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BIBTEX RIS

Immune-Mediated Hypertrophic Pachymeningitis and its Mimickers: Magnetic Resonance Imaging Findings

2023; Elsevier BV; Volume: 30; Issue: 11 Linguagem: Inglês

10.1016/j.acra.2023.01.017

1878-4046

Thiago Bezerra Matias, Rafael Alves Cordeiro, Juliana Àvila Duarte, Vinicius Menezes de Jarry, Simone Appenzeller, Luciano de Lima Villarinho, Fabiano Reis,

Amyloidosis: Diagnosis, Treatment, Outcomes

Hypertrophic pachymeningitis (HP) is a rare and chronic inflammatory disorder presenting as localized or diffuse thickening of the dura mater. It can be idiopathic or an unusual manifestation of immune-mediated, infectious, and neoplastic conditions. Although some cases may remain asymptomatic, HP can lead to progressive headaches, cranial nerve palsies, hydrocephalus, and other neurological complications, which makes its recognition a fundamental step for prompt treatment. Regarding the diagnosis workup, enhanced MRI is the most useful imaging method to evaluate dural thickening. This article addresses the MR imaging patterns of immune-mediated HP, including immunoglobulin G4-related disease, neurosarcoidosis, granulomatosis with polyangiitis, rheumatoid pachymeningitis, and idiopathic HP. The main infectious and neoplastic mimicking entities are also discussed with reference to conventional and advanced MR sequences.