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Magnetic resonance imaging of uveitis

  • Head and Neck Radiology
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Abstract

Introduction

Uveitis is a term used to describe inflammation of the choroid, iris, or ciliary body, which make up the uveal tract. It can be idiopathic or associated with a systemic disease which may be infectious or noninfectious. With the exception of B-scan ultrasonography, current imaging methods for diagnosing and monitoring uveitis are predominately non-radiologic. Although MRI has been anecdotally shown to detect various inflammatory conditions of the globe, such as posterior scleritis, endophthalmitis, and posterior uveitis secondary to Vogt-Koyanagi-Harada disease, a more comprehensive review of the MRI findings in uveitis of various etiologies is presented here.

Methods

The MRI and CT studies of seven patients with uveitis and the clinical history of three of them (not available in four patients) were reviewed. Etiologies included ankylosing spondylitis, relapsing polychondritis, Vogt-Koyanagi-Harada disease, sarcoidosis, and tuberculosis.

Results

Increased gadolinium enhancement of the uveal tract, which is visualized as the enhancing layer immediately deep to the low-signal sclera, was seen on all six MRI studies. Diffusion-weighted imaging of a case with posterior uveitis and subretinal effusions revealed restriction within the uvea and effusions. Two patients had inflammatory nodules adherent to the uvea, two patients had vitreous humor abnormalities, and one patient exhibited proximal perineural and perimuscular spread of enhancement. Uveoscleral thickening and enhancement with a posterior calcification were observed in the patient with chronic uveitis imaged with CT.

Conclusions

Increased uveal tract enhancement is a common finding in patients with uveitis, regardless of anatomic distribution and etiology. MRI can also further evaluate complications of uveitis and help differentiate it from masquerade syndromes.

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Abbreviations

CT:

Computed tomography

MRI:

Magnetic resonance imaging

T1WI, T2WI:

T1-weighted image, T2-weighted image

FLAIR:

Fluid-attenuated inversion recovery

DWI:

Diffusion-weighted imaging

ADC:

Apparent diffusion coefficient

HLA:

Human leukocyte antigen

VKH:

Vogt-Koyanagi-Harada

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Acknowledgments

The authors would like to thank Dr. Brandon C. Cho for his clinical expertise in uveitis management.

Ethical standards and patient consent

We declare that all human and animal studies have been approved by the University of California, San Diego, Institutional Review Board and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that the Institutional Review Board waived informed consent for all patients prior to inclusion in this study.

Conflict of interest

We declare that we have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Radiology, University of California, San Diego, 200 West Arbor Drive #8756, San Diego, CA, 92103, USA

    Charles Q. Li & Mahmood F. Mafee

  2. Naval Medical Center, San Diego, CA, USA

    Aaron A. Cho

  3. Department of Anesthesiology, University of Cincinnati, Cincinnati, OH, USA

    Neeraj J. Edward

  4. King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia

    Deepak P. Edward

  5. Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD, USA

    Deepak P. Edward

  6. Shiley Eye Center, University of California, San Diego, La Jolla, CA, USA

    Roman G. Fajardo

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  1. Charles Q. Li
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Correspondence to Charles Q. Li.

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Li, C.Q., Cho, A.A., Edward, N.J. et al. Magnetic resonance imaging of uveitis. Neuroradiology 57, 825–832 (2015). https://doi.org/10.1007/s00234-015-1531-7

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  • DOI: https://doi.org/10.1007/s00234-015-1531-7

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