Hypertrophic pachymeningitis (HP) is a rare and chronic inflammatory disorder presenting
as localized or diffuse thickening of the dura mater. It can be idiopathic or an unusual
manifestation of immune-mediated, infectious, and neoplastic conditions. Although
some cases may remain asymptomatic, HP can lead to progressive headaches, cranial
nerve palsies, hydrocephalus, and other neurological complications, which makes its
recognition a fundamental step for prompt treatment. Regarding the diagnosis workup,
enhanced MRI is the most useful imaging method to evaluate dural thickening. This
article addresses the MR imaging patterns of immune-mediated HP, including immunoglobulin
G4-related disease, neurosarcoidosis, granulomatosis with polyangiitis, rheumatoid
pachymeningitis, and idiopathic HP. The main infectious and neoplastic mimicking entities
are also discussed with reference to conventional and advanced MR sequences.
Graphical Abstract
Graphical Abstract
Key Words
Abbreviations:
HP (Hypertrophic Pachymeningitis), CT (Computed Tomography), MRI (Magnetic Resonance Imaging), WI (Weighted Imaging), IgG4-RD (Immunoglobulin G4-Related Disease), NS (Neurosarcoidosis), GPA (Granulomatosis with Polyangiitis), RP (Rheumatoid pachymeningitis), IH (Intracranial Hypotension), CNS (Central nervous system), PNS (Peripheral nervous system), RA (Rheumatoid Arthritis), CSF (Cerebrospinal fluid), VDRL (Venereal Disease Research Laboratory), FTA-ABS (Fluorescent Treponemal Antibody Absorption)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 06, 2023
Accepted:
January 13,
2023
Received in revised form:
January 8,
2023
Received:
July 16,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
