Abstract

Purpose: Miliary enhancement refers to the presence of multiple small, monomorphic, enhancing foci on T1-weighted post-contrast MRI images. In the absence of a clear clinical presentation, a broad differential diagnosis may result in invasive procedures and possibly brain biopsy for diagnostic purposes. Methods: An extensive review of the literature is provided for diseases that may present with miliary enhancement on T1-weighted brain MR images. Additional disease-specific findings, both clinical and radiological, are summarized and categorized by the presence or absence of perivascular space involvement. Results: Miliary pattern of enhancement may be due to a variety of underlying causes, including inflammatory, infectious, nutritional or neoplastic processes. The recognition of disease spread along the perivascular spaces in addition to the detection or exclusion of disease-specific features on MRI images, such as leptomeningeal enhancement, presence of haemorrhagic lesions, spinal cord involvement and specific localisation or systemic involvement, allows to narrow the potential differential diagnoses. Conclusion: A systematic approach to disease-specific findings from both clinical and radiological perspectives might facilitate diagnostic work-up, and recognition of disease spread along the perivascular spaces may help narrowing down differential diagnoses and may help to minimize the use of invasive diagnostic procedures.
Original languageEnglish
JournalNeuroradiology
DOIs
Publication statusPublished - 2020

Cite this

@article{6a36f6164d134f3987c7645a16df6220,
title = "Brain miliary enhancement",
abstract = "Purpose: Miliary enhancement refers to the presence of multiple small, monomorphic, enhancing foci on T1-weighted post-contrast MRI images. In the absence of a clear clinical presentation, a broad differential diagnosis may result in invasive procedures and possibly brain biopsy for diagnostic purposes. Methods: An extensive review of the literature is provided for diseases that may present with miliary enhancement on T1-weighted brain MR images. Additional disease-specific findings, both clinical and radiological, are summarized and categorized by the presence or absence of perivascular space involvement. Results: Miliary pattern of enhancement may be due to a variety of underlying causes, including inflammatory, infectious, nutritional or neoplastic processes. The recognition of disease spread along the perivascular spaces in addition to the detection or exclusion of disease-specific features on MRI images, such as leptomeningeal enhancement, presence of haemorrhagic lesions, spinal cord involvement and specific localisation or systemic involvement, allows to narrow the potential differential diagnoses. Conclusion: A systematic approach to disease-specific findings from both clinical and radiological perspectives might facilitate diagnostic work-up, and recognition of disease spread along the perivascular spaces may help narrowing down differential diagnoses and may help to minimize the use of invasive diagnostic procedures.",
keywords = "Brain, Contrast, Magnetic resonance imaging, Miliary, Virchow–Robin spaces",
author = "Bot, {Joseph C. J.} and Linda Mazzai and Hagenbeek, {Rogier E.} and Silvia Ingala and {van Oosten}, Bob and Esther Sanchez-Aliaga and Frederik Barkhof",
year = "2020",
doi = "10.1007/s00234-019-02335-5",
language = "English",
journal = "Neuroradiology",
issn = "0028-3940",
publisher = "Springer Verlag",

}

Brain miliary enhancement. / Bot, Joseph C. J.; Mazzai, Linda; Hagenbeek, Rogier E.; Ingala, Silvia; van Oosten, Bob; Sanchez-Aliaga, Esther; Barkhof, Frederik.

In: Neuroradiology, 2020.

Research output: Contribution to journalReview articleAcademicpeer-review

TY - JOUR

T1 - Brain miliary enhancement

AU - Bot, Joseph C. J.

AU - Mazzai, Linda

AU - Hagenbeek, Rogier E.

AU - Ingala, Silvia

AU - van Oosten, Bob

AU - Sanchez-Aliaga, Esther

AU - Barkhof, Frederik

PY - 2020

Y1 - 2020

N2 - Purpose: Miliary enhancement refers to the presence of multiple small, monomorphic, enhancing foci on T1-weighted post-contrast MRI images. In the absence of a clear clinical presentation, a broad differential diagnosis may result in invasive procedures and possibly brain biopsy for diagnostic purposes. Methods: An extensive review of the literature is provided for diseases that may present with miliary enhancement on T1-weighted brain MR images. Additional disease-specific findings, both clinical and radiological, are summarized and categorized by the presence or absence of perivascular space involvement. Results: Miliary pattern of enhancement may be due to a variety of underlying causes, including inflammatory, infectious, nutritional or neoplastic processes. The recognition of disease spread along the perivascular spaces in addition to the detection or exclusion of disease-specific features on MRI images, such as leptomeningeal enhancement, presence of haemorrhagic lesions, spinal cord involvement and specific localisation or systemic involvement, allows to narrow the potential differential diagnoses. Conclusion: A systematic approach to disease-specific findings from both clinical and radiological perspectives might facilitate diagnostic work-up, and recognition of disease spread along the perivascular spaces may help narrowing down differential diagnoses and may help to minimize the use of invasive diagnostic procedures.

AB - Purpose: Miliary enhancement refers to the presence of multiple small, monomorphic, enhancing foci on T1-weighted post-contrast MRI images. In the absence of a clear clinical presentation, a broad differential diagnosis may result in invasive procedures and possibly brain biopsy for diagnostic purposes. Methods: An extensive review of the literature is provided for diseases that may present with miliary enhancement on T1-weighted brain MR images. Additional disease-specific findings, both clinical and radiological, are summarized and categorized by the presence or absence of perivascular space involvement. Results: Miliary pattern of enhancement may be due to a variety of underlying causes, including inflammatory, infectious, nutritional or neoplastic processes. The recognition of disease spread along the perivascular spaces in addition to the detection or exclusion of disease-specific features on MRI images, such as leptomeningeal enhancement, presence of haemorrhagic lesions, spinal cord involvement and specific localisation or systemic involvement, allows to narrow the potential differential diagnoses. Conclusion: A systematic approach to disease-specific findings from both clinical and radiological perspectives might facilitate diagnostic work-up, and recognition of disease spread along the perivascular spaces may help narrowing down differential diagnoses and may help to minimize the use of invasive diagnostic procedures.

KW - Brain

KW - Contrast

KW - Magnetic resonance imaging

KW - Miliary

KW - Virchow–Robin spaces

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85077721910&origin=inward

UR - https://www.ncbi.nlm.nih.gov/pubmed/31925469

U2 - 10.1007/s00234-019-02335-5

DO - 10.1007/s00234-019-02335-5

M3 - Review article

JO - Neuroradiology

JF - Neuroradiology

SN - 0028-3940

ER -