Article Figures & Data
Figures
- Figure 1 Chronologic Heat Map
In this figure, we detail the condition of the patient over time. The longitudinal axis (left to right) depicts the condition of disease, where the smaller amplitude and lighter color indicates greater stability of disease. Alternately, the expanded amplitude of the colored heat map (above and below the horizontal linear axis over time) designates increased disease activity (whether on a clinical or paraclinical basis) or complications of the treatment of disease. Other fields of information are added either above or below the heat map and include information about treatments, diagnoses, commentaries adding contextual perspectives, and results from specific test assessments from each most relevant period of clinical decision-making. Each field is consistently color-coded throughout as defined in the figure legend.1
- Figure 2 T1, Fat-Suppressed, Postcontrast MRI of the Orbits
Axial (A) image demonstrates longitudinally extensive enhancement of the right optic nerve extending into the prechiasmatic area (black and red arrow) along with faint contrast enhancement of the left optic nerve (black and red chevron) in a pattern of subtle and very thin ‘tram tracking’, signifying optic nerve sheath enhancement (i.e., perineuritis). Furthermore, there are nodular enhancements involving the left optic nerve sheath at the orbital apex, but also the intracanalicular, prechiasmatic portion of the optic nerve, with very subtle ‘tram tracking’ (black and red chevrons). Coronal image (B) shows diffuse right optic nerve enhancement (black and red arrow) and perineural enhancement of the left optic nerve (black and red chevron), in keeping with the ‘donut sign’ of perineuritis.
- Figure 3 Coronal (A) and Axial (B) Fat-Suppressed, T1 Postcontrast MRI of the Orbits Demonstrating Right Optic Nerve Sheath Enhancement on the Coronal View, Consistent With the ‘Donut Sign’ of Perineuritis (Small Red Arrow)
There is also homogeneous enhancement of the left optic nerve (large black and red arrow). The axial image in B shows subtle thin linear ‘tram tracking’ of the right optic nerve (small black and red arrow), as well as a longitudinally extensive enhancing left optic nerve, also with features of ‘tram tracking’ (large black and red arrow). Sagittal T1 imaging (C) reveals punctate enhancement in the pons (1), an open “u”-shaped enhancing lesion, with a small vertical linear enhancement extending caudally from the “u” lesion in the dorsal cervicomedullary region (2), a ring-like configuration of enhancement at C6-7 (3), and a subtle small ring of enhancement at T3-4 (4). Sagittal T1 imaging (D) demonstrates a punctate area of enhancement in the upper (5) and a complex multifocal pattern of punctate and linear enhancements in the lower thoracic spinal cord (6).
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