Neuro-Behcet's Disease: Initial and Follow-up MR Imaging Findings

ABSTRACT

PURPOSE: The purpose of this study was to evaluate initial and follow-up MR imaging(MRI) findings ofneuro-Behcet's disease. MATERIALS AND METHODS: MRI of seven clinically diagnosed cases of neuro-Behcet's diseasewere retrospectively analysed in terms of involved site, pattern, signal intensity, contrast enhancement patternand changes seen on follow-up. Using a 0.35T or 1.0T unit T2- and T1-weighted spin-echo contrast-enhanced imageswere obtained in six patients. Follow-up MRI after steroid therapy lastion between two weeks and 16 months wasperformed in six patients. RESULTS: Lesions involved the midbrain(6/7), pons(5/7), thalamus(4/7), medullaoblongata(3/7), tegmentum(3/7), internal capsule(3/7), middle cerebellar peduncle(2/7), dentate nucleus(1/7),basal ganglia(1/7) and temporal lobe(1/7). They were 1-3cm in size, and their shape was ill-defined and patchy.Inhomogeneous high and low signal-intensity was seen on T2-weighted and T1-weighted images, respectively. In twoof six cases there was focal mild patchy enhancement. Euring follow-up lasting for between two weeks and 16 monthsafter steroid therapy, the lesions decreased in extent(n=5) or disappeared(n=1), and in the brainstem, focal brainatrophy occurred in three cases. CONCLUSION: Although MRI findings of neuro-Behcet's disease are nonspecific,common involvement of the brainstem, tegmentum and internal capsule, as well as improvement on follow-up MRI, maybe helpful diagnostic indicators of this condition.