Detecting immunoglobulin G4-related intracranial arteriopathy with magnetic resonance vessel wall imaging: a preliminary experience in two cases
Abstract Background Detecting immunoglobulin G4 (IgG4)-related intracranial arteriopathy, a rare neurovascular complication of IgG4-related disease, is challenging. While magnetic resonance (MR) vessel wall imaging (VWI) can visualize various neurovascular pathologies, its application to this arteri...
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| Format: | Article |
| Language: | English |
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BMC
2022-12-01
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| Series: | BMC Neurology |
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| Online Access: | https://doi.org/10.1186/s12883-022-03010-8 |
| _version_ | 1797980499037126656 |
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| author | Koki Mitani Takeshi Funaki Masahiro Tanji Hideo Onizawa Hajime Yoshifuji Yasutaka Fushimi Shinya Torimaki Kazumichi Yoshida Susumu Miyamoto |
| author_facet | Koki Mitani Takeshi Funaki Masahiro Tanji Hideo Onizawa Hajime Yoshifuji Yasutaka Fushimi Shinya Torimaki Kazumichi Yoshida Susumu Miyamoto |
| author_sort | Koki Mitani |
| collection | DOAJ |
| description | Abstract Background Detecting immunoglobulin G4 (IgG4)-related intracranial arteriopathy, a rare neurovascular complication of IgG4-related disease, is challenging. While magnetic resonance (MR) vessel wall imaging (VWI) can visualize various neurovascular pathologies, its application to this arteriopathy has not been reported as of this writing. Case presentation A 74-year-old male and a 65-year-old female manifested multiple cranial nerve palsy and neck pain, respectively. Both cases exhibited multiorgan masses with markedly elevated serum IgG4 levels and were clinically diagnosed with IgG4-related disease. Three-dimensional T1-weighted black blood VWI with and without contrast agent identified intracranial vascular lesions characterized as nearly-circumferential mural thickening with homogeneous contrast enhancement in the internal carotid and vertebral arteries; some of the lesions had been unrecognized with screening MR angiography due to expansive remodeling. The former patient underwent corticosteroid therapy, and VWI after treatment revealed decreased mural thickening and enhancement. Conclusion Further studies to elucidate characteristic findings of VWI might contribute to early detection of this treatable pathology. |
| first_indexed | 2024-04-11T05:55:16Z |
| format | Article |
| id | doaj.art-45efd347798d4d76b3c025d12aa2fa52 |
| institution | Directory Open Access Journal |
| issn | 1471-2377 |
| language | English |
| last_indexed | 2024-04-11T05:55:16Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Neurology |
| spelling | doaj.art-45efd347798d4d76b3c025d12aa2fa522022-12-22T04:41:55ZengBMCBMC Neurology1471-23772022-12-012211610.1186/s12883-022-03010-8Detecting immunoglobulin G4-related intracranial arteriopathy with magnetic resonance vessel wall imaging: a preliminary experience in two casesKoki Mitani0Takeshi Funaki1Masahiro Tanji2Hideo Onizawa3Hajime Yoshifuji4Yasutaka Fushimi5Shinya Torimaki6Kazumichi Yoshida7Susumu Miyamoto8Department of Neurosurgery, Kyoto University Graduate School of MedicineDepartment of Neurosurgery, Kyoto University Graduate School of MedicineDepartment of Neurosurgery, Kyoto University Graduate School of MedicineDepartment of Advanced Medicine for Rheumatic Diseases, Graduate School of Medicine, Kyoto UniversityDepartment of Rheumatology and Clinical Immunology, Kyoto University Graduate School of MedicineDepartment of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of MedicineDepartment of Neurosurgery, Kyoto University Graduate School of MedicineDepartment of Neurosurgery, Kyoto University Graduate School of MedicineDepartment of Neurosurgery, Kyoto University Graduate School of MedicineAbstract Background Detecting immunoglobulin G4 (IgG4)-related intracranial arteriopathy, a rare neurovascular complication of IgG4-related disease, is challenging. While magnetic resonance (MR) vessel wall imaging (VWI) can visualize various neurovascular pathologies, its application to this arteriopathy has not been reported as of this writing. Case presentation A 74-year-old male and a 65-year-old female manifested multiple cranial nerve palsy and neck pain, respectively. Both cases exhibited multiorgan masses with markedly elevated serum IgG4 levels and were clinically diagnosed with IgG4-related disease. Three-dimensional T1-weighted black blood VWI with and without contrast agent identified intracranial vascular lesions characterized as nearly-circumferential mural thickening with homogeneous contrast enhancement in the internal carotid and vertebral arteries; some of the lesions had been unrecognized with screening MR angiography due to expansive remodeling. The former patient underwent corticosteroid therapy, and VWI after treatment revealed decreased mural thickening and enhancement. Conclusion Further studies to elucidate characteristic findings of VWI might contribute to early detection of this treatable pathology.https://doi.org/10.1186/s12883-022-03010-8CNS vasculitisIgG4-related diseaseMagnetic resonance imagingVessel wall imagingDANTECase report |
| spellingShingle | Koki Mitani Takeshi Funaki Masahiro Tanji Hideo Onizawa Hajime Yoshifuji Yasutaka Fushimi Shinya Torimaki Kazumichi Yoshida Susumu Miyamoto Detecting immunoglobulin G4-related intracranial arteriopathy with magnetic resonance vessel wall imaging: a preliminary experience in two cases BMC Neurology CNS vasculitis IgG4-related disease Magnetic resonance imaging Vessel wall imaging DANTE Case report |
| title | Detecting immunoglobulin G4-related intracranial arteriopathy with magnetic resonance vessel wall imaging: a preliminary experience in two cases |
| title_full | Detecting immunoglobulin G4-related intracranial arteriopathy with magnetic resonance vessel wall imaging: a preliminary experience in two cases |
| title_fullStr | Detecting immunoglobulin G4-related intracranial arteriopathy with magnetic resonance vessel wall imaging: a preliminary experience in two cases |
| title_full_unstemmed | Detecting immunoglobulin G4-related intracranial arteriopathy with magnetic resonance vessel wall imaging: a preliminary experience in two cases |
| title_short | Detecting immunoglobulin G4-related intracranial arteriopathy with magnetic resonance vessel wall imaging: a preliminary experience in two cases |
| title_sort | detecting immunoglobulin g4 related intracranial arteriopathy with magnetic resonance vessel wall imaging a preliminary experience in two cases |
| topic | CNS vasculitis IgG4-related disease Magnetic resonance imaging Vessel wall imaging DANTE Case report |
| url | https://doi.org/10.1186/s12883-022-03010-8 |
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