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(Radiology. 1999;213:794-799.)
© RSNA, 1999

Neuroradiology

Wegener Granulomatosis: MR Imaging Findings in Brain and Meninges1

Joseph M. Murphy, FRCR, Beatriz Gomez-Anson, MD, PhD, Jonathan H. Gillard, MD, Nagui M. Antoun, FRCP, FRCR, Justin Cross, FRCR, Jane D. Elliott, BSc, RGN and Martin Lockwood, FRCP

1 From the Departments of Radiology (J.M.M., B.G.A., J.H.G., N.M.A., J.C.) and Medicine (J.D.E., M.L.), Addenbrooke's Hospital and University of Cambridge, England. Received December 17, 1998; revision requested January 5, 1999; revision received March 10; accepted July 1. Address reprint requests to J.M.M., Department of Radiology, Sunnybrook Health Science Centre, 2075 Bayview Ave, North York, Toronto, Ontario, Canada M4N 3MS (e-mail: joemmurphy@hotmail.com).

PURPOSE: To determine the spectrum of intracranial magnetic resonance (MR) imaging appearances of Wegener granulomatosis.

MATERIALS AND METHODS: MR imaging studies in 19 patients with Wegener granulomatosis and possible central nervous system involvement were reviewed by two neuroradiologists. Intermediate-weighted and T2-weighted fast spin-echo MR images of the brain had been acquired in all patients, and spin-echo T1-weighted nonenhanced and gadolinium-enhanced images had been acquired in 18 patients.

RESULTS: MR imaging findings included diffuse linear dural thickening and enhancement (n = 6); focal dural thickening and enhancement contiguous with orbital, nasal, or paranasal disease (n = 5); infarcts (n = 4); nonspecific white matter areas of high signal intensity on intermediate-weighted and T2-weighted images (n = 10); enlarged pituitary gland with infundibular thickening and enhancement (n = 2); a discrete cerebellar lesion that was probably granulomatous in origin (n = 1); and cerebral (n = 8) and cerebellar atrophy (n = 2).

CONCLUSION: 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.

Index terms: Brain, atrophy, 13.83, 153.83 • Brain, diseases, 10.622 • Brain, infarction, 13.78 • Brain, MR, 10.121411, 10.121415, 10.12143 • Gadolinium • Meninges, 10.622 • Wegener granulomatosis, 10.622




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