MRI findings in neuro-Behcet's disease

AIM: To evaluate the pattern and site of involvement in neuro-Behcet's dise ase (NBD). MATERIALS AND METHODS: Twenty-one patients with NBD were evaluated, Using 1 .5T magnetic resonance imaging (MRT), T1-weighted axial and sagittal images , gadolinium enhanced axial and coronal images and T2-weighted axial images were obtained, RESULTS: The brainstem, basal ganglia, cerebral white matter, internal caps ule, thalamus and spinal cord were involved in eighteen, nine, nine, seven, six and two patients, respectively, In nine patients with cerebral white m atter involvement, four had subcortical involvement and three had periventr icular involvement, in addition to two patients with focal deep white matte r lesions, Among the brainstem lesions, pens involvement was seen in fourte en patients, all had ventrally located lesions, and nine had tegmental invo lvement, Midbrain involvement was seen in fourteen patients; the cerebral p eduncle was involved in 11 of these, Five patients had brainstem atrophy: t wo cases were demonstrated at initial MRI, the other three cases were seen on follow-up MRI. Pyramidal signs, the most common neurological signs, were demonstrated in fourteen patients. Follow-up MRI was obtained 10 days to 2 0 months after the initial MRI in eight cases; all showed changes in size, shape and site of involvement, After gadolinium enhancement, thirteen patie nts demonstrated mottled non-confluent enhancement in the brainstem (eight patients), posterior limb of the internal capsule (three patients), pachyme ninges (two patients) and spinal cord (two patients). CONCLUSION: NBD manifests a reversible course, but chronic NBD may result i n brainstem atrophy, Characteristic involvement along the corticospinal tra ct is well correlated with neurological signs. (C) 2001 The Royal College o f Radiologists.