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

Bruce A. Wasserman1, John H. Stone2, David B. Hellmann2 and Martin G. Pomper1

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.



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Fig. 1A. 37-year-old woman with systemic lupus erythematosus who presented with decline in mental function that progressed to unresponsiveness. Axial spin-echo MR image (TR/TE, 3200/100) shows no evidence of parenchymal ischemia or infarction.

 


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Fig. 1B. 37-year-old woman with systemic lupus erythematosus who presented with decline in mental function that progressed to unresponsiveness. Lateral right internal carotid angiogram shows segmental dilatation (arrow) of anterior cerebral artery and beading (arrowheads) of middle cerebral artery.

 


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Fig. 1C. 37-year-old woman with systemic lupus erythematosus who presented with decline in mental function that progressed to unresponsiveness. Lateral right common carotid angiogram shows segmental dilatation (arrows) of middle meningeal artery.

 


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Fig. 2A. 57-year-old woman with primary angiitis of central nervous system who presented with headache. Axial spin-echo MR image (TR/TE, 2200/90) shows no evidence of supratentorial parenchymal ischemia or infarction.

 


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Fig. 2B. 57-year-old woman with primary angiitis of central nervous system who presented with headache. Axial spin-echo MR image (2200/90) shows no evidence of infratentorial parenchymal ischemia or infarction.

 


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Fig. 2C. 57-year-old woman with primary angiitis of central nervous system who presented with headache. Lateral left internal carotid angiogram shows beading of anterior (thick solid arrows) and middle (thin solid arrows) cerebral arteries and segmental dilatation of anterior (arrowheads) and middle (open arrows) cerebral arteries.

 


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Fig. 2D. 57-year-old woman with primary angiitis of central nervous system who presented with headache. Lateral right internal carotid angiogram shows beading of anterior cerebral arteries (arrowheads) and beading (straight arrows), segmental dilatation (curved arrow), and narrowing (open arrow) of middle cerebral arteries.

 


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Fig. 2E. 57-year-old woman with primary angiitis of central nervous system who presented with headache. Anteroposterior left vertebral angiogram shows beading (arrows) and segmental dilatation (arrowheads) of posterior cerebral arteries.

 

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