Disorders from Multiple Sclerosis

1Department of Radiology, New York University School of Medicine, 660 First Avenue, New York, NY 10026, USA
2Department of Radiology, Azienda Ospedaliero Universitaria, di Cagliari Polo di Monserrato, SS 554 Monserrato, 09045 Cagliari, Italy
3NYU Multiple Sclerosis Center, Department of Neurology, New York University School of Medicine, 240 East 38th Street, New York, NY 10026, USA

Received 16 August 2013; Accepted 19 December 2013; Published 9 February 2014

Academic Editor: Hayrettin Tumani

Copyright © 2014 Eytan Raz et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To compare periventricular lesions in multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOsd). Materials and Methods. Sagittal and axial fluid attenuated inversion recovery (FLAIR) sequences of 20 NMOsd and 40 group frequency-matched MS patients were evaluated by two neuroradiologists. On axial FLAIR, periventricular area was characterized as free of lesions/smooth-bordered (“type A”) or jagged-bordered (“type B”) pattern. On sagittal FLAIR, the images were evaluated for presence of “Dawson’s fingers.” Results. Type A pattern was observed in 80% of NMOsd patients by Reader 1 and 85% by Reader 2 but only in 5% MS patients by either Reader. Type B was seen in 15% NMOsd patients by Reader 1 and 20% by Reader 2 and in 95% MS patients by either Reader. Dawson’s fingers were observed in no NMOsd patients by Reader 1 and 5% by Reader 2. In MS, Dawson’s fingers were seen in 92.5% patients by Reader 1 and 77.5% by Reader 2. The differences in periventricular patterns and Dawson’s finger detection between NMOsd and MS were highly significant ( ). Conclusions. Dawson’s fingers and “jagged-bordered” periventricular hyperintensities are typical of MS and almost never seen in NMOsd, which suggests a practical method for differentiating the two diseases.