A 30-year-old female presents with acute onset weakness and sensory deficits in her lower limbs. MRI of the cervical and thoracic spine is performed. Which of the following findings is most characteristic of a demyelinating lesion due to Multiple Sclerosis (MS) in the spinal cord?

Explanation

Spinal cord lesions in MS are typically short-segment (less than 2 vertebral segments), often peripheral, and involve only a portion of the cord in cross-section. They are usually T2 hyperintense and may enhance acutely. Longitudinally extensive transverse myelitis (LETM), spanning 3 or more vertebral segments, is more characteristic of Neuromyelitis Optica Spectrum Disorder (NMOSD) or other inflammatory myelopathies. Central cord involvement with syrinx is more typical of intramedullary tumors or syringomyelia. Diffuse cord swelling with homogenous enhancement can be seen in acute inflammatory myelitis but is less specific for MS.