title: 3.0T MR investigation of CLIPPERS: role of susceptibility weighted and perfusion weighted imaging.
abstract: For the first time we describe and interpret Susceptibility Weighted Imaging (SWI) and Perfusion Weighted Imaging (PWI) findings in a case of Chronic Lymphocytic Inflammation with Perivascular Pontine Enhancement Responsive to Steroids (CLIPPERS). The diagnosis of the disease was formulated on the basis of typical Magnetic Resonance (MR) findings and its responsiveness to steroids in a 40-year-old man with acute onset of dizziness, ataxia and diplopia. The patient underwent a 3 tesla (T) MR examination including SWI and PWI sequences. SWI revealed prominent veins and multiple hypointense lesions of different size widely distributed in brainstem and cerebellum, which could be expression of iron deposition or cellular infiltrates. PWI demonstrated global infratentorial hypoperfusion. SWI and PWI provide new information on CLIPPERS that might be helpful to understand the physiopathology of the disease. Further observations are needed to evaluate if these findings are peculiar for CLIPPERS and if they might have a role in a non-invasive diagnosis of the disease.
authors: Unit of Neuroradiology, AOUP, Santa Chiara Hospital, Pisa, Italy.
authors: Ilaria
authors: I
authors: Pesaresi
authors: Mario
authors: M
authors: Sabato
authors: Ilaria
authors: I
authors: Desideri
authors: Michele
authors: M
authors: Puglioli
authors: Policarpo
authors: P
authors: Moretti
authors: Mirco
authors: M
authors: Cosottini
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology; D001927:Brain Diseases / Q000175:diagnosis / Q000473:pathology*; D001933:Brain Stem / Q000473:pathology*; D002493:Central Nervous System Diseases / Q000175:diagnosis / Q000473:pathology; D002531:Cerebellum / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007249:Inflammation; D008214:Lymphocytes / Q000473:pathology; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D055420:Perfusion Imaging; D011149:Pons / Q000473:pathology; D013256:Steroids / Q000009:adverse effects
chemical_list: D013256:Steroids
keywords: 3.0 tesla; CLIPPERS; Inflammatory diseases; MR imaging; Perfusion weighted imaging; Susceptibility weighted imaging