[Magnetic resonance imaging and PET/CT with 11C-methionine for primary central nervous system vasculitis]

Primary central nervous system vasculitis is still a challenge due to rarity of disease, unspecific clinical and neurological presentation, as well as low specificity of MRI and laboratory tests.

To present the potential of hybrid neuroimaging in diagnosis of primary central nervous system vasculitis.

The results of MRI, PET/CT with 11C-methionine, histological and immunochemical data in a 23-year-old patient with first-time epileptic seizure are demonstrated.

MRI revealed multifocal lesion of the left frontal lobe with contrast accumulation, edema and mass effect. The largest lesion demonstrated high 11C-methionine uptake that was typical for tumor. Stereotactic biopsy of this lesion was performed. Morphological examination revealed lymphocytic vasculitis.

Radiological and metabolic semiotics of primary central nervous system vasculitis can mimic cerebral tumor. High ¹¹C-methionine uptake in active inflammation focus is valuable to choose the target for biopsy.