Ependymal “Dot-Dash” Sign, a Typical Symptom in Patients with Multiple Sclerosis

Authors: M. Vaněčková 1;  Z. Seidl 1,2;  J. Krásenský 1
Authors‘ workplace: Radiodiagnostická klinika, oddělení MR, 1. LF UK a VFN v Praze 1;  Vysoká škola zdravotnická, Praha 2
Published in: Cesk Slov Neurol N 2009; 72/105(1): 57-59
Category: Short Communication


By magnetic resonance imaging (MRI), 45 patients with clinically defined multiple sclerosis (MS) and 14 patients without MS was inspected for “Dot-Dash” sign. This ependymal irregularity should be an indication of a future ovoid periventricular lesion. Sagittal 2-mm fluid attenuated inversion recovery images were used. This sign was positive in 93.3% of patients with MS and in just 35.7% of the control group. Ependymal “Dot-Dash” sign was highly associated (p = 0.0012) with definite clinical MS. In our opinion, a standard MRI protocol for MS diagnosis should be supplemented by this sequence.

Key words:
multiple sclerosis – diagnostic – magnetic resonance imaging – ependym


1. Filippi M, Grossman RI. MRI techniques to monitor MS evolution: the present and the future. Neurology 2002; 58(8): 1147–1153.

2. Baratti C, Yousry T, Kandziora C, Spuler S, Mammi S. Comparison of fast-FLAIR vs. Standard SE sequences for measurement of brain MRI lesion loads in patients with multiple sclerosis. Neuroradiology 1995; 37: 90–95.

3. Woo JH, Henry LP, Krejza J, Melhem ER. Detection of simulated multiple sclerosis lesions on T2-weighted and FLAIR images of the brain: observer performance. Radiology 2006; 241(1): 206–212.

4. Palmer S, Bradley WG, Chen DY, Patel S. Subcallosal striations: early findings of multiple sclerosis on sagittal, thin section, fast FLAIR MR images. Radiology 1999; 210(1): 149–153.

5. Filippi M, Rocca MA. Conventional MRI in Multiple Sclerosis. J Neuroimaging 2007; 17: 3S–9S.

6. Hashemi RH, Bradley GW jr, Chen DY, Jordan JE, Queralt JA, Cheng EA et al. Suspected Multiple Sclerosis: MR Imaging with a Thin Section Fast FLAIR Pulse Sequence. Radiology 1995; 196(2): 505–510.

7. Lisanti JC, Asbach P, Bradley WG. The Ependymal „Dot-Dash“ Sign: An MR Imaging Finding of Early Multiple Sclerosis. AJNR Am J Neuroradiol 2005; 26: 2033–2036.

8. Miller DH, Ormerod IE, Gibson A, du Boulay EP, Rudge P, McDonald WI. MR brain scanning in patients with vasculitis: differentiation from multiple sclerosis. Neuroradiology 1987; 29(3): 226–231.

Paediatric neurology Neurosurgery Neurology

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