Magnetic resonance imaging of Balo ’s concentric sclerosis: literature review and presentation of two focused cases

AbstractThe aim of our study was to describe two cases of Bal ò’s Concentric Sclerosis (BCS) and further to review the state‐of‐the‐art literature.This dissertation is the result of a critical analysis matching the literature and our professional experience. Data were synthesized into a narrative review.BCS is often referred to as a variant of Multiple Sclerosis (MS), it is still unclear whether BCS is an acute variant of MS or a distinct entity that happens to coexist with MS. BCS and MS ‐like lesions might be present at the same time. BCS lesions are characterized by large concentric “onion‐like” shape on MRI T2‐weighted images composed of alternating hypointense and hyperintense layers. On contrast‐enhanced T1‐weighted images, BCS active lesions usually show enhancin g and non‐enhancing pattern. The advancing edge of demyelination could be represented by peripheral restricted diffusion and contrast enhancement. Balo’s lesions is mainly found in the supratentorial white matter, however the cerebellum, the brainstem, and the spinal cord might be affected as we ll.Our two cases both show onion ‐like lesions, case 1 demonstrates typical BCS features while case 2 is atypical and could be classified as probably BCS or as a BCS‐like lesion in the course of MS. It is important for radiologists to be able to recognize this type of lesions and to cooperate with clinicians in order to help th em perform earlier diagnosis and treatment, determining a bet...
Source: Clinical and Experimental Neuroimmunology - Category: Neurology Authors: Tags: REVIEW ARTICLE Source Type: research