Characterizing Persistent CNS MRI Enhancement in Patients With Treated Neurosarcoidosis

BACKGROUND AND OBJECTIVES: The aim of this study was to quantify the relative percentage of patients with neurosarcoidosis who demonstrate persistent gadolinium enhancement on MRI, despite apparent clinical remission. METHODS: Data from 39 patients with neurosarcoidosis were collected retrospectively for use in electronic chart analysis. Data were anonymized, and patient data (demographics, clinical presentation, radiographic characteristics, and treatment profile) were collected. Standard descriptive statistics were performed, comparing populations with and without persistent gadolinium enhancement. RESULTS: There was no significant difference in disease and treatment data between patient groups with and without persistent gadolinium enhancement. Persistent gadolinium enhancement was common and not associated with clinical disease activity in patients with neurosarcoidosis. There was no correlation between radiographic and clinical improvements. DISCUSSION: Our study demonstrates that persistent gadolinium enhancement is common and does not necessarily correspond to active disease. Given that neurosarcoidosis is commonly monitored with serial MR imaging, these data suggest that persistent enhancement alone should not be used to guide treatment and needs to be taken in the context of the patients' clinical status, previous imaging findings, and examination.