Magnetic resonance imaging evaluation of head and neck involvement in IgG4-related disease

Abstract

Objective: To evaluate the radiological features of IgG4-related disease (IgG4-RD) in the head and neck region. Methods: In this radiology-based study, radiological features, clinical, laboratory, pathological findings, and prognosis of nine patients with head and neck involvement diagnosed with IgG4-RD were investigated retrospectively. Results: The median age of the patients was 38 years (range: 2.5-79 years), and there were six males and three females. The most common symptoms and clinical findings of the patients were eyelid and lacrimal gland swelling, painless exophthalmos, and ophthalmoplegia. The most common site of involvement on MRI was the orbit. Orbital involvement was followed by branches of the trigeminal nerve, sinonasal cavity, cervical lymph nodes, and dural involvement. The most common and remarkable imaging features were T2 hypointensity and diffuse homogeneous contrast enhancement. Conclusions: Head and neck involvement of the IgG4-RD, has specific imaging features that can help with diagnosis. Thus, early diagnosis and better outcomes can be achieved with increasing awareness of these features of this relatively new pathology.

Keywords

• igg4; head and neck imaging; magnetic resonance imaging; orbit; perineural spreading