Figure. Spinal MRI evolution of LETM with necrotizing area.
Sagittal T2-weighted (A–C) and sagittal postcontrast T1-weighted (D–F). Baseline performed (A and D), follow-up 1 week (B and E), and plasmapheresis posttreatment (C and F). A LETM is seen in the cervical spinal cord (A) with patchy enhancement (D). Progressive swelling of the spinal cord and a new necrotizing area (B: arrow) that shows peripheral enhancement (E: arrow). Significant decreases of both myelitis extension (C) and enhancement (F) after plasmapheresis treatment, with necrosis area in evolution. LETM = longitudinal extensive transverse myelitis.
