MRI findings and correlative study of MRI and visual evoked potentials in optic neuritis

Objective: To investigate the effective MRI sequences and describe the correlation between MRI and visual evoked potential (VEP) in diagnosing optic neuritis. Methods: One hundred and fifty-four eyes with visual impairment of 98 patients with diagnoses of optic neuritis, papillitis, multiple sclerosis and Devic's disease underwent MRI and VEP examination. The MRI findings were analyzed and correlated with VEP results and clinical presentation by using X2 test, wilco xon test and Kappa test. Results Out of the 154 sick eyes, 56 eyes presented thickened optic nerves, 76 eyes had normal diameter of the optic nerve, and 22 eyes had thin optic nerves. A total of 132 optic nerves showed abnormally high signal in STIR sequences, including involvement of intraocular segment in 7, intraorbital segment in 1.35, intracanalicular segment in 109, intracranial segment in 97, optic chiasm in 56, and optic tract in 23. A total of 54 patients underwent postcontrast MRI. Seventy-four optic nerves of 87 eyes showed enhancement. Among the 196 eyes of 98 patients, 132 eyes presented visual impairment and simultaneous abnormal MR signal of the optic nerve, and 26 eyes had both normal vision and normal MR signal of optic nerve. The consistency of MRI findings and vision status was 80. 61% (Kappa 0.453,P<0.01). Among the 175 eyes with VEP results, 129 eyes had visual loss with simultaneous VEP abnormalities, and 30 eyes had both normal vision and normal VEP results. The consistency of VEP and vision status was 90.86% (Kappa=0.731, P<0.01). Among the 175 eyes with VEP results, 117 eyes had abnormal MR signal of the optic nerve and simultaneous abnormal VEP, and 24 eyes had both normal MR signal of the optic nerve and normal VEP. The consistency of MRI findings and VEP was 80.57% (Kappa=0.460, P<0.01). Conclusion: STIR sequence and gadolinium-enhanced T1-weighted MR sequence combined with fat- suppression are helpful in diagnosis of optic neuritis. VEP is helpful in diagnosing optic neuritis and in finding subclinical visual problem. The MRI combined with VEP could improve the diagnostic accuracy of optic neuritis. (authors)