1naresh2naresh<pre>Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [ab35dea6-bf25-426c-a032-845a764e4427] => Array
        (
            [runtime-id] => ab35dea6-bf25-426c-a032-845a764e4427
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [dd7624c0-e186-4d5c-95f4-5c3b79232600] => Array
                        (
                            [runtime-id] => dd7624c0-e186-4d5c-95f4-5c3b79232600
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;0128a1b783ad72129d1990321d082c30df51143b
                )

        )

)
1naresh2naresh<pre>Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => FreeToRead
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [e5c050ae-f88a-4869-a044-e7b8d08f79a1] => Array
        (
            [runtime-id] => e5c050ae-f88a-4869-a044-e7b8d08f79a1
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => FreeToRead
            [privilege] => Array
                (
                    [9fb33414-bbef-4376-98c2-97bd303f32e8] => Array
                        (
                            [runtime-id] => 9fb33414-bbef-4376-98c2-97bd303f32e8
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;0128a1b783ad72129d1990321d082c30df51143b
                )

        )

)
PT  - JOURNAL ARTICLE
AU  - Prayer, Daniela
AU  - Grois, Nicole
AU  - Prosch, Helmut
AU  - Gadner, Helmut
AU  - Barkovich, Anthony J.
TI  - MR Imaging Presentation of Intracranial Disease Associated with Langerhans Cell Histiocytosis
DP  - 2004 May 01
TA  - American Journal of Neuroradiology
PG  - 880--891
VI  - 25
IP  - 5
4099  - http://www.ajnr.org/content/25/5/880.short
4100  - http://www.ajnr.org/content/25/5/880.full
SO  - Am. J. Neuroradiol.2004 May 01; 25
AB  - BACKGROUND AND PURPOSE: Intracranial manifestations of Langerhans cell histiocytosis (LCH) are underestimated in frequency and diversity. We categorized the spectrum of MR imaging changes in LCH.METHODS: We retrospectively reviewed 474 MR images in 163 patients with LCH and 55 control subjects. Lesions were characterized by anatomic region and signal intensity. Brain atrophy was assessed.RESULTS: We noted osseous lesions in the craniofacial or skull bones in 56% of patients, meningeal lesions in 29%, and choroid-plexus involvement in 6%. In the hypothalamic-pituitary region, infundibular thickening occurred in 50%; pronounced hypothalamic mass lesions in 10%; and infundibular atrophy in 29%. The pineal gland had a cystic appearance in 28%, and pineal-gland enlargement (&amp;gt;10 mm) was noted in 14%. Nonspecific paranasal-sinus or mastoid opacifications were seen in 55% of patients versus 20% of controls, and accentuated Virchow-Robin spaces occurred in 70% of patients versus 27% of controls (P &amp;lt; .001). Intra-axial, white-matter parenchymal changes resulted in a leukoencephalopathy-like pattern in 36%. Enhancing lesions in a vascular distribution were noted in 5%. Gray-matter changes suggestive of neurodegeneration were identified in the cerebellar dentate nucleus in 40% and in the supratentorial basal ganglia in 26%. All patients with neurodegenerative lesions had lesions in the extra-axial spaces. Cerebral atrophy was found in 8%.CONCLUSION: In LCH, cranial and intracranial changes at MR imaging include 1) lesions of the craniofacial bone and skull base with or without soft-tissue extension; 2) intracranial, extra-axial changes (hypothalamic-pituitary region, meninges, circumventricular organs); 3) intracranial, intra-axial changes (white matter and gray matter); and 4) cerebral atrophy.