Wegener Granulomatosis: MR Imaging Findings in Brain and Meninges

Murphy, Joseph; Gómez‐Anson, Beatriz; Gillard, Jonathan H.; Antoun, Nagui M.; Cross, Justin; Elliott, Jane; Lockwood, Martin

doi:10.1148/radiology.213.3.r99dc11794

Cited by 128 publications

(96 citation statements)

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“…In our study we noted DTS in 1 of 4 medulloblastomas (Figure 12). Wegener's granulomatosis of the paranasal sinuses, with cerebral and meningeal involvement, may present with DTS (24,40). In our study we also had one patient with Wegener's granulomatosis with DTS present (Figure 13).…”

Section: Figurementioning

confidence: 79%

Dural tail sign adjacent to different intracranial lesions on contrast-enhanced MR images

Bećirević-Ibrišević

2011

JHSCI

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Introduction: The aim of this study is to determine the prevalence of dural tail sign (DTS) in meningiomas, glioblastomas multiforme, metastasis, pituitary macro-adenomas, acoustic neuromas, medulloblastomas, lymphomas and Wegener's granulomatosis, and to reveal if DTS is specifi c for meningiomas. Methods: In this retrospective, cross sectional study 96 patients were included with 95 intracranial and 1 extracranial lesions. The study was conducted in the period from January 2008 to May 2010 and the group pattern was made consecutively. The patients underwent surgery and all 96 lesions were examined by histopathology analysis. DTS was analysed on contrast T1-weighted spin echo images after injection of 0.1 mmol/kg gadolinium contrast medium. The presence of this sign was defi ned using Goldsher et al's criteria. Results: Histopathology results of the 96 lesions revealed the presence of: 35 meningiomas, 25 glioblastomas multiforme, 13 metastasis, 10 pituitary adenomas, 5 acoustic neuromas, 4 medulloblastomas, 3 lymphomas and 1 Wegener's granulomatosis. On the contrast-enhanced T1 MR images, DTS was noted in 31 (32.3%) lesions, in the following histological samples: meningioma, GBM, adenoma, schwannoma, medulloblastoma and Wegener's granulomatosis, while in the cases of metastasis and lymphomas DTS was not noted. We found the dural tail sign to have a sensitivity of 68.6% and specifi city of 88.5% in the diagnosis of meningioma. Conclusion:The dural tail is a common but not a pathognomic sign of meningioma on contrast-enhanced T1 MR images. Other intracranial lesions, such as glioblastoma multiforme, pituitary adenoma, schwannoma, medulloblastoma and Wegener's granulomatosis may also be represented with this sign.

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Section: Figurementioning

confidence: 79%

Dural tail sign adjacent to different intracranial lesions on contrast-enhanced MR images

Bećirević-Ibrišević

2011

JHSCI

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“…The hemorrhagic neurological complications are thought to be secondary to weakening of blood vessel walls due to an inflammatory vasculitis, resulting in vessel rupture and subsequent bleeding. 18,20 It is difficult to identify the pathogenesis of every case in the absence of an examination of vascular tissue obtained by biopsy or at the time of autopsy. By themselves, cerebral imaging methods may not be able to the specific findings of vasculitis that include irregularity of arterial walls or obstruction of arteries.…”

Section: Discussionmentioning

confidence: 99%

Hemorrhagic complications associated with PR3-ANCA crescentic glomerulonephritis

Cao

Tian

et al. 2015

Renal Failure

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“…Une étude systématique portant sur 19 patients atteints de GW compliquée d'une atteinte neurologique centrale montrait un épaississement méningé, diffus ou focalisé, dans plus de la moitié des cas [7]. À noter la présence d'hypersignaux en pondération T2 d'allure non spé-cifique et un élargissement de la tige pituitaire chez dix et deux patients, respectivement.…”

Section: Discussionunclassified

Atteinte cérébrale au cours d’une maladie de Wegener

Jouret

Noirhomme

Grandin

et al. 2008

La Revue de Médecine Interne

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Disponible sur Internet le 2 juillet 2008 RésuméIntroduction. -La granulomatose de Wegener (GW) est une vascularite nécrosante systémique associée à la présence d'auto-anticorps de type c-ANCA. L'atteinte du système nerveux central dans la GW est rare et correspond à une vascularite intraparenchymateuse, à la formation in situ de granulomes cérébroméningés ou à une extension par contiguïté au départ de la sphère ORL.Observation. -Nous rapportons ici le cas d'une GW nasosinusienne sévère compliquée d'une extension intracrânienne pseudotumorale, confirmée par l'examen histologique.Conclusion. -L'apport de la tomographie par émission de positons, dans notre observation, est un nouvel exemple de l'intérêt de cette imagerie fonctionnelle dans le bilan d'activité et d'extension, voire le suivi de la GW. © 2008 Publié par Elsevier Masson SAS. SummaryIntroduction. -Wegener's granulomatosis (WG) is a systemic necrotizing vasculitis associated with c-ANCA antibodies. The involvement of the central nervous system in WG is uncommon and usually caused by in situ vasculitis, intracranial granuloma formation or contiguous invasion from extracranial sites.Case report. -Here, we report on a tumour-like expansion of a severe nasosinusal WG into the brain, which was confirmed by brain biopsy examination.Conclusion. -The positivity of positron emission tomography in our observation supports the potential role of such functional imaging in the staging, as well as in the follow-up of WG.

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Wegener Granulomatosis: MR Imaging Findings in Brain and Meninges

Abstract: MR imaging demonstrated the wide spectrum of findings of central nervous system involvement in patients with Wegener granulomatosis and was particularly useful for the evaluation of direct intracranial spread from orbital, nasal, or paranasal disease.

Cited by 128 publications

References 15 publications

Dural tail sign adjacent to different intracranial lesions on contrast-enhanced MR images

Dural tail sign adjacent to different intracranial lesions on contrast-enhanced MR images

Hemorrhagic complications associated with PR3-ANCA crescentic glomerulonephritis

Atteinte cérébrale au cours d’une maladie de Wegener

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