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The microstructural underpinnings of reduced diffusivity in transient splenial lesion remain unclear. Here, we report findings from oscillating gradient spin-echo (OGSE) diffusion imaging in a case of transient splenial lesion. Compared with normal-appearing white matter, the splenial lesion exhibited greater differences between diffusion time t = 6.5 and 35.2 ms, indicating microstructural changes occurring within the corresponding length scale. We also conducted 2D Monte-Carlo simulation. The results suggested that emergence of small and non-exchanging compartment, as often imagined in intramyelinic edema, does not fit well with the in vivo observation. Simulations with axonal swelling and microglial infiltration yielded results closer to the in vivo observations. The present report exemplifies the importance of controlling t for more specific radiological image interpretations.

Time-dependent Diffusion in Transient Splenial Lesion: Comparison between Oscillating-gradient Spin-echo Measurements and Monte-Carlo Simulation