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Figure 3 | BMC Medicine

Figure 3

From: Clinical considerations and key issues in the management of patients with Erdheim-Chester Disease: a seven case series

Figure 3

Various intracranial MRI findings of patients #1, #2 and #4. Coronal T1 weighted, gadolinium enhanced MR images of the retro-bulbar regions of patient #1 one year following diagnosis (A) and 4.5 years after diagnosis (B). The former (A) demonstrates bilateral nodular masses located at the superior lateral aspect of the retro-orbit. These masses involve both the lacrimal glands and superior rectus muscles and undergo heterogeneous enhancement following gadolinium administration. The latter (B) demonstrates a marked reduction in the size of these lesions, presumably due to treatment with interferon-α. (C) Coronal T1 weighted, gadolinium enhanced MR image of patient #1 showing mucosal thickening in the sphenoidal sinus as well as soft tissue fullness which undergoes enhancement following gadolinium administration. This finding is also apparent in patient #4 (F), who also exhibits an extra axial enhancing lesion situated in the vicinity of the planum sphenoidale (E). In SWI sequence, both patients #4 (D) and #2 (G) exhibit multiple punctate hypointensities in the basal ganglia. These patterns are not typical for senile calcifications. Patient #2 also exhibits infiltrative enhancing tissue which narrows the transverse left sinus, adjacent to the falx and tentorium (I). The same tissue is seen displacing the superior sagittal sinus (H). MR, magnetic resonance; SWI, susceptibility weighted imaging.

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