Use of Fluid Attenuated Inversion Recovery (FLAIR) Pulse Sequences in MRI of the Brain

Hajnal, Joseph V.; Bryant, David; Kasuboski, Larry; Pattany, Pradip M.; Coene, B.; Lewis, Paul D.; Pennock, J. M.; Oatridge, Angela; Young, I. R.; Bydder, Graeme M.

doi:10.1097/00004728-199211000-00001

Cited by 257 publications

(160 citation statements)

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“…Because of the so-called "flow-void" phenomenon, normal arteries are not usually visible against the dark CSF background on FLAIR sequences. 13 Recently, hyperintense vessels have been described on FLAIR images in hyperacute stroke patients with an arterial occlusion 8,9,14 and are considered to be an indicator of slow flow and inadequate collateral circulation. The results of this case-control study suggest that (1) the assessment of HVS on FLAIR is reproducible, (2) multiple HVS on FLAIR is significantly more frequent in patients with multiple intracerebral stenoses (68%) than in asymptomatic patients without intracerebral stenoses (5.2%) regardless of the presence of a brain infarct, and (3) HVSs on FLAIR underestimate the extent of intracerebral stenoses as demonstrated by angiogram.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Hyperintense Vessels on FLAIR MRI for the Diagnosis of Multiple Intracerebral Arterial Stenoses

Iancu

Oppenheim

Touzé

et al. 2003

Stroke

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Background and Purpose-Hyperintense vessel sign (HVS) on fluid-attenuated inversion recovery (FLAIR) has been described in hyperacute stroke patients with arterial occlusion. We sought to determine whether HVS was more frequent in patients with intracerebral arterial stenoses than in those without stenosis regardless of the presence of a brain infarct. Methods-In this case-control study (19 symptomatic patients with multiple intracerebral arterial stenoses compared with 19 age-matched asymptomatic patients without stenosis), we looked for HVS (ie, focal or tubular hyperintensities in the subarachnoid space) on FLAIR images. We compared the proportion of HVS-positive patients in the 2 groups and evaluated the concordance between the arterial distribution of stenoses on angiogram and that of HVS on FLAIR. Results-HVS was found in 13 of 19 patients (68%) in the study group and 1 of 19 control patients (5.2%) (PϽ0.0001).The concordance between the territorial distribution of stenoses on angiogram and HVS on FLAIR was higher for the right and left middle cerebral artery (ϭ0.6 and 0.63, respectively) compared with the right and left anterior cerebral artery (ϭ0.35 and 0.2, respectively). HVSs were observed in 1 of 7 patients with posterior cerebral artery stenoses on angiogram. HVSs were seen equally in patients with acute focal (7 of 10) or diffuse (6 of 9) cerebral involvement. In the 6 HVS-positive patients with acute stroke confirmed by MRI, additional HVSs were observed in a different arterial territory than that of the stroke lesion.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Hyperintense Vessels on FLAIR MRI for the Diagnosis of Multiple Intracerebral Arterial Stenoses

Iancu

Oppenheim

Touzé

et al. 2003

Stroke

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“…An initial 15-s scout scan composed of three orthogonal planes was used to confirm head positioning. Whole-brain structural scans were obtained using a T2-weighted fluid-attenuated inversion-recovery (FLAIR) TSE sequence (Hajnal et al 1992). FLAIR images were obtained in the following parameters: a transverse plane with TR = 10,000 ms, TE=98 ms, TI=2,150 ms; field of view (FOV)=256×180 mm, matrix size=256 (frequency)× 164 (left-right phase encoding), 3.0 mm slice thickness, 39 slices acquired via 2D multislice mode with no slice gaps, N av =1, voxel size= 1.0 × 1.1 × 3.0 mm 3 , and 130 Hz pixel −1 bandwidth.…”

Section: Neuropsychological Testingmentioning

confidence: 99%

Impact of the AGTR1 A1166C polymorphism on subcortical hyperintensities and cognition in healthy older adults

Salminen

Schofield

Pierce

et al. 2014

AGE

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Vascular aging consists of complex and multifaceted processes that may be influenced by genetic polymorphisms of the renin-angiotensin system. A polymorphism in the angiotensin II type 1 receptor gene (AGTR1/rs5186) has been associated with an increased risk for arterial stiffness, hypertension, and ischemic stroke. Despite these identified relationships, the impact of AGTR1 A1166C on white matter integrity and cognition is less clear in a healthy aging population. The present study utilized indices of neuroimaging and neuropsychological assessment to examine the impact of the A1166C polymorphism on subcortical hyperintensities (SH) and cognition in 49 healthy adults between ages 51-85. Using a dominant statistical model (CC + CA (risk) vs. AA), results revealed significantly larger SH volume for individuals with the C1166 variant (p<0.05, partial eta 2 = 0.117) compared with those with the AA genotype. Post hoc analyses indicated that increased SH volume in C allele carriers could not be explained by vascular factors such as pulse pressure or body mass index. In addition, cognitive performance did not differ significantly between groups and was not significantly associated with SH in this cohort. Results suggest that presence of the C1166 variant may serve as a biomarker of risk for suboptimal brain integrity in otherwise healthy older adults prior to changes in cognition.

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“…T2 shortening may occur in the case of massive SAH and in chronic and repeated SAHs secondary to superficial siderosis [5,22]. Fluid-attenuated inversion recovery (FLAIR) is the most sensitive MRI pulse sequence for detecting SAH and is comparable to the CT scan in diagnosing acute SAH [25][26][27][28][29][30]. SAH appears hyperintense CSF on fluidattenuated inversion recovery images.…”

Section: Subarachnoid Hemorrhage and Intracranial Aneurysmmentioning

confidence: 99%

Neuroimaging of Hemorrhage and Vascular Defects

2011

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Summary: Intracranial hemorrhage is the third most common cause of stroke and involves the accumulation of blood within brain parenchyma or the surrounding meningeal spaces. Accurate identification of acute hemorrhage and correct characterization of the underlying pathology, such as tumor, vascular malformation, or infarction, is a critical step in planning appropriate therapy. Neuroimaging studies are required not only for diagnosis, but they also provide important information on the type of hemorrhage, etiology, and the pathophysiological process. Historically, computed tomography (CT) scan has been the diagnostic imaging study of choice; however, there is growing evidence suggesting that magnetic resonance imaging (MRI) is at least as sensitive as CT to detect intraparenchymal hemorrhages in the hyperacute setting, and actually superior to CT in the subacute and chronic settings. Unique MRI and CT characteristics differentiate secondary causes of hemorrhage from the more common hypertensive hemorrhage. Baseline and serial studies can be used to identify patients who might benefit from acute interventions. In addition, new imaging modalities, (such as magnetic resonance spectroscopy, diffusion tensor imaging, and 320-row CT) are promising research techniques that have the potential to enhance our understanding of the tissue injury and recovery after intracranial hemorrhages.

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Use of Fluid Attenuated Inversion Recovery (FLAIR) Pulse Sequences in MRI of the Brain

Cited by 257 publications

References 0 publications

Evaluation of Hyperintense Vessels on FLAIR MRI for the Diagnosis of Multiple Intracerebral Arterial Stenoses

Evaluation of Hyperintense Vessels on FLAIR MRI for the Diagnosis of Multiple Intracerebral Arterial Stenoses

Impact of the AGTR1 A1166C polymorphism on subcortical hyperintensities and cognition in healthy older adults

Neuroimaging of Hemorrhage and Vascular Defects

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