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2015, Number 3

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Anales de Radiología México 2015; 14 (3)

Granulomatosis with polyangiitis in images of head and neck: what the radiologist needs to know

Delgado-Hernández RD, Reynoso-Topete A, Tovar-Calderón IL, Higuera V, Ruiz N, Vázquez-Lamadrid J, Flores-Suárez LF

Language: Spanish
References: 30
Page: 262-272
PDF size: 543.64 Kb.


ABSTRACT

Granulomatosis with polyangiitis is a necrotising vasculitis with multisystem granulomatous inflammation which predominantly affects small blood vessels; it is associated with anti-neutrophil cytoplasmic antibodies (ANCAs). The purpose of this article is to describe the most common image findings in the areas of the head and the neck, in patients with granulomatosis with polyangiitis. To date no Mexican publications provide orientation on this point. The paranasal sinuses and the nasal septum are the best known areas, in head and neck, for this disease; however, disorders which may appear in eye sockets, ear, central nervous system, pituitary gland, and larynx, even without clinical manifestation at the time of image evaluation, should not be overlooked. It is important to opportunely report lesions due to granulomatosis with polyangiitis which suggest activity identified by imaging methods to the clinical physician and perform comparative studies to assess new lesions. In most cases active lesions identified by imaging are characterized by heightened signal intensity following administration of intravenous contrast medium, using T1 weighted sequences with fatty suppression. Image findings which suggest activity may be compared at different evolution times to determine possible remission or for histological confirmation. Long term, the presence of active lesions will help modify treatment, which may include starting corticoids or modifying or intensifying their use.


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