[Magnetic resonance imaging and PET/CT with 11C-methionine for primary central nervous system vasculitis].

Abstract

Primary central nervous system vasculitis is still a challenge due to rarity of disease, unspecific clinical and neurological presentation, as well as low specificity of MRI and laboratory tests.

Objective: To present the potential of hybrid neuroimaging in diagnosis of primary central nervous system vasculitis.

Material and methods: The results of MRI, PET/CT with 11C-methionine, histological and immunochemical data in a 23-year-old patient with first-time epileptic seizure are demonstrated.

Results: MRI revealed multifocal lesion of the left frontal lobe with contrast accumulation, edema and mass effect. The largest lesion demonstrated high 11C-methionine uptake that was typical for tumor. Stereotactic biopsy of this lesion was performed. Morphological examination revealed lymphocytic vasculitis.

Conclusion: Radiological and metabolic semiotics of primary central nervous system vasculitis can mimic cerebral tumor. High ¹¹C-methionine uptake in active inflammation focus is valuable to choose the target for biopsy.