3.0T MR investigation of CLIPPERS: role of susceptibility weighted and perfusion weighted imaging

Magn Reson Imaging. 2013 Nov;31(9):1640-2. doi: 10.1016/j.mri.2013.06.012. Epub 2013 Aug 19.


For the first time we describe and interpret Susceptibility Weighted Imaging (SWI) and Perfusion Weighted Imaging (PWI) findings in a case of Chronic Lymphocytic Inflammation with Perivascular Pontine Enhancement Responsive to Steroids (CLIPPERS). The diagnosis of the disease was formulated on the basis of typical Magnetic Resonance (MR) findings and its responsiveness to steroids in a 40-year-old man with acute onset of dizziness, ataxia and diplopia. The patient underwent a 3 tesla (T) MR examination including SWI and PWI sequences. SWI revealed prominent veins and multiple hypointense lesions of different size widely distributed in brainstem and cerebellum, which could be expression of iron deposition or cellular infiltrates. PWI demonstrated global infratentorial hypoperfusion. SWI and PWI provide new information on CLIPPERS that might be helpful to understand the physiopathology of the disease. Further observations are needed to evaluate if these findings are peculiar for CLIPPERS and if they might have a role in a non-invasive diagnosis of the disease.

Keywords: 3.0 tesla; CLIPPERS; Inflammatory diseases; MR imaging; Perfusion weighted imaging; Susceptibility weighted imaging.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Brain / pathology
  • Brain Diseases / diagnosis
  • Brain Diseases / pathology*
  • Brain Stem / pathology*
  • Central Nervous System Diseases / diagnosis
  • Central Nervous System Diseases / pathology
  • Cerebellum / pathology*
  • Humans
  • Image Processing, Computer-Assisted
  • Inflammation
  • Lymphocytes / pathology
  • Magnetic Resonance Angiography*
  • Magnetic Resonance Imaging*
  • Male
  • Perfusion Imaging
  • Pons / pathology
  • Steroids / adverse effects


  • Steroids