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CSF cytology and HIV serology were both negative. EMG, however, confirmed the clinical findings of polyradiculopathy. T1W and T2W MRI of the lumbar spine demonstrated diffuse thickening of the nerve roots of the cauda equina, which enhanced following intravenous gadolinium administration (Figs. 1 and 2). No parenchymal involvement was seen.
MRI is the imaging study of choice and slightly more sensitive than CT (66%) because of the use of paramagnetic contrast agents. Although seldom indicated, myelography may show nodularities or thickening of the nerve roots in approximately 25% of patients with LC, with similar findings apparent on MRI. Myelography can show intra-arachnoid nodular filling defects, longitudinal striations, prominent and crowded nerve roots of the cauda equina, or scalloping of the subarachnoid space.