title: Infraorbital nerve involvement on magnetic resonance imaging in European patients with IgG4-related ophthalmic disease: a specific sign.
abstract: OBJECTIVE
  To measure the frequency of infraorbital nerve enlargement (IONE) on magnetic resonance imaging (MRI) in European patients suffering from an IgG4-related ophthalmic disease (IgG4-ROD) as compared to patients suffering from non-IgG4-related ophthalmic disease (non-IgG4-ROD).
  
  
  METHODS
  From January 2006 through April 2015, 132 patients were admitted for non-lymphoma, non-thyroid-related orbital inflammation. Thirty-eight had both pre-therapeutic orbital MRI and histopathological IgG4 immunostaining. Fifteen patients were classified as cases of IgG4-ROD and 23 patients as cases of non-IgG4-ROD. Two readers performed blinded analyses of MRI images. The main criterion was the presence of an IONE, defined as the infraorbital nerve diameter being greater than the optic nerve diameter in the coronal section.
  
  
  RESULTS
  IONE was present in 53% (8/15) of IgG4-ROD cases whereas it was never present (0/23) in cases of non-IgG4-ROD (P < 0.0001). IONE was only present in cases where, on MRI, the inflammation of the inferior quadrant was present and in direct contact with the ION canal.
  
  
  CONCLUSIONS
  In European patients suffering from orbital inflammation, the presence of IONE on an MRI is a specific sign of IgG4-ROD. Recognition of this pattern may facilitate the accurate diagnosis for clinicians and allow for the adequate management and appropriate care of their patients.
  
  
  CONCLUSIONS
  • IONE on an MRI is a specific sign of IgG4-ROD. • IONE recognition allows for a quicker diagnosis and appropriate management. • IONE appears when inflammation is in direct contact with the ION canal.
authors.affiliation: Department of Radiology, Fondation Ophtalmologique Adolphe de Rothschild, 25 rue Manin, 75019, Paris, France.
authors.forename: J Ben
authors.initials: JB
authors.lastname: Soussan
authors.affiliation: Department of Neurology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.
authors.forename: R
authors.initials: R
authors.lastname: Deschamps
authors.affiliation: Department of Radiology, Fondation Ophtalmologique Adolphe de Rothschild, 25 rue Manin, 75019, Paris, France.
authors.forename: J C
authors.initials: JC
authors.lastname: Sadik
authors.affiliation: Department of Radiology, Fondation Ophtalmologique Adolphe de Rothschild, 25 rue Manin, 75019, Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Savatovsky
authors.affiliation: Department of Pathology, Bichat Hospital, APHP, Paris, France.
authors.forename: L
authors.initials: L
authors.lastname: Deschamps
authors.affiliation: Department of Pathology, Necker-Enfants Malades Hospital, APHP, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Puttermann
authors.affiliation: Department of Orbitopalpebral Surgery, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Zmuda
authors.affiliation: Department of Radiology, Fondation Ophtalmologique Adolphe de Rothschild, 25 rue Manin, 75019, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Heran
authors.affiliation: Department of Orbitopalpebral Surgery, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.
authors.forename: O
authors.initials: O
authors.lastname: Galatoire
authors.affiliation: Clinical Research Unit, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.
authors.forename: H
authors.initials: H
authors.lastname: Picard
authors.affiliation: Department of Radiology, Fondation Ophtalmologique Adolphe de Rothschild, 25 rue Manin, 75019, Paris, France. alecler@fo-rothschild.fr.
authors.forename: A
authors.identifier: http://orcid.org/0000-0001-7869-1815
authors.initials: A
authors.lastname: Lecler
mesh_terms: D005060:Europe; D005260:Female; D006801:Humans; D006984:Hypertrophy; D007074:Immunoglobulin G / Q000097:blood*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009900:Optic Nerve / Q000000981:diagnostic imaging / Q000473:pathology*; D009916:Orbital Diseases / Q000097:blood / Q000000981:diagnostic imaging* / Q000473:pathology; D010265:Paraproteinemias / Q000097:blood / Q000000981:diagnostic imaging* / Q000473:pathology; D012189:Retrospective Studies
chemical_list: D007074:Immunoglobulin G
keywords: Diagnosis; IgG4-related ophthalmic disease; Infra-orbital nerve enlargement; MRI; Orbital inflammation