Magnetic resonance imaging of uveitis

• Published in: Neuroradiology Vol. 57; no. 8; pp. 825 - 832
• Main Authors: Li, Charles Q., Cho, Aaron A., Edward, Neeraj J., Edward, Deepak P., Fajardo, Roman G., Mafee, Mahmood F.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-08-2015; Springer Nature B.V
• Subjects: Evidence-Based Medicine; Eye diseases; Head and Neck Radiology; Humans; Image Enhancement - methods; Imaging; Inflammation; Magnetic Resonance Imaging - methods; Medicine; Medicine & Public Health; Mycobacterium; Neurology; Neuroradiology; Neurosciences; Neurosurgery; NMR; Nuclear magnetic resonance; Radiology; Reproducibility of Results; Sensitivity and Specificity; Tomography; Uveitis - pathology; Inflammatory conditions; Ocular disease; Magnetic resonance imaging; Computed tomography; Uveitis
• ISSN: 0028-3940; 1432-1920
• DOI: 10.1007/s00234-015-1531-7

Introduction
Uveitis is a term used to describe inflammation of the choroid, iris, or ciliary body, which make up the uveal tract. It can be idiopathic or associated with a systemic disease which may be infectious or noninfectious. With the exception of B-scan ultrasonography, current imaging methods for diagnosing and monitoring uveitis are predominately non-radiologic. Although MRI has been anecdotally shown to detect various inflammatory conditions of the globe, such as posterior scleritis, endophthalmitis, and posterior uveitis secondary to Vogt-Koyanagi-Harada disease, a more comprehensive review of the MRI findings in uveitis of various etiologies is presented here.
Methods
The MRI and CT studies of seven patients with uveitis and the clinical history of three of them (not available in four patients) were reviewed. Etiologies included ankylosing spondylitis, relapsing polychondritis, Vogt-Koyanagi-Harada disease, sarcoidosis, and tuberculosis.
Results
Increased gadolinium enhancement of the uveal tract, which is visualized as the enhancing layer immediately deep to the low-signal sclera, was seen on all six MRI studies. Diffusion-weighted imaging of a case with posterior uveitis and subretinal effusions revealed restriction within the uvea and effusions. Two patients had inflammatory nodules adherent to the uvea, two patients had vitreous humor abnormalities, and one patient exhibited proximal perineural and perimuscular spread of enhancement. Uveoscleral thickening and enhancement with a posterior calcification were observed in the patient with chronic uveitis imaged with CT.
Conclusions
Increased uveal tract enhancement is a common finding in patients with uveitis, regardless of anatomic distribution and etiology. MRI can also further evaluate complications of uveitis and help differentiate it from masquerade syndromes.