Hida Kosuke, Takano Koichi, Yoshimitsu Kengo, Fukae Jiro, Hokao Koichi
Department of Radiology, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
Department of Neurology, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
BJR Case Rep. 2016 Sep 16;3(1):20160090. doi: 10.1259/bjrcr.20160090. eCollection 2017.
Vogt-Koyanagi-Harada (VKH) disease is an autoimmune disorder that occurs in the melanocytes present in the uvea, leptomeninges, skin and inner ear. Clinically, this disease is characterized by bilateral uveitis and retinal detachment and is associated with meningismus and hearing loss. Gadolinium (Gd)-enhanced MRI may aid in demonstrating bilateral choroidal thickening and central nervous system involvement. We present a case of VKH where Gd-enhanced three-dimensional (3D) fluid attenuation inversion recovery (FLAIR) imaging showed abnormal bilateral enhancement in the inner ears. A 36-year-old female was referred to our institution with symptoms of visual disturbance, headache and tinnitus, and was diagnosed with VKH based on fundus examination and clinical presentations. MRI findings revealed bilateral enhancement in the choroid, leptomeninges, and inner ears. In particular, Gd-enhanced 3D FLAIR showed more conspicuous enhancement of the leptomeninges and inner ear compared with Gd-enhanced 3D weighted image. Therefore, Gd-enhanced 3D FLAIR imaging can be used when leptomeningeal or inner ear pathology is clinically suspected.
伏格特-小柳-原田（VKH）病是一种自身免疫性疾病，发生于葡萄膜、软脑膜、皮肤和内耳中的黑素细胞。临床上，该病以双侧葡萄膜炎和视网膜脱离为特征，并伴有颈项强直和听力丧失。钆（Gd）增强磁共振成像（MRI）可能有助于显示双侧脉络膜增厚和中枢神经系统受累情况。我们报告一例VKH病例，Gd增强三维（3D）液体衰减反转恢复（FLAIR）成像显示内耳双侧异常强化。一名36岁女性因视力障碍、头痛和耳鸣症状转诊至我院，根据眼底检查和临床表现诊断为VKH。MRI检查结果显示脉络膜、软脑膜和内耳双侧强化。特别是，与Gd增强3D加权图像相比，Gd增强3D FLAIR显示软脑膜和内耳强化更明显。因此，当临床上怀疑有软脑膜或内耳病变时，可使用Gd增强3D FLAIR成像。
