Role of radiology in the diagnosis of neurosarcoidosis

Clinical studies report a rate of 5 % and autopsy results a rate of 25 % of brain involvement in sarcoidosis. The aim of this study was to evaluate th e; role of radiology in the diagnosis of patients with neurosarcoidosis. Th e chest radiographs and MRI brain scans of 22 patients with sarcoidosis wer e retrospectively reviewed, along with the information that was provided in the request form and clinical charts. All patients had neurological signs and symptoms; 21 patients were examined with contrast enhancement. Facial n erve paralysis was the most common clinical manifestation identified in 10 patients. A wide spectrum of MR findings was noted: periventricular high-si gnal lesions on T2-weighted images (46 %); multiple supratentorial and infr atentorial brain lesions (36 %); solitary intra-axial mass (9 %); solitary extraaxial mass (5 %); and leptomeningeal enhancement (36 %). Neurological signs and symptoms can be significant manifestations of sarcoidosis. Magnet ic resonance imaging shows a wide spectrum of brain abnormalities associate d with neurosarcoidosis. The patient's history and chest X-ray are helpful in arriving at the correct diagnosis, but in selected cases with isolated b rain involvement biopsy may still be required.