Summary
Sequential gadolinium-DTPA (Gd-DTPA) enhanced MR images were obtained before and after steroid therapy in a case of neuro-Behçet's disease. Multiple scattered lesions, which could not be detected on pre-and post-contrast CT, were demonstrated mainly in the white matter of the pons and/or the cerebrum with both T1-and T2-weighted images. Some of these lesions, however, were not enhanced at all by infusion of Gd-DTPA. The Gd-DTPA infusion study demonstrated marked enhancement in the white matter of the pons and cerebrum. Some lesions not seen with T2-weighted images were also strongly enhanced by Gd-DTPA infusion at the acute stage. After steroid therapy, the symptoms and abnormal laboratory findings were resolved. The pontine and cerebral lesions on plain MR images remained unchanged even after resolution of the symptoms, suggesting that they were inactive old foci. On the other hand, the lesions detected in the enhancement study before steroid therapy disappeared with the repeat Gd-DTPA enhanced MR images which were performed after resolution of the symptoms. Some active inflammatory lesions in, neuro-Behçet's disease may be demonstrated only on Gd-DTPA enhanced MR images. Gd-DTPA enhanced MR imaging appears to be potentially useful for detecting active inflammatory lesions in neuro-Behçet's disease and for evaluating the efficacy of treatment.
Similar content being viewed by others
References
Chajek T, Fainaru M (1975) Behçet's disease: report of 41 cases and a review of the literature. Medicine (Baltimore) 54: 179–196
O'Duffy JD, Goldstein NP (1976) Neurologic involvement in seven patients with Behçet's disease. Am J Med 61: 170–178
Wolf SM, Schotland DL, Phillips LL (1965) Involvement of nervous system in Behçet's syndrome. Arch Neurol 12: 315–325
Alema G (1972) Behçet's disease. In: Vinken P, Bruyn G (eds) Handbook of, clinical neurology, vol 34. Elsevier, North-Holland, pp. 475–512
Willeit J, Schmutzhard E, Aichner F, Mayr U, Weber F, Gerstenbrand F (1986) CT and MR imaging in neuro-Behçet disease. J Comput Assist Tomogr 10: 313–315
Fukuyama H, Kameyama M, Nabatame H, Takemura M, Nishimura K, Fujisawa I, Torizuka K (1987) Magnetic resonance images of neuro-Behçet syndrome show precise brain stem lesions: report of a case. Acta Neurol Scand 75: 70–73
Vidaller A, Carratalà J, Moreno R, Arbizu T, Rubio F (1988) Magnetic resonance imaging in neuro-Behçet's disease. Br J Rheumatol 27: 79–80
Kataoka S, Hirose G, Tsukada K (1989) Brain stem type neuro-Behçet's syndrome: correlation of enhanced CT scans and MRI during the acute and chronic stage of the illness. Neuroradiology 31: 258–262
Patel DV, Neuman MJ, Hier DB (1989) Reversibility of CT and MR findings in neuro-Behçet disease. J Comput Assist Tomogr 13: 669–673
Wildhagen K, Meyer GJ, Stoppe G, Heintz P, Deicher H, Hundeshagen H (1989) PET and MR imaging in a neuro-Behçet syndrome. Eur J Nucl Med 15: 764–766
Shimizu T, Ehrlich GE, Inaba G, Hayashi K (1979) Behçet disease (Behçet syndrome). Semin Arthr Rheum 8: 223–260
Virapongse C, Mancuso A, Quisling R (1986) Human brain infarcts: Gd-DTPA-enhanced MR imaging. Radiology 161: 785–794
Imakita S, Nishimura T, Naito H, Yamada N, Yamamoto K, Takamiya M, Yamada Y, Sakashita Y, Minamikawa J, Kikuchi H, Terada T (1987) Magnetic resonance imaging of human cerebral infarction: enhancement with Gd-DTPA. Neuroradiology 29: 422–429
Grossman RI, Gonzalez-Scarano F, Atlas SW, Galetta S, Silberberg DH (1986) Multiple sclerosis: Gadolinium enhancement in MR imaging. Radiology 161: 722–725
Miller DH, Rudge P, Johnson G, Kendall BE, Macmanus DG, Moseley IF, Barnes D, McDonald WI (1988) Serial gadolinium enhanced magnetic resonance imaging in multiple sclerosis. Brain 111: 927–939
Stack JP, Antoun NM, Jenkins JPR, Metcalfe R, Isherwood I (1988) Gadolinium-DTPA as a contrast agent in magnetic resonance imaging of the brain. Neuroradiology 30: 145–154
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kazui, S., Naritomi, H., Imakita, S. et al. Sequential gadolinium-DTPA enhanced MRI studies in neuro-Behçet's disease. Neuroradiology 33, 136–139 (1991). https://doi.org/10.1007/BF00588251
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00588251