Serrano Alcalá E, Grivé Isern E, Díez Borras L, Salaya Díaz J T
Departamento de Radiología, Hospital Universitari Sagrat Cor, Barcelona, España.
Departamento de Radiología, Hospital Universitari Sagrat Cor, Barcelona, España.
Radiologia (Engl Ed). 2020 Mar-Apr;62(2):160-163. doi: 10.1016/j.rx.2019.11.006. Epub 2019 Dec 27.
Optic nerve enhancement is a sign seen in different disease states; however, perineural enhancement is less common. This article presents the case of a patient with bilateral amaurosis in whom the diagnosis of giant cell arteritis was suggested by perineural enhancement on orbital magnetic resonance imaging (MRI) and confirmed by biopsy of the temporal artery. The clinical presentation of giant cell arteritis is occasionally nonspecific; patients can have visual symptoms, even blindness if the branches of the ophthalmic artery are affected; in these cases, orbital MRI can be very useful for early diagnosis. Although the MRI findings are uncommon, distinct patterns of enhancement have been reported, the most characteristic of which is perineural enhancement. The pattern of optic nerve involvement is relatively unknown, but important because it orients the diagnosis of a disease that can lead to permanent blindness.
视神经强化是在不同疾病状态下可见的一种征象；然而，神经周围强化则较为少见。本文介绍了一例双侧黑矇患者，眼眶磁共振成像（MRI）显示神经周围强化提示巨细胞动脉炎，颞动脉活检得以确诊。巨细胞动脉炎的临床表现有时不具有特异性；患者可能出现视觉症状，如果眼动脉分支受累甚至会失明；在这些情况下，眼眶MRI对早期诊断非常有用。虽然MRI表现并不常见，但已有不同的强化模式报道，其中最具特征性的是神经周围强化。视神经受累模式相对尚不明确，但很重要，因为它有助于对一种可导致永久性失明的疾病进行诊断。
