Imaging of Arteritis and Granulomatious Diseases in the Brain <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />

祁吉

Qi Ji

First Central Hospital of Tianjin Medical University ,Tianjin 300192

Abstract

Arteritis and granulomatious diseases are relatively rare in the CNS . According to different standards ,there are several kinds of classification .The etiology of some diseases ,such as granulomations arteritis ,central sarcoidosis ,are unknown .In the past ,the entities could not be well recognized because of the limitation and non-specificity of imaging methods .The common pathologic characteristics of the entities are inflammation ,necrosis and fibrosis on the wall of blood vessels ,stenosis and secondary clot formation ,occlusion and infarction .Angio-graphy is one of most basic methods for the entities ,but not “golden standard ”.Only the morphological changes of blood vessels ,e.g. arterial stenosis ,aneurysm and arterial occlusion could be displayed .CT and MRI could supply more information .MRI is more sensitive to detect secondary changes of lesion .Special sequences and paramelers may be help to determine hemorrhage ,infarct ,nodus and edema ,etc .If contrast examination is employed ,more useful information ,e.g. leptomening enhanced ,could be acquired .In addition ,the common type of the entities was introduced in details .According to etiology ,the arteritis was divided into infectious and non-infectious diseases ,which including bacterial arteritis ,tuberculosis artenitis ,fungal artenitis ,syphilic and polyarteritis nodosa . granulomatous arteritis ,central sarcoidsis,etc .The advantage of advanced CT,MRI and MRA was evaluated on aspects of etiology ,morbidity ,pathology and imaging findings .Systemic lupus erythematosus(SLE),drug abuse and whipple disease which are more than before were also discussed ,especially their involvment to CNS . In conclusion ,the entities are lack of spcifical imaging findings though each disease has their characteristics separately .Clinical manifestation , laboratory examination and epidemicity all are very important to imaging diagnosis.