Most remnant hyperintense lesions in hemispheric white matter on T2/FLAIR images were irregular in shape and located mainly in the subcortical/deep white matter (Ab, Bb). Acute hyperintense lesions in the bilateral hypothalamus (Ca) and around the fourth ventricle and cerebellum (Da, Ea), basal ganglia, and cortical/subcortical (Fa) on T2/FLAIR images resolved completely on follow-up brain MRI (Cb, Db, Eb, Fb).
Chronic cystic changes of brain lesions on MRI
At the time of an acute brain attack, brain MRI showed multiple T2-hyperintense lesions with subtle T1 hypo-intensity in the frontal white matter (Aa), corticospinal tract (Ba, Ca), occipital white matter (Da) and corpus callosum (Ea). On follow-up MRI, all T2 hyperintense lesions were markedly decreased in size but revealed focal T1-hypointensity with cystic changes (Ab, Bb, Cb, Db, Eb).
Focal atrophy on follow-up brain MRI
Acute lesions in crus cerebri (Aa) and corpus callosum (Ba) revealed focal atrophy with remnant T2-hyperintense lesions on chronic MRI (Ab, Bb). Chronic changes in acute brain lesions on MRI in patients with NMOSD. More than half of the brain lesions decreased in size significantly on T2/FLAIR images, and a quarter of the lesions disappeared completely on follow-up MRI. No lesion increased in size.
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