MRI features of primary angiitis of central nervous system / 中国医学影像技术

ABSTRACT

Objective: To explore MRI features of primary angiitis of central nervous system (PACNS). Methods Clinical and imaging data of 16 patients with PACNS were retrospectively analyzed. MRI features of PACNS were observed. Results Among 16 patients with PACNS, 9 patients were found with single lesion and 7 with multiple lesions. A total of 45 lesions were detected with MRI in all 16 patients, including 38 lesions (38/45, 84.44%) on the supratentorial, 4 lesions (4/45, 8.89%) in the brainstem, 2 lesions (2/45, 4.44%) in the spinal cord and 1 lesion (1/45, 2.22%) in cerebellum. Lesions of 14 patients were demonstrated large or patchy shaped on MRI, while multiple masses or single mass like lesions were found in the other 2 patients. For MR plain scan, the lesions were mainly hypointense on T1WI, hyperintense on T2WI and FLAIR images. Hemorrhage lesions were found in 6 patients. For DWI, hyperintense lesions were found in all of 16 patients, including 13 with hyperintense and 3 with hypointense in ADC map. Various degrees of edema were shown around the lesions. For enhanced MRI, enhanced lesions were found in 14 patients, while lesions without obvious enhancement were found in the other 2 patients. Only 1 patient underwent MRA, with A4 segment of the left anterior cerebral artery stenosis. Conclusion: MRI manifestations of PACNS are complex and diverse. Comprehensive analysis of MRI features is needed, but mass-like PACNS is still difficult to be distinguished from brain tumors.