Unit of Neuroradiology, AOUP, Santa Chiara Hospital, Pisa, Italy.
Magn Reson Imaging. 2013 Nov;31(9):1640-2. doi: 10.1016/j.mri.2013.06.012. Epub 2013 Aug 19.
For the first time we describe and interpret Susceptibility Weighted Imaging (SWI) and Perfusion Weighted Imaging (PWI) findings in a case of Chronic Lymphocytic Inflammation with Perivascular Pontine Enhancement Responsive to Steroids (CLIPPERS). The diagnosis of the disease was formulated on the basis of typical Magnetic Resonance (MR) findings and its responsiveness to steroids in a 40-year-old man with acute onset of dizziness, ataxia and diplopia. The patient underwent a 3 tesla (T) MR examination including SWI and PWI sequences. SWI revealed prominent veins and multiple hypointense lesions of different size widely distributed in brainstem and cerebellum, which could be expression of iron deposition or cellular infiltrates. PWI demonstrated global infratentorial hypoperfusion. SWI and PWI provide new information on CLIPPERS that might be helpful to understand the physiopathology of the disease. Further observations are needed to evaluate if these findings are peculiar for CLIPPERS and if they might have a role in a non-invasive diagnosis of the disease.
我们首次描述并解释了一例慢性淋巴细胞性炎症伴血管周围增强反应性类固醇（CLIPPERS）的磁共振磁敏感加权成像（SWI）和灌注加权成像（PWI）的表现。该疾病的诊断基于一位 40 岁男性的典型磁共振（MR）表现及其对类固醇的反应性，患者表现为突发性头晕、共济失调和复视。该患者进行了 3 特斯拉（T）MR 检查，包括 SWI 和 PWI 序列。SWI 显示出明显的静脉和多个大小不一的低信号病变广泛分布于脑干和小脑，这可能是铁沉积或细胞浸润的表现。PWI 显示出全小脑幕下低灌注。SWI 和 PWI 为 CLIPPERS 提供了新的信息，可能有助于了解疾病的病理生理学。需要进一步观察以评估这些表现是否是 CLIPPERS 的特征，以及它们是否可能在疾病的非侵入性诊断中发挥作用。
