Clinical Utility of Diffusion-weighted Whole-body Magnetic Resonance Imaging with Background Body Signal Suppression for Assessing and Monitoring IgG4-related Disease

Intern Med. 2020 Apr 1;59(7):951-955. doi: 10.2169/internalmedicine.3712-19. Epub 2019 Nov 29.

Abstract

A 77-year-old man with symptoms of chest pain was diagnosed with immunoglobulin G4 (IgG4)-related disease. Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) revealed an intense uptake in the submandibular gland, lymph nodes and abdominal aortic wall. Diffusion-weighted imaging with background body signal suppression (DWIBS) revealed signal enhancements at the same location as those of the FDG-PET/CT findings. The DWIBS signal intensity decreased after steroid treatment, so we decreased the steroid dosage. Relapse did not occur. DWIBS makes it possible to adjust the medicine dosage while confirming the therapeutic effects and will likely be a useful method for monitoring IgG4-related disease.

Keywords: DWIBS; IgG4-related disease; MRI.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Inflammatory Agents / therapeutic use*
  • Diffusion Magnetic Resonance Imaging / methods
  • Humans
  • Immunoglobulin G4-Related Disease / diagnosis*
  • Immunoglobulin G4-Related Disease / drug therapy*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Multimodal Imaging / methods*
  • Positron Emission Tomography Computed Tomography / methods*
  • Prednisolone / therapeutic use*
  • Tomography, Spiral Computed / methods
  • Treatment Outcome
  • Whole Body Imaging / methods*

Substances

  • Anti-Inflammatory Agents
  • Prednisolone