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Reliability of Normal Findings on MR Imaging for Excluding the Diagnosis of Vasculitis of the Central Nervous System

¹ Department of Radiology, Neuroradiology Division, The Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Phipps B-108, 600 N. Wolfe St., Baltimore, MD 21287-2182.
² Department of Medicine, Division of Rheumatology, The Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, MD 21287-2182.

OBJECTIVE. We attempt to determine whether angiography is indicated in patients with suspected central nervous system (CNS) vasculitis who present with negative findings on MR imaging studies.

CONCLUSION. MR imaging findings may be negative in the setting of CNS vasculitis confirmed on angiography, indicating that advanced imaging techniques tailored to detect infarction (i.e., fluid-attenuated inversion recovery, diffusion-weighted, and perfusion imaging) may be necessary to enhance the sensitivity of an MR study and that despite the high sensitivity of MR imaging for CNS vasculitis, angiography may still be required to render an accurate diagnosis.

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