Contrast-enhanced flair imaging in the evaluation of infectious leptomeningeal diseases

Parmar, Hemant; Sitoh, Yih Yian; Anand, Pooja; Chua, Violet; Hui, Francis

doi:10.1016/j.ejrad.2005.11.012

Cited by 61 publications

(49 citation statements)

References 12 publications

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“…However, as the T2 relaxation time of the lesion itself also influences signal intensity in ceFLAIR, lesion visibility might be reduced in some cases 8. As a result, the diagnostic value of ceFLAIR to detect brain disease in human medicine is controversial 9, 10, 11, 12, 13, 14, 15, 16, 17. In veterinary medicine, ceFLAIR is superior to precontrast FLAIR sequences (nFLAIR) and contrast‐enhanced T1‐weighted (ceT1W) sequences for the detection of brain lesions 5.…”

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confidence: 99%

Use of Contrast‐Enhanced Fluid‐Attenuated Inversion Recovery Sequence to Detect Brain Lesions in Dogs and Cats

Merhof¹,

Lang²,

Dürr

et al. 2014

Veterinary Internal Medicne

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BackgroundThe diagnostic value of a contrast‐enhanced T2‐weighted FLAIR sequence (ceFLAIR) in brain imaging is unclear.Hypothesis/ObjectivesThat the number of brain lesions detected with ceFLAIR would be no greater than the sum of lesions detected with nFLAIR and ceT1W sequence.AnimalsOne hundred and twenty‐nine animals (108 dogs and 21 cats) undergoing magnetic resonance imaging (MRI) of the head between July 2010 and October 2011 were included in the study.MethodsA transverse ceFLAIR was added to a standard brain MRI protocol. Presence and number of lesions were determined based on all available MRI sequences by 3 examiners in consensus and lesion visibility was evaluated for nFLAIR, ceFLAIR, and ceT1W sequences.ResultsEighty‐three lesions (58 intra‐axial and 25 extra‐axial) were identified in 51 patients. Five lesions were detected with nFLAIR alone, 2 with ceT1W alone, and 1 with ceFLAIR alone. Significantly higher numbers of lesions were detected using ceFLAIR than nFLAIR (76 versus 67 lesions; P = 0.04), in particular for lesions also detected with ceT1W images (53 versus 40; P =.01). There was no significant difference between the number of lesions detected with combined nFLAIR and ceT1W sequences compared to those detected with ceFLAIR (82 versus 76; P =.25).Conclusion and Clinical ImportanceUse of ceFLAIR as a complementary sequence to nFLAIR and ceT1W sequences did not improve the detection of brain lesions and cannot be recommended as part of a routine brain MRI protocol in dogs and cats with suspected brain lesions.

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confidence: 99%

Use of Contrast‐Enhanced Fluid‐Attenuated Inversion Recovery Sequence to Detect Brain Lesions in Dogs and Cats

Merhof¹,

Lang²,

Dürr

et al. 2014

Veterinary Internal Medicne

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“…However, in the last decade, post-contrast Fluid Attenuated Inversion Recovery (PCFLAIR) has emerged as a useful sequence to evaluate leptomeningeal pathologies [4][5][6][7][8][9][10][11][12][13][14][15][16]. The nullification of CSF signal, inconspicuous vascular enhancement as compared to T1-weighted imaging (T1WI) and some degree of T1 relaxivity effect makes meningeal enhancement easily discernible on PCFLAIR images [7,[11][12][13][14]. Despite its utility in leptomeningeal diseases, there have been controversies regarding the routine use of PCFLAIR in MR practice and its relative advantage over post contrast T1WI (PCT1W) with or without fat suppression (FS) [15][16][17][18].…”

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confidence: 99%

Differentiation of Leptomeningeal and Vascular Enhancement on Post-contrast FLAIR MRI Sequence: Role in Early Detection of Infectious Meningitis

Ahmad¹,

Azad²,

Azad³

2015

JCDR

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“…Sekarang ini, MRI kepala sekuens T2 fluid attenuated inversion recovery dengan pemberian kontras gadolinium-DTPA (selanjutnya disebut T2-FLAIR post contrast) banyak diteliti oleh para ahli untuk mendeteksi keberadaan penyangatan meningeal pada meningitis TB. 14,15 Pada penelitian yang telah dilakukan oleh Splendiani dkk.…”

Section: -13unclassified

“…16 di Pakistan, dan juga Parmar dkk. 15 di Singapura menyatakan bahwa pemeriksaan MRI kepala pada pasien suspek meningitis dengan sekuens T2-FLAIR poskontras lebih sensitif dan spesifik daripada T1WI poskontras dalam mendeteksi keberadaan penyangatan meningeal tersebut. Penelitian yang dilakukan oleh Stuckey dkk.…”

Section: -13unclassified

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Perbedaan Intensitas Penyengatan Meningeal Hasil MRI antara Sekuens T2 FLAIR Post Contrast dan T1WI Post Contrast Gadolinium-DTPA dalam Mendeteksi Penyangatan Meningeal pada Kasus Meningitis Tuberkulosis

Hendarin¹,

Soetikno²,

Nugraha³

2017

mkb

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AbstrakDiagnosis meningitis TB terutama pada kasus possible dan probable sulit ditegakkan. Pemeriksaan MRI kepala dengan kontras Gadolinium-DTPA adalah modalitas radiologi yang paling sensitif untuk membantu mendiagnosis penyakit ini. Penyangatan meningeal di daerah basal merupakan gambaran MRI yang paling banyak ditemukan pada meningitis TB. Tujuan penelitian ini adalah mengetahui perbedaan peningkatan intensitas sinyal meningen sekuens T2-FLAIR dengan T1WI pada pasien meningitis tuberkulosis menggunakan pemeriksaan MRI kepala dengan kontras Gadolinium-DTPA di RSUP Dr. Hasan Sadikin Bandung pada bulan Januari 2015-Juni 2016. Subjek penelitian sebanyak 21 orang dengan meningitis TB dilakukan pemeriksaan MRI kepala dengan kontras Gadolinium-DTPA. Analisis statistik komparatif dilakukan untuk menguji perbedaan peningkatan intensitas sinyal meningen sekuens T2-FLAIR post contrast dengan T1WI post contrast. Hasil penelitian menujukkan rerata peningkatan intensitas sinyal meningen sekuen T2-FLAIR (∆T2-FLAIR) sebesar 360,59±182,19 aμ sedangkan T1WI (∆T1WI) sebesar 126,47±72,57 aμ. Hasil uji statistik menggunakan uji T pada derajat kepercayaan 95% menunjukkan perbedaan yang bermakna ∆T2-FLAIR dengan ∆T1WI pada nilai p=0,000. Difference between Gadolinium-DTPA Enhanced T2 FLAIR Sequence and T1WI Sequence MRI in Detecting Meningeal Enhancement in Tuberculous Meningitis AbstractThe diagnosis of TB meningitis, especially in possible and probable cases, is difficult. Contrast-enhanced MRI of the head with Gadolinium-DTPA is the most sensitive imaging modality that supports diagnosis of this disease. The most common presentation of TB meningitis in MRI is basal meningeal enhancement. The objective of this study was to determine the difference in the increase of T2-FLAIR and T1WI sequence meningeal signal intensity of in patients with tuberculous meningitis using contrast-enhanced MRI of the head with Gadolinium-DTPA in Dr. Hasan Sadikin General Hospital from January 2015-June 2016. Contrast enhanced MRI examination was conducted in 21 subjects with TB meningitis. Statistical analysis was performed to examine the difference in the increase in meningeal signal intensity of post contrast T2-FLAIR and post contrast T1WI. The result showed that the mean increases in meningeal signal intensity of T2-FLAIR (ΔT2-FLAIR) and T1WI (ΔT1WI) were 360.59±182.19 au and 126.47±72.57 aμ respectively. Statistical test results using T test at 95% confidence level indicated that there was a difference between ΔT2-FLAIR and ΔT1WI at p-value=0.000. In conclusion, the mean increase in meningeal signal intensity of post contrast T2-FLAIR is greater than in the post contrast T1WI in TB meningitis. [MKB. 2017;49(3):172-77]

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Contrast-enhanced flair imaging in the evaluation of infectious leptomeningeal diseases

Cited by 61 publications

References 12 publications

Use of Contrast‐Enhanced Fluid‐Attenuated Inversion Recovery Sequence to Detect Brain Lesions in Dogs and Cats

Use of Contrast‐Enhanced Fluid‐Attenuated Inversion Recovery Sequence to Detect Brain Lesions in Dogs and Cats

Differentiation of Leptomeningeal and Vascular Enhancement on Post-contrast FLAIR MRI Sequence: Role in Early Detection of Infectious Meningitis

Perbedaan Intensitas Penyengatan Meningeal Hasil MRI antara Sekuens T2 FLAIR Post Contrast dan T1WI Post Contrast Gadolinium-DTPA dalam Mendeteksi Penyangatan Meningeal pada Kasus Meningitis Tuberkulosis

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