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MR Imaging in Wegener Granulomatosis of the Spinal Cord

Hans-J. Mentzela, Thomas Neumannb, Clemens Fitzeka, Dieter Saunera, Jürgen R. Reichenbacha and Werner A. Kaisera

a Institute of Diagnostic and Interventional Radiology, Friedrich-Schiller University, Jena, Germany
b Department of Internal Medicine, Friedrich-Schiller University, Jena, Germany



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  		FIG 1. Chest radiograph demonstrates pulmonary nodules and infiltrates



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  		FIG 2. MR images of the cervical spine.

A, T2-weighted sagittal image shows hyperintense fluid (arrow) enclosed by hypointense masses overlying the spinal cord.

B, Sagittal T1-weighted image without contrast enhancement. Arrow indicates a prolapse of the nucleus pulposus.

C, Sagittal T1-weighted image obtained after the administration of gadopentetate dimeglumine demonstrates enhancing granulomatous masses (arrow) and central necrotic hypointense fluid.

D, Axial T2-weighted image shows a hyperintense liquid epidural mass (arrow).

E, Axial T1-weighted contrast-enhanced image shows hyperintense granulomatous tissue surrounding the liquid necrotic mass (arrow).



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  		FIG 3. Histologic findings in the surrounding soft tissue with signs of a granulomatous inflammatory process due to WG. The vessels show endothelial necrosis, fibrin deposition, and dense granulocytic tissue with an inflammatory infiltrate.





Copyright © 2008 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X