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MRI for Diagnosis and Monitoring of Patients with Eosinophilic Fasciitis

¹ Institute of Diagnostic Radiology, University Hospital, Raemistrasse 100, Zurich CH-8091, Switzerland.
² Clinic of Rheumatology, University Hospital, Zurich, Switzerland.

OBJECTIVE. The objective of this study was to describe MRI findings in patients with eosinophilic fasciitis (EF) and to correlate clinical and laboratory findings with the MRI findings.

MATERIALS AND METHODS. Six patients with histologically proven EF underwent MRI at the time of diagnosis and after therapy (15 MRI examinations). Unenhanced T1-weighted, T2-weighted, and STIR sequences were performed using a 1.5-T MRI system. In addition, all patients were imaged with contrast-enhanced T1-weighted sequences. MRI findings, clinical findings, and laboratory parameters were retrospectively reviewed.

RESULTS. At the time the six patients presented, all eight MRI examinations revealed symmetric thickening and hyperintensity of the superficial muscle fasciae of the thigh, calves, or arms on unenhanced T1-weighted, T2-weighted, or STIR sequences, with strong enhancement after administration of IV contrast agent. In seven of the eight MRI examinations, similar signal changes were also present in the deep muscle fasciae. After treatment, the fascial abnormalities found on MRI disappeared on six of eight MRI examinations performed in five patients—a rate that correlated well with the clinical findings. In one patient with EF involvement of the thigh, the MRI abnormalities showed partial remission, which also correlated well with the clinical findings.

CONCLUSION. In EF, MRI reveals characteristic findings including thickening, signal abnormalities, and contrast enhancement of the superficial and, to a lesser extent, deep muscle fasciae. MRI is useful for establishing the diagnosis, guiding the choice of biopsy site, and assessing treatment response.

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