Silvera Stéphane, Vignaux Olivier, Legmann Paul
Service de radiologie A, Hôpital Cochin, Paris, France.
Presse Med. 2007 May;36(5 Pt 2):913-21. doi: 10.1016/j.lpm.2007.01.033. Epub 2007 Mar 26.
Sinonasal CT must be studied with both soft tissue and bone algorithms. Sinonasal findings in Wegener's granulomatosis are mucosal thickening, subtotal opacification, air-fluid level, bony destruction (mainly of the nasal septum), and sclerosing osteitis. Orbital MRI helps to define the extent of the disease. Contiguous granulomatous infiltration of the orbit appears dark (hypointense signals) on both T2-weighted-and T1-weighted images, but is enhanced after gadolinium administration. Cerebral MRI findings include diffuse linear dural thickening, enhanced by injection, and local dural thickening contiguous with orbital, nasal and paranasal disease. The remote granulomatous lesions in brain parenchyma are the least common form of central nervous system lesion. The pituitary gland and infundibulum can also be involved in Wegener's granulomatosis. These imaging findings of Wegener's granulomatosis are nonspecific. They should be combined with clinical examination and c-ANCA tests to confirm the diagnosis.
鼻窦CT必须采用软组织和骨算法进行研究。韦格纳肉芽肿的鼻窦表现为黏膜增厚、部分性浑浊、气液平面、骨质破坏(主要是鼻中隔)以及硬化性骨炎。眼眶MRI有助于明确疾病范围。眼眶的连续性肉芽肿浸润在T2加权和T1加权图像上均呈暗区(低信号),但在给予钆剂后会强化。脑部MRI表现包括弥漫性线性硬脑膜增厚,注射后强化,以及与眼眶、鼻腔和鼻窦疾病相邻的局部硬脑膜增厚。脑实质内的远处肉芽肿性病变是中枢神经系统病变最不常见的形式。垂体和漏斗也可累及韦格纳肉芽肿。韦格纳肉芽肿的这些影像学表现不具有特异性。它们应与临床检查和c-ANCA检测相结合以确诊。