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Published on: January 23, 2019
Diffusion-weighted MR findings in isolated angiitis of the central nervous system (IACNS)
1Department of Neurology and Clinical Research Institute, Seoul National University Hospital, Neuroscience Research Institute of SNUMRC, Seoul, South Korea.
Objectives:
To describe the diffusion-weighted MR (DWI) findings of isolated angiitis of the central nervous system (IACNS) and narrow the differential diagnosis.
Methods:
The DWI findings of two IACNS patients. Apparent diffusion coefficient (ADC) values were measured in the abnormal lesions, and DWI and T2-weighted MR images were visually inspected.
Results:
IACNS was diagnosed based on clinical history, MR findings and cerebral angiographic findings. DWI showed hyperintense lesions with heterogeneous ADC values (287-1359 x 10(-6) mm2/s), which indicate the coexistence of cytotoxic and vasogenic oedema.
Conclusions:
The findings suggest that the various stages of inflammatory process with ischaemia might exist in IACNS and allow a differentiation from the usual arterial ischaemic infarction. DWI with ADC map can be a useful non-invasive diagnostic test increasing specificity in the diagnosis of IACNS, combined with conventional MRI and cerebral angiography.
Insights
Diffusion-weighted MR imaging reveals characteristic lesions in isolated central nervous system angiitis. These findings aid in differentiating this condition from typical arterial ischemic infarction.
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Background:
- Isolated angiitis of the central nervous system (IACNS) is a rare condition affecting blood vessels in the brain and spinal cord.
- Accurate and timely diagnosis is crucial for effective management and preventing neurological damage.
Observation:
- This study analyzed diffusion-weighted MR (DWI) findings in two patients diagnosed with IACNS.
- Apparent diffusion coefficient (ADC) values were measured in abnormal lesions, alongside visual inspection of DWI and T2-weighted MR images.
Findings:
- DWI demonstrated hyperintense lesions in IACNS patients.
- Heterogeneous ADC values (287-1359 x 10(-6) mm2/s) were observed, suggesting a mix of cytotoxic and vasogenic edema.
- These DWI characteristics may indicate varying stages of inflammation and ischemia within the CNS.
Implications:
- Diffusion-weighted imaging with ADC mapping can serve as a valuable non-invasive tool for diagnosing IACNS.
- Combined with conventional MRI and cerebral angiography, DWI enhances diagnostic specificity.
- These neuroimaging findings help differentiate IACNS from arterial ischemic infarction, guiding clinical decision-making.
