Department of Radiology, Teikyo University School of Medicine, Tokyo, Japan.
AJNR Am J Neuroradiol. 2012 Dec;33(11):2136-9. doi: 10.3174/ajnr.A3147. Epub 2012 Jun 14.
IgG4-related disease is characterized by histologic fibrosis with IgG4-positive plasma cell infiltration. Our study evaluated MR imaging features of IgG4-related disease in the head and neck and brain. Images from 15 patients were retrospectively evaluated for the location, signal intensity, and enhancement patterns of lesions. Lacrimal gland enlargement was observed in 8 cases. Other lesions included orbital pseudotumor in 5, pituitary enlargement in 5, and cranial nerve enlargement in 7; the infraorbital nerve was involved in 4. All lesions were hypointense on T2-weighted images, which is typical for IgG4-related lesions. Multiple sites were involved in the head and neck and brain in 11 patients. The diagnosis of IgG4-related disease should be considered in a patient presenting with T2 hypointense lacrimal gland, pituitary, or cranial nerve enlargement, or a T2 hypointense orbital mass, especially if multiple sites in the head and neck are involved in the presence of elevated serum IgG4.
IgG4 相关疾病的特征是组织纤维化伴有 IgG4 阳性浆细胞浸润。本研究评估了 IgG4 相关疾病在头颈部和脑部的 MRI 特征。对 15 例患者的图像进行了位置、信号强度和增强模式的回顾性评估。8 例观察到泪腺肿大。其他病变包括眼眶假瘤 5 例，垂体增大 5 例，颅神经增大 7 例；眶下神经受累 4 例。所有病变在 T2 加权图像上均呈低信号，这是 IgG4 相关病变的典型表现。11 例患者头颈部和脑部多个部位受累。如果血清 IgG4 升高，伴有 T2 低信号泪腺、垂体或颅神经增大，或 T2 低信号眼眶肿块，尤其是头颈部多个部位受累，应考虑 IgG4 相关疾病的诊断。
