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Clinical Neuroradiology
Published in: Clinical Neuroradiology 1/2019

01-03-2019 | Original Article

Neuroradiologic Characteristics of Primary Angiitis of the Central Nervous System According to the Affected Vessel Size

Authors: Christian Thaler, Ann-Katrin Kaufmann-Bühler, Tserenchunt Gansukh, Amarjargal Gansukh, Simon Schuster, Henrike Bachmann, Götz Thomalla, Tim Magnus, Jakob Matschke, Jens Fiehler, Susanne Siemonsen

Published in: Clinical Neuroradiology | Issue 1/2019

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Abstract

Introduction

Magnetic resonance imaging (MRI) has an important impact in diagnosing primary angiitis of the central nervous system (PACNS). However, neuroradiologic findings may vary immensely, making an easy and definite diagnosis challenging.

Methods

In this retrospective, single center study, we analyzed neuroradiologic findings of patients with PACNS diagnosed at our hospital between 2009 and 2014. Furthermore, we classified patients according to the affected vessel size and compared imaging characteristics between the subgroups.

Results

Thirty-three patients were included (mean age 43 [±15.3] years, 17 females) in this study. Patients with positive angiographic findings were classified as either medium or large vessel PACNS and presented more ischemic lesions (p < 0.001) and vessel wall enhancement (p = 0.017) compared to patients with small vessel PACNS. No significant differences were detected for the distribution of contrast-enhancing lesions (parenchymal or leptomeningeal), hemorrhages, or lesions with mass effect. Twenty-five patients underwent brain biopsy. Patients with medium or large vessel PACNS were less likely to have positive biopsy results.

Discussion

It is essential to differentiate between small and medium/large vessel PACNS since results in MRI, digital subtraction angiography and brain biopsy may differ immensely. Since image quality of MR scanners improves gradually and brain biopsy may often be nonspecific or negative, our results emphasize the importance of MRI/MRA in the diagnosis process of PACNS.
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Metadata
Title
Neuroradiologic Characteristics of Primary Angiitis of the Central Nervous System According to the Affected Vessel Size
Authors
Christian Thaler
Ann-Katrin Kaufmann-Bühler
Tserenchunt Gansukh
Amarjargal Gansukh
Simon Schuster
Henrike Bachmann
Götz Thomalla
Tim Magnus
Jakob Matschke
Jens Fiehler
Susanne Siemonsen
Publication date
01-03-2019
Publisher
Springer Berlin Heidelberg
Published in
Clinical Neuroradiology / Issue 1/2019
Print ISSN: 1869-1439
Electronic ISSN: 1869-1447
DOI
https://doi.org/10.1007/s00062-017-0622-8

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