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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.

View larger version (124K): [in a new window]   Fig. 1A. —76-year-old woman with eosinophilic fasciitis of right upper arm. Axial T1-weighted spin-echo MR image (TR/TE, 400/9) shows slight thickening of superficial fasciae (arrows).

View larger version (142K): [in a new window]   Fig. 1B. —76-year-old woman with eosinophilic fasciitis of right upper arm. Signal hyperintensity is noted in fasciae of superficial (arrows) and deep (arrowheads) muscles on axial STIR MR image (4,400/32; inversion time, 150 msec).

View larger version (124K): [in a new window]   Fig. 1C. —76-year-old woman with eosinophilic fasciitis of right upper arm. On contrast-enhanced, inhomogeneously fat-suppressed, T1-weighted spin-echo images (440/11), fascial enhancement is noted at corresponding locations of STIR MR image (arrows). Stranding of subcutaneous tissue in A and B represents panniculitis.

View larger version (87K): [in a new window]   Fig. 2A. —34-year-old woman with eosinophilic fasciitis of both thighs. On axial T2-weighted fat-suppressed fast spin-echo MR image (TR/TE, 2,800/100; echo-train length, 8), only slight signal abnormalities of superficial muscle fasciae (arrows) are noted.

View larger version (88K): [in a new window]   Fig. 2B. —34-year-old woman with eosinophilic fasciitis of both thighs. On corresponding T1-weighted spin-echo image (400/9) after contrast administration, superficial muscle fasciae enhance only slightly (arrows).

View larger version (90K): [in a new window]   Fig. 3A. —34-year-old woman with eosinophilic fasciitis of both thighs before (A and B) and after (C and D) therapy. Axial T2-weighted fat-suppressed fast spin-echo image (TR/TE, 3,800/99; echo-train length, 8) shows thickening and signal hyperintensity in superficial (arrows) and deep muscle fasciae. 1 = biceps muscle (caput breve), 2 = biceps muscle (caput longum), 3 = semitendinosus muscle, 4 = semimembranosus muscle, 5 = gracilis muscle, 6 = sartorius muscle.

View larger version (75K): [in a new window]   Fig. 3B. —34-year-old woman with eosinophilic fasciitis of both thighs before (A and B) and after (C and D) therapy. T1-weighted, fat-suppressed spin-echo image (460/20) after IV contrast administration shows enhancement of superficial (arrows) and deep muscle fasciae. Inflammatory changes are more prominent in dorsal than ventral muscle groups.

View larger version (91K): [in a new window]   Fig. 3C. —34-year-old woman with eosinophilic fasciitis of both thighs before (A and B) and after (C and D) therapy. After therapy with corticosteroids, complete remission of abnormalities is seen both on fat-suppressed T2-weighted fast spin-echo image (3,500/99; echo-train length, 8) (C) and on contrast-enhanced fat-suppressed T1-weighted spin-echo image (440/20) (D). Arrows show sites of former abnormalities.

View larger version (75K): [in a new window]   Fig. 3D. —34-year-old woman with eosinophilic fasciitis of both thighs before (A and B) and after (C and D) therapy. After therapy with corticosteroids, complete remission of abnormalities is seen both on fat-suppressed T2-weighted fast spin-echo image (3,500/99; echo-train length, 8) (C) and on contrast-enhanced fat-suppressed T1-weighted spin-echo image (440/20) (D). Arrows show sites of former abnormalities.

View larger version (133K): [in a new window]   Fig. 4. —76-year-old woman with eosinophillic fasciitis of right thigh. Axial T2-weighted fat-suppressed MR image (TR/TE, 3,340/99) shows thickening and signal hyperintensity of dorsal superficial muscle fasciae and slight signal hyperintensity of adjacent muscle fibers (arrow).

View larger version (151K): [in a new window]   Fig. 5. —34-year-old man with eosinophilic fasciitis. Photomicrograph of H-and-E-stained histopathologic specimen from right calf shows thickening of fascia with mixed, predominantly cellular, infiltrate containing lymphocytes, plasma cells, and occasional eosinophils. (x100)

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