PMC4545307_01
Axial fluid attenuated inversion recovery (FLAIR) (a) and axial T2-weighted images (b) show extensive hyperintense and axial T1-weighted image (c) shows hypointense lesions in the subcortical and periventricular white matter bilaterally. There is also compression of the posterior horn of the lateral ventricle due to mass effect. There is no remarkable contrast enhancement on T1-weighted postcontrast images (d). Axial FLAIR image (e) reveals that there is no lesion in the pons
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F1
T1-weighted images showed no obvious contrast enhancement. There was mass effect with compression of the posterior horn of the lateral ventricle on the left side (Figure 1a-1e).
After immunosuppressive treatment withdrawal, axial FLAIR (a), T2-weighted (b), T1-weighted (c), and T1-weighted postcontrast (d) images show that the lesion extension and mass effect did not improve. Moreover, new lesions in the pons are appeared bilaterally, in keeping with progression (arrows) (e
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F2
Three weeks later, a second MRI was obtained that showed the extension and character of the lesions and their mass effect had not been changed (Figure 2a-2e); also a new increased signal in the pons was seen bilaterally (Figure 2e).