Vols. Videos

Tumefactive Demyelination

Last Updated: October 1, 2018

Figure 1: T1 hypointense (top row left) oval, subcortical lesion with corresponding FLAIR hyperintense signal (top row right) and faint rim of incomplete (horse-shoe) enhancement (bottom row left). Notice the mildly increased cerebral blood volume on MR perfusion imaging (bottom row right) along the medial margin. The incomplete rim of enhancement and low T1 signal is fairly classic for a tumefactive, demyelinating lesion. While perfusion can be mildly increased along the periphery of the lesion, it is often much less than would be expected with a high grade glioma.

 

Figure 2: Tumefactive demyelinating lesions are often large and mass-like, demonstrating FLAIR hyperintensity throughout the lesion (top row left – sagittal, top row right, bottom row left - axial). These lesions common...