Contrast-enhanced T2-FLAIR MR imaging in patients with uveitis.

Abstract

To report MRI findings which reflect a pathological inflammatory condition of the uveal tract. This study includes single-center retrospective case series of five patients with clinical diagnosis of uveitis. There were 1 male (20%) and 4 female patients (80%). The average age was 29.6years (range 25-38years). Patients and 50 age-range-matched control subjects were scanned using a 1.5 T scanner. Ten additional control subjects scanned at 3 T were evaluated to have reference images at that high field. All patients (n=5, 100%) presented uveal tract enhancement on post-contrast T2-FLAIR fat-suppressed images and only 2 (40%) had enhancement on T1-weighted images. The enhancement was anterior in 2 (40%), pan-uveal in 2 (40%), and posterior in 1 patient (20%). Two patients (40%) had unilateral increased vitreous signal on T2-FLAIR. One patient (20%) had bilateral retrobulbar fat enhancement in both post-contrast T2-FLAIR and T1-weighted images. Post-contrast T2-FLAIR images can reveal abnormal enhancement of the uveal tract and retrobulbar fat as well as increased vitreous signal in patients with uveitis. In our small series, the sensitivity of post-contrast T2-FLAIR was higher than the conventional post-contrast T1-weighted images. Nonetheless, when bilateral uveal tract enhancement is present, there should be discretion before calling uveitis because the finding has been reported in different eye conditions as well as in a small percentage of healthy subjects at 1.5 T. In addition, it should be noted that post-contrast T2-FLAIR enhancement of the uveal tract is a normal finding at 3 T imaging.