18F-FDG Uptake in Neurosarcoid Dural Plaque on PET/CT

Khodarahmi, Iman; Turbin, Roger E.; Frohman, Larry; Ghesani, Nasrin

doi:10.1097/rlu.0000000000001284

Cited by 8 publications

(4 citation statements)

References 7 publications

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“…Elevated ACE in CSF is neither sufficiency sensitive nor specific for NS. 27 Of the radiologic studies, PET/CT has been used for identifying active NS 29 it was found helpful for differentiating spinal NS from spinal malignancies. 30 To our knowledge, this technique has not yet been applied for discriminating NS from other inflammatory diseases of CNS.…”

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confidence: 99%

Multiple sclerosis and sarcoidosis

et al. 2019

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BackgroundPatients with biopsy-proven systemic sarcoidosis who develop a chronic CNS disorder are often presumed to have neurosarcoidosis (NS), however, the possibility of comorbid neurologic disease, such as MS, must be considered if presentation and course are not typical for NS.MethodsRetrospective chart review across 4 academic MS centers was undertaken to identify patients with diagnosis of MS (2017 McDonald criteria) and biopsy-confirmed extraneural sarcoidosis. Data were abstracted from each chart using a case report form that systematically queried for demographic, clinical, and paraclinical characteristics relevant to NS and MS.ResultsTen patients met our inclusion criteria (mean age 47.7 [±5.9] years; 80% female). Noncaseating granulomas consistent with sarcoidosis were found on biopsy in all cases (lung 7/10, mediastinum 2/10, liver 1/10, spleen 1/10, and skin 1/10). Diagnosis of MS was based on clinical history of MS-like relapses and MRI findings characteristic of demyelination and typical disease evolution during follow-up (average of 7 years). No patient developed features of NS that could be considered a “red flag” against the diagnosis of MS (such as meningeal enhancement, hydrocephalus, and pituitary involvement). All patients were treated with disease-modifying therapy for MS.ConclusionsWe propose a rational diagnostic approach to patients with sarcoidosis who may have comorbid MS. When the clinical picture is equivocal, the presence of multiple “MS-typical lesions” and the absence of any “NS-typical lesions” on MRI favor diagnosis of MS. Close follow-up is required to ascertain whether clinical and radiologic disease evolution and response to MS therapies conform to the proposed diagnosis of MS.

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Section: %mentioning

confidence: 99%

Multiple sclerosis and sarcoidosis

et al. 2019

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“…С этой целью используют высокопольные магнитнорезонансные томографы с разными режимами исследования и введением пациенту контрастных препаратов на основе гадолиния. Однако неспецифичность нейровизуализационной картины не позволяет создать четкие радиологи- [23,[41][42][43][44][45].…”

Section: проблемы диагностикиunclassified

Current views on neurosarcoidosis: pathogenesis, clinical manifestations, diagnosis

Pushkaryov

Тибекина

Чурилов

2019

RJTAO

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The review gives data on the etiology, pathogenesis, and clinical manifestations of sarcoidosis, which are associated particularly with damage to the central and peripheral nervous system. Sarcoidosis is currently regarded as a genetically determined, polyetiologic, and multisystem, disease of mainly autoimmune origin, which is accompanied by a productive inflammatory response with the formation of space-occupying noncaseous granulomas. The detection rates for the classical forms of sarcoidosis of the lungs, lymph nodes, and eyes are increasing, while the intravital diagnosis of neurosarcoidosis is still difficult. The latter mimics many other neurological diseases, frequently in persistent disabling disorders and death. Studies focus on searching for imaging, biological and/or immune markers that can reliably diagnose this disease. The problem of small fiber neuropathy that is considered to be the most common and early manifestation of neurosarcoidosis is being actively studied. In 2018, Neurosarcoidosis Consortium Consensus Group (NCCG), USA, proposed the diagnostic criteria for neurosarcoidosis, which are presented in this article.

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“…Hypertrophic pachymeningitis should be included in the differential diagnosis of abnormal dural FDG accumulation along with malignant and nonmalignant conditions. [11][12][13][14][15][16][17][18]…”

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confidence: 99%

“…These 3 cases indicate FDG PET/CT is helpful in identifying the affected dura and evaluating the extent of the inflammatory process. Hypertrophic pachymeningitis should be included in the differential diagnosis of abnormal dural FDG accumulation along with malignant and nonmalignant conditions 11–18 …”

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confidence: 99%

FDG PET/CT in 3 Cases of Hypertrophic Pachymeningitis Associated With Antineutrophil Cytoplasmic Antibody–Associated Vasculitis

Zhang

Dong

et al. 2021

Clin Nucl Med

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Hypertrophic pachymeningitis associated with antineutrophil cytoplasmic antibody–associated vasculitis is a rare dural inflammatory disorder. We describe MRI and FDG PET/CT findings in 3 cases of hypertrophic pachymeningitis associated with antineutrophil cytoplasmic antibody–associated vasculitis. Enhanced brain MRI of the 3 cases showed linear enhancement of the thickened dura matter involving the skull base, tentorium, and/or convexity. On FDG PET/CT, the thickened dura matter showed diffusely increased FDG uptake with SUVmax ranging from 5.8 to 11.3. Familiarity with these MRI and FDG PET/CT findings is helpful for correct diagnosis and treatment.

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18F-FDG Uptake in Neurosarcoid Dural Plaque on PET/CT

Cited by 8 publications

References 7 publications

Multiple sclerosis and sarcoidosis

Multiple sclerosis and sarcoidosis

Current views on neurosarcoidosis: pathogenesis, clinical manifestations, diagnosis

FDG PET/CT in 3 Cases of Hypertrophic Pachymeningitis Associated With Antineutrophil Cytoplasmic Antibody–Associated Vasculitis

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