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Related Experiment Videos

Cerebral vasculitis: MR imaging and angiographic correlation.

T J Greenan1, R I Grossman, H I Goldberg

  • 1Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.

Radiology
|January 1, 1992
PubMed
Summary

Primary angiitis of the central nervous system (PACNS) is rare. While MR imaging is often positive, some patients with confirmed PACNS may present with normal MR imaging findings.

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Area of Science:

  • Neurology
  • Radiology
  • Pathology

Background:

  • Cerebral vasculitis encompasses various causes, with noninfectious granulomatous angiitis of the nervous system (GANS), also known as primary angiitis of the central nervous system (PACNS), being exceptionally rare.
  • GANS/PACNS characteristically affects the central nervous system's arteries and veins, often involving both leptomeningeal and parenchymal vessels.

Purpose of the Study:

  • To retrospectively analyze and correlate magnetic resonance (MR) imaging and angiography findings in patients with presumed PACNS.
  • To evaluate the sensitivity of MR imaging in detecting cerebral vasculitis in the context of PACNS.

Main Methods:

  • Retrospective analysis of MR imaging and angiography results in seven patients diagnosed with PACNS.
  • Correlation of imaging findings with angiographic evidence of cerebral vasculitis.

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Main Results:

  • MR imaging was positive in all seven cases, revealing characteristic multiple, bilateral, and supratentorial lesions.
  • Infarcts, predominantly in the deep white matter, were observed in four patients. PACNS manifestations also included parenchymal hemorrhage or glioma-like appearances.
  • While all MR-identified lesions corresponded to positive angiographic findings, 12 vascular distributions with angiographic evidence of vasculitis showed no corresponding MR lesions.

Conclusions:

  • MR imaging is a valuable tool for diagnosing PACNS, demonstrating characteristic lesion patterns.
  • Despite its utility, normal MR imaging results can occur in patients with proven PACNS, highlighting the importance of considering angiography when clinical suspicion is high.