[Cranial manifestation of Wegener's granuolomatosis: CT and MRI characteristics]

Wegener's granulomatosis is a rare systemic granulomatous disease which primarily involves the upper and lower respiratory tract and the kidneys. In addition the orbits, the peripheral and the central nervous system may also be affected. Computed tomography and magnetic resonance imaging have been proven to be quite useful for the detection of these lesions, for assessment of the extent of involvement, and for documentation of response to therapy. The drawback of CT and MR studies is that they lack specificity. Characteristic imaging findings for WG is a medial wall destruction of the maxillary sinus with gross thickening of the anterior and infratemporal walls with relatively low soft tissue proliferation. On T2-weighted MR images the granulomatous tissue appears markedly hypo-intense with dense enhancement. Although these findings are not specific, if they are obvious, Wegener's granulomatosis should be considered in the differential diagnosis.