RSNA 2003 

Abstract Archives of the RSNA, 2003


M23-1194

Eosinophilic Fasciitis: MR Imaging Characteristics

Scientific Papers

Presented on December 3, 2003
Presented as part of M23: Musculoskeletal (Muscle and Soft-Tissue Disorders)

Participants

Stacy Moulton MD, PRESENTER: Nothing to Disclose

Abstract: HTML Purpose: To descibe the spectrum of MR imaging features in eosinophilic fasciitis. Methods and Materials: We retrospecively reviewed the MR imaging findings and presenting clinical symptoms in five patients with eosinophilic fasciitis. Diagnosis was made by a combination of clinical, laboratory, and histologic evaluation. Study group consisted of three men and two women, mean age 60 years (range 49-67). A total of ten studies were reviewed, including forearm (n=6) and calf (n=4). All imaging was done utilizing high-field strength magnets and included T1-weighted and fluid sensitive sequences. Gadolinium enhanced imaging was done in eight cases. Images were evaluated for intensity and location of abnormal signal and enhancement. Clinical evaluation included presenting symptoms and extent of peripheral eosinophilia. Patients were categorized as acute (n=3; 6 studies), subacute (n=1; 3 studies), and chronic (n=1; 1 study) according to duration of symptoms at time of imaging (acute = <6 months; subacute = 6-12 months; and chronic = > 12 months). Results: MR images in acute disease demonstrated both intense increased signal on fluid sensitive sequences and marked enhancement following contrast administration (n=6). Findings were centered on the fascia (n=6) with slight signal abnormality in the adjacent muscle (n=6). T1-weighted images in acute disease showed prominent fascial thickening with slight increased signal relative to muscle (n=3). Findings were similar, but less marked in the subacute group, and significantly reduced in the chronic group. All patients demonstrated peripheral eosinophilia at the time of presentation. Presenting symptoms included extremity stiffness (n=2), swelling (n=5), and pain with exertion (n=2). Physical exam demonstrated induration in four patients. All patients denied Raynaud's phenomenon. None were immunocomprised or had a history of bone marrow transplant. Biopsy was performed on all patients with three of the biopsies demonstrating findings consistent with eosinophilic fasciitis. The other two patients biopsy specimens did not include fascia and were therefore deemed inadequate. Conclusion: MR imaging findings in eosinophilic fasciitis are characteristic, clearly demonstrating the presence of fascial involvement. Both signal intensity and enhancement are directly proportional to disease activity. Therefore, MR imaging provides a useful aid for diagnosis, as well as a marker for disease activity and response to treatment.       Questions about this event email: moulton.stacy@mayo.edu

Cite This Abstract

Moulton MD, S, Eosinophilic Fasciitis: MR Imaging Characteristics.  Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL. http://archive.rsna.org/2003/3101203.html