A neuroradiological study of optic neuritis using short TI inversion recovery (STIR) sequence of MRI

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  • YAMADA Y.
    Department of Ophthalmology, Kinki University School of Medicine

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Magnetic resonance imaging (MRI) using the short inversion time inversion recovery (STIR) sequence, which is one of the fat suppression MRI sequences, was conducted on 28 patients with optic neuritis in order to study changes in STIR images in relation to changes in visual functions following steroid therapy. From 28 cases, the clinical course was followed up closely for 12 months in 12 patients who were seen in the acute phase. Sixteen patients (10 children and 6 adults) were followed up for more than 3 years after the treatment (the long term follow-up group). The data of 28 patients were compared with those of 24 healthy controls. The signal intensities of both the optic nerve and the cerebral white matter were measured on each slice image. The ratio of the signal intensity of the optic nerve to that of the cerebral white matter (the signal intensity ratio) was calculated so that the signal intensity of the optic nerve of the patient group could be evaluated objectively. In normal controls, the signal intensity ratio averaged 1.09±0.10. This indicated that the signal intensity was similar in the optic nerve and the cerebral white matter of the control group. The average signal intensity ratio of the patient group before the treatment was markedly higher than that of the control group. When the average signal intensity ratios determined before and 1,6 and 12 months after the end of the treatment were analyzed, the signal intensity ratio of the patient group was found to decrease gradually after the recovery of visual functions, but it remained higher than that of the control group. From 10 children followed up for long periods of time, 7 children continued to have the high signal intensity ratios after the treatment. The ratio also remained higher than normal in adult patients with optic neuritis although visual functions recovered in all adult patients. These results suggest that once the optic nerve fibers are damaged in optic neuritis, pathologic changes in MRI using the STIR sequence will partially persist even after the recovery of visual functions.

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