<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_abm-2019-0049_s_005_w2aab2b8c12b1b7b1aab1c14b1Aa"><h3>Background</h3><p>Hypertrophic pachymeningitis (HP) is a rare chronic inflammatory disorder characterized by marked fibrous thickening of the cerebral and/or spinal dura mater. This condition is caused by infection, inflammation, autoimmune disorder, neoplasms, or idiopathic. Magnetic resonance imaging (MRI) may play an important role in differentiating idiopathic HP from secondary HP, may avoid unnecessarily invasive dural biopsy, and prompt specific treatment.</p></sec><sec id="j_abm-2019-0049_s_006_w2aab2b8c12b1b7b1aab1c14b2Aa"><h3>Objective</h3><p>To determine the specific MRI findings for differentiation between idiopathic HP and secondary HP.</p></sec><sec id="j_abm-2019-0049_s_007_w2aab2b8c12b1b7b1aab1c14b3Aa"><h3>Method</h3><p>A total of 34 patients underwent MRI of the brain and cervical spine from January 2003 to December 2015. In all, 23 patients were diagnosed idiopathic HP and 11 patients were secondary HP. Demographic data and imaging findings reveal the following: configuration, thickness, signal intensity on T1-weighted image (T1WI), T2-weighted image (T2WI), and enhancement pattern of the lesions. The data were analyzed by T-test and Fisher’s exact test.</p></sec><sec id="j_abm-2019-0049_s_008_w2aab2b8c12b1b7b1aab1c14b4Aa"><h3>Result</h3><p>Secondary HP were significantly located at anterior and middle cranial fossa (<italic>P</italic> = 0.033). There is no significant difference of lesions in configurations, T1 and T2 signal intensity and patterns of enhancement. There was significant and exclusive difference in T2 hypointense/dark intensity and homogeneous enhancement in idiopathic HP (75%, <italic>P</italic> = 0.044).</p></sec><sec id="j_abm-2019-0049_s_009_w2aab2b8c12b1b7b1aab1c14b5Aa"><h3>Conclusions</h3><p>MRI may play a complimentarily important role in distinguishing idiopathic HP from secondary HP. Idiopathic HP is probably preferred diagnosis in the lesions with T2-rim pattern and T2 hypointense/dark intensity with homogeneous enhancement.</p></sec></abstract>

BackgroundHypertrophic pachymeningitis (HP) is a rare chronic inflammatory disorder characterized by marked fibrous thickening of the cerebral and/or spinal dura mater. This condition is caused by infection, inflammation, autoimmune disorder, neoplasms, or idiopathic. Magnetic resonance imaging (MRI) may play an important role in differentiating idiopathic HP from secondary HP, may avoid unnecessarily invasive dural biopsy, and prompt specific treatment.ObjectiveTo determine the specific MRI findings for differentiation between idiopathic HP and secondary HP.MethodA total of 34 patients underwent MRI of the brain and cervical spine from January 2003 to December 2015. In all, 23 patients were diagnosed idiopathic HP and 11 patients were secondary HP. Demographic data and imaging findings reveal the following: configuration, thickness, signal intensity on T1-weighted image (T1WI), T2-weighted image (T2WI), and enhancement pattern of the lesions. The data were analyzed by T-test and Fisher’s exact test.ResultSecondary HP were significantly located at anterior and middle cranial fossa (P = 0.033). There is no significant difference of lesions in configurations, T1 and T2 signal intensity and patterns of enhancement. There was significant and exclusive difference in T2 hypointense/dark intensity and homogeneous enhancement in idiopathic HP (75%, P = 0.044).ConclusionsMRI may play a complimentarily important role in distinguishing idiopathic HP from secondary HP. Idiopathic HP is probably preferred diagnosis in the lesions with T2-rim pattern and T2 hypointense/dark intensity with homogeneous enhancement.

Distinguishing magnetic resonance imaging features between idiopathic hypertrophic pachymeningitis and secondary hypertrophic pachymeningitis

Asian Biomedicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

BackgroundHypertrophic pachymeningitis (HP) is a rare chronic inflammatory disorder characterized by marked fibrous thickening of the cerebral and/or spinal...

Distinguishing magnetic resonance imaging features between idiopathic hypertrophic pachymeningitis and secondary hypertrophic pachymeningitis

Article Category: Brief communication (original)

Published Online: Dec 30, 2019

Page range: 113 - 119

DOI: https://doi.org/10.1515/abm-2019-0049

Keywords
dural inflammation, dural thickening, thickened dura, hypertrophic pachymeningitis, idiopathic hypertrophic pachymeningitis

© 2019 Warittikoon and Jakchairoongruang, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Distinguishing magnetic resonance imaging features between idiopathic hypertrophic pachymeningitis and secondary hypertrophic pachymeningitis

Article Category: Brief communication (original)

Published Online: Dec 30, 2019

Page range: 113 - 119

DOI: https://doi.org/10.1515/abm-2019-0049

Keywordsdural inflammation, dural thickening, thickened dura, hypertrophic pachymeningitis, idiopathic hypertrophic pachymeningitis

© 2019 Warittikoon and Jakchairoongruang, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Keywords
dural inflammation, dural thickening, thickened dura, hypertrophic pachymeningitis, idiopathic hypertrophic pachymeningitis