Imaging features and curative effect monitoring of IgG4-related disease / 实用放射学杂志

ABSTRACT

Objective To explore imaging features of IgG4-related diseases (IgG4-RD)and to evaluate curative effect after treatment with steroid.Methods Imaging data were reviewed retrospectively in thirteen patients with pathologically proved IgG4-RD.CT scans were performed in all patients,while MR scans in five of them.Six patients were examined before and after steroid treatment in 3-6 months. Imaging data were analyzed with regard to the shape,distribution and characteristics of the lesions.The image changes between pre-and post-treatment with steroid were analyzed as well.Results The IgG4-RD occurred in the lacrimal gland in 1 case,submandibular glands in 1 case,biliary duct in 1 case,pancreas in 3 cases,kidney in 4 cases,retroperitoneum in 2 cases and lung in 1 case.Multiple organs including the retroperitoneum,kidney and pancreas were involved in two patients.Diffusely swelling organ or soft tissue mass, which manifested as low density on CT and low signal intensity on T2-weighted images on MR,were characteristics of IgG4-RD.All lesions mildly enhanced with contrast media administration.The lesions decreased in size accompanied by raised signal intensity on T2 WI after treatment with steroid in six patients.Conclusion Diffusely swelling organ,low density and low signal intensity on T2 WI with mildly homogenous enhancement are characteristics of IgG4-RD.CT and MR plays a vital role in diagnosis of IgG4-RD and monitoring the curative effect with steroid treatment.