title: Multiple sclerosis with open-ring enhancement in the cerebrum and spinal cord.
abstract: A 67-year-old woman presented with open-ring enhancement on MR images in the thoracic spinal cord. Steroid therapy improved the patient's paraplegia, but six months later she developed left hemiparesis and a new open-ring enhancement appeared in the right cerebrum. Despite high-dose methylprednisolone therapy and plasmapheresis, another lesion appeared at the middle portion of the left centrum semiovale. Stereotaxic brain biopsy demonstrated active demyelination characteristics of multiple sclerosis (MS). This case indicates that openring enhancement can help differentiate MS from nondemyelinating disease, and that MS showing ring enhancement may contribute to disease severity and need more intensive immunomodulatory therapies.
authors.affiliation: Department of Neurology, Suwa Red Cross Hospital, Suwa.
authors.forename: Naoko
authors.initials: N
authors.lastname: Dohi
authors.forename: Shozo
authors.initials: S
authors.lastname: Ishikawa
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Kamijyo
authors.forename: Tomotsugu
authors.initials: T
authors.lastname: Nakamura
authors.forename: Shinji
authors.initials: S
authors.lastname: O-Hara
authors.forename: Keiko
authors.initials: K
authors.lastname: Maruyama
mesh_terms: D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D008775:Methylprednisolone / Q000627:therapeutic use; D009103:Multiple Sclerosis / Q000473:pathology* / Q000628:therapy; D010956:Plasmapheresis; D013116:Spinal Cord / Q000473:pathology*; D013687:Telencephalon / Q000473:pathology*
chemical_list: D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone