Orbital and optic pathway sarcoidosis: MR findings

• Published in: American journal of neuroradiology : AJNR Vol. 15; no. 4; pp. 775 - 783
• Main Authors: Carmody, RF, Mafee, MF, Goodwin, JA, Small, K, Haery, C
• Format: Journal Article
• Language: English
• Published: Oak Brook, IL Am Soc Neuroradiology 01.04.1994; American Society of Neuroradiology
• Subjects: Adolescent; Adult; Biological and medical sciences; Cavernous Sinus - pathology; Contrast Media; Drug Combinations; Female; Gadolinium; Gadolinium DTPA; Humans; Image Enhancement; Lacrimal Apparatus Diseases - diagnosis; Magnetic Resonance Imaging; Male; Medical sciences; Meglumine; Middle Aged; Ophthalmoplegia - diagnosis; Optic Atrophy - diagnosis; Optic Chiasm - pathology; Optic Nerve Diseases - diagnosis; Orbital Diseases - diagnosis; Organometallic Compounds; Pentetic Acid - analogs & derivatives; Retrospective Studies; Sarcoidosis - diagnosis; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Human; Eye disease; Sarcoidosis; Visual pathway; Systemic disease; Orbit(eye) disease; Exploration; Orbit(eye); Nuclear magnetic resonance imaging; Differential diagnostic
• ISSN: 0195-6108; 1936-959X

To identify and characterize the MR findings of sarcoidosis when it involves the orbit and visual pathways. The MR scans of 15 patients, 3 with presumed and 12 with proved orbital or optic pathway sarcoidosis were retrospectively reviewed. Eight patients had MR evidence of optic nerve involvement by sarcoid granuloma. Perineural enhancement was seen in four cases, optic atrophy in one. Three who had had unenhanced scans showed optic nerve enlargement. Nine patients had optic chiasmal involvement. One patient had increased T2 signal in the optic radiations. Three patients had orbital masses that had MR signal characteristics similar to pseudotumor. Five patients had periventricular white matter abnormalities closely resembling multiple sclerosis. Sarcoidosis should be considered in the differential diagnosis of optic nerve or nerve sheath enhancement on MR. Orbital sarcoidosis has MR characteristics very similar to pseudotumor.