Brain Perfusion MRI Findings in Patients with Behcet’s Disease

Abstract

Objective. To search brain perfusion MRI (pMRI) changes in Behcet's disease (BD) with or without neurological involvement. Materials and Method. The pMRI were performed in 34 patients with BD and 16 healthy controls. Based on neurologic examination and post-contrast MRI, 12 patients were classified as Neuro-Behcet (group 1, NBD) and 22 patients as BD without neurological involvement (group 2). Mean transit time (MTT), time to peak (TTP), relative cerebral blood volume (rCBV), and relative cerebral blood flow (rCBF) were obtained and compared to those of healthy control group (group 3). Results. There was a significant difference in the MTT and rCBF within the pons and parietal cortex in groups 1 and 2. rCBV increased in cerebral pedicle in group 1 compared with groups 2 and 3. In the temporal lobe white matter, prolonged MTT and decreased rCBF were found in groups 1 and 2. In the corpus striatum, internal capsule, and periventricular white matter, rCBF increased in group 1 compared with group 3 and decreased in groups 1 and 2. Conclusion. Brain pMRI is a very sensitive method to detect brain involvement in patients with BD and aids the clinical diagnosis of NBD, especially in patients with negative MRI findings.

Neuro-Behcet: The Value of Transcranial Doppler

“…Neurologic lesions in BD are most frequently observed in the areas irrigated by the posterior system, as the neurologic involvement may originate from the vertebrobasilar system [30]. This could explain the highly significant decline in the MV of the VA in our patients.…”

Focus on neuro-Behçet's disease: A review

“…[49,54,55] Clinical findings report that brain perfusion MRI could be a very sensitive method to detect brain involvement in patients with parenchymal NBD, providing direct information related to regional hypoperfusion, in which small vasculitic lesions may be seen. [41,56] Localization of the lesions is the second fundamental diagnostic parameter, which may be visible on neuro-imaging; the brainstem is the favored site of the lesions that is usually seen in NBD; the pons, the midbrain, and the diencephalon may be involved. Cerebral involvement does not give a specific pattern of presentation, but the location is quite characteristic; the lesions are different from that seen in MS as the lesions in NBD are not peri-ventricular.…”

Central Nervous System Involvement in Pediatric Systemic Autoimmune Diseases

“…Single-photon emission computed tomography (SPECT) may be more sensitive, revealing hypoperfusion within the temporal cortex, frontal cortex, and basal ganglia. 14,120 Recently, a brain perfusion MRI study of 34 patients with BD showed increased relative cerebral blood flow in the cerebral peduncles, corpus striatum, internal capsule and perviventricular white matter to be associated with neurologic involvement, 121 but its comparability to SPECT has not been studied. CSF examination may reveal a lymphocyticpredominant meningitis.…”