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Neurosarcoidosis: gadolinium-enhanced MR imaging

D W Williams1, A D Elster, S I Kramer

  • 1Department of Radiology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27104.

Insights

Two neurosarcoidosis cases revealed white matter abnormalities near meningeal enhancement. Gadolinium-enhanced MRI suggests spread along Virchow-Robin spaces via blood vessels.

Area of Science:

  • Neurology
  • Radiology
  • Immunology

Background:

  • Neurosarcoidosis is a rare granulomatous inflammatory disease affecting the central nervous system.
  • Magnetic resonance imaging (MRI) is crucial for diagnosing and monitoring neurosarcoidosis.

Observation:

  • Two patients with neurosarcoidosis underwent Gd-diethylenetriamine pentaacetic acid (Gd-DTPA)-enhanced MRI.
  • Both patients presented with multifocal white matter abnormalities.

Findings:

  • White matter lesions were clustered near areas of intense meningeal enhancement.
  • Contrast enhancement along perivascular spaces (Virchow-Robin spaces) suggested disease spread along these pathways.

Implications:

  • This imaging pattern supports the hypothesis of neurosarcoidosis dissemination along perivascular spaces.
  • Enhanced MRI provides valuable insights into the pathophysiology and distribution of neurosarcoidosis.

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