ARRS 2022 Abstracts


E1696. Navigating the Imaging Manifestations Of Neurosarcoidosis
  1. Mussanna Ahmed; SUNY Downstate Health Sciences University
  2. Mossum Sawhney; SUNY Downstate Health Sciences University
  3. Christian Fourquet; SUNY Downstate Health Sciences University
  4. Anju Dubey; SUNY Downstate Health Sciences University
Sarcoidosis is a systemic inflammatory disease characterized by the formation of noncaseating granulomas in many tissues. Pulmonary and lymph node involvement is characteristic. Bilateral hilar lymphadenopathy and pulmonary parenchymal involvement is commonly evident on chest imaging in the majority of patients. Multiple extrapulmonary organs may be affected. CNS involvement may be seen in 5–25% of cases. A multimodal approach is usually required to establish a diagnosis of neurosarcoidosis, utilizing a combination of laboratory parameters such as serum angiotensin-converting enzyme (ACE) levels and cerebrospinal fluid (CSF) analysis, in conjunction with neuroimaging. MRI is the preferred modality to evaluate for meningeal, parenchymal, and cranial nerve involvement.

Educational Goals / Teaching Points
Sarcoidosis is a systemic disease featuring noncaseating granuloma in many tissues. This exhibit includes an overview the epidemiology and diagnostic approach for sarcoidosis and reviews common and uncommon imaging findings on MRI.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This exhibit reviews the imaging distribution of neurosarcoidosis. CNS disease most often involves the leptomeninges, cranial nerves and hypothalamus/infundibulum, but can also include pachymeninges and brain parenchyma. Spinal cord involvement is not uncommon. In head and neck disease, the orbit, lacrimal glands, and salivary glands are most often involved. Enlarged cervical lymph nodes may be seen. Infrequently, tracheal or laryngeal thickening may be seen.

Neurosarcoidosis has a spectrum of imaging appearances. Diagnosis requires correlation of clinical and imaging findings.