scholarly journals Postcontrast Fluid-Attenuated Inversion Recovery (FLAIR) Sequence MR Imaging in Detecting Intracranial Pathology

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Ajit Mahale ◽  
Shaloo Choudhary ◽  
Sonali Ullal ◽  
Merwyn Fernandes ◽  
Sonali Prabhu
Keyword(s):  
Multiple Sclerosis ◽  
Mr Imaging ◽  
Observational Study ◽  
Low Grade ◽  
Meningeal Enhancement ◽  
Axial Parenchyma ◽  
Flair Imaging ◽  
Flair Sequence ◽  
Fluid Attenuated Inversion Recovery ◽  
The Brain

Background. Imaging sequences for detection of meningeal and parenchymal lesions are critical in intracranial pathology. Our study analysed FLAIR MRI sequence for evaluating postcontrast enhancement. Objectives. FLAIR imaging sequences have been used in evaluation of enhancement in the brain. We conducted a study of FLAIR imaging sequences to better delineate postcontrast enhancement. Materials and Methods. In this prospective hospital-based observational study, postcontrast T1 MTC and delayed postcontrast T2 FLAIR and T1 FLAIR images of 66 patients with intracranial pathology were assessed by experienced radiologists from November 2017 to November 2019. Results. 28 cases of meningeal enhancement were identified in delayed postcontrast T2 FLAIR images. Low-grade gliomas included in the study showed postcontrast enhancement on postcontrast T1 MTC images. Multiple sclerosis lesions were better seen on postcontrast T1 FLAIR. In extraaxial lesions of 11 cases of meningioma, brighter enhancement was seen on delayed postcontrast T2 FLAIR images. Conclusion. We found that delayed postcontrast T2 FLAIR was better in detection of meningeal enhancement in infectious meningitis and in meningitis carcinomatosis than T1 MTC images. In delayed postcontrast T2 FLAIR images, intra-axial parenchyma lesions appeared more conspicuous or similar to T1 MTC images. Delayed postcontrast T1 FLAIR images provided better anatomic delineation of intra-axial lesions.

scholarly journals FLAIR MR sequence in the diagnosis and follow-up of low-grade astrocytomas

2005 ◽  
Vol 62 (7-8) ◽  
pp. 525-528 ◽  
Author(s):  
Tatjana Stosic-Opincal ◽  
Mihail Gavrilov ◽  
Srboljub Stosic ◽  
Slobodan Lavrnic ◽  
Vesna Peric ◽  
...  
Keyword(s):  
Spin Echo ◽  
Diagnostic Value ◽  
Inversion Recovery ◽  
Low Grade ◽  
Flair Imaging ◽  
Flair Sequence ◽  
Cystic Component ◽  
Fluid Attenuated Inversion Recovery ◽  
Age Range

Aim. To evaluate the sensitivity of fluid-attenuated inversion recovery (FLAIR) sequence in the diagnosis and follow-up of the patients with low-grade astrocytomas compared with T2-weighted (T2W) sequence. Methods. Twenty-four patients with biopsy- confirmed low-grade astrocytoma (age range, 15-66 years) underwent T1- weighted (T1W), T2W and FLAIR imaging with a superconducting unit 1.0 T. FLAIR images were qualitatively evaluated by comparison with T2W images by the three experienced neuroradiologists. To evaluate the diagnostic value of FLAIR, the neuroradiologists individually assessed the possibilities of the detection of lesions, as well as the possibilities of the differentiation of tumor from the surrounding edema on FLAIR vs. T2W images. Every examiner ranked FLAIR sequence vs. T2W in three degrees: worse, equal and better. Results. The comparison of FLAIR with T2W spin-echo (SE) images with regard to the detection of the lesions showed that 82.8% of FLAIR studies were superior, 17.2% were of similar diagnostic value, and none was inferior to the T2W images. The comparison of images with regard to the differentiation of tumor boundaries vs. surrounding edema showed that 92.5% of FLAIR studies were superior, 7.5% were of similar diagnostic value, and none was inferior to the T2W images. Conclusion. Our results were similar to the previous studies' results concerning the advantages of FLAIR sequence in the diagnosis of low grade astrocytomas over T2W sequence. FLAIR was better at showing different tumor components, and at distinguishing CSF from the cystic component, and the postoperative cavity, compared with T2W images. Our conclusion was that FLAIR could be routinely used in the evaluation and follow-up of low-grade astrocytomas.

scholarly journals Rheumatoid disease: an unusual cause of relapsing meningoencephalitis

2018 ◽  
pp. bcr-2017-222587 ◽  
Author(s):  
Sian K Alexander ◽  
Maria Di Cicco ◽  
Ute Pohl ◽  
Alberto Cifelli
Keyword(s):  
Brain Biopsy ◽  
Oligoclonal Bands ◽  
Rheumatoid Disease ◽  
Persistent Lymphocytosis ◽  
Meningeal Enhancement ◽  
Elevated Protein ◽  
Fluid Attenuated Inversion Recovery ◽  
Leg Weakness ◽  
Ischaemic Attack ◽  
The Brain

A 73-year-old man presented with three episodes of dysphasia and disinhibited behaviour, a single seizure and transient ischaemic attack-like events characterised by right arm and/or leg weakness. These episodes were separated by month-long asymptomatic intervals. Medical history included rheumatoid arthritis, which was clinically quiescent on leflunomide.Repeated cerebrospinal fluid examination showed a persistent lymphocytosis with mildly reduced glucose and elevated protein; oligoclonal bands and viral PCR were negative. MRI of the brain was initially normal, but 7 months after initial presentation revealed meningeal enhancement with bifrontal cortical hyperintensities on T2/fluid-attenuated inversion recovery. Brain biopsy demonstrated necrotising granulomatous meningitis with mixed T cell and B cell infiltrates and without evidence of vasculitis or infection. Serum anticyclic citrullinated peptide antibodies were strongly positive.The diagnosis of rheumatoid meningoencephalitis was made on the basis of brain biopsy findings and serological evidence of active rheumatoid disease. Steroids and rituximab therapy were started leading to clinical stabilisation.

scholarly journals Lesion load assessment among multiple sclerosis patient using DIR, FLAIR, and T2WI sequences

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Abdullah Dhaifallah Almutairi ◽  
Hasyma Abu Hassan ◽  
Subapriya Suppiah ◽  
Othman I. Alomair ◽  
Abdulbaset Alshoaibi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Neurological Disorders ◽  
Lesion Detection ◽  
Inversion Recovery ◽  
Daily Routine ◽  
Lesion Load ◽  
Significant Difference ◽  
Fluid Attenuated Inversion Recovery ◽  
Magnetic Resonance Imaging Mri ◽  
The Brain

Abstract Background Magnetic resonance imaging (MRI) is one of the diagnostic imaging modalities employing in lesion detection in neurological disorders such as multiple sclerosis (MS). Advances in MRI techniques such as double inversion recovery (DIR) made it more sensitive to distinguish lesions in the brain. To investigate the lesion load on different anatomical regions of the brain with MS using DIR, fluid attenuated inversion recovery (FLAIR) and T2-weighted imaging (T2WI) sequences. A total of 97 MS patients were included in our retrospective study, confirmed by neurologist. The patients were randomly selected from the major hospital in Saudi Arabia. All images were obtained using 3T Scanner (Siemens Skyra). The images from the DIR, FLAIR, and T2WI sequence were compared on axial planes with identical anatomic position and the number of lesions was assigned to their anatomical region. Results Comparing the lesion load measurement at various brain anatomical regions showed a significant difference among those three methods (p < 0.05). Conclusion DIR is a valuable MRI sequence for better delineation, greater contrast measurements and the increasing total number of MS lesions in MRI, compared with FLAIR, and T2WI and DIR revealed more intracortical lesions as well; therefore, in MS patients, it is recommended to add DIR sequence in daily routine imaging sequences.

Tuberculous Meningitis: Comparison of Contrast Enhanced T1-Weighted and Flair MR Imaging with Magnetization Transfer Contrast

2005 ◽  
Vol 18 (2) ◽  
pp. 185-190 ◽  
Author(s):  
H. Mutlu ◽  
E. Silit ◽  
Z. Pekkafali ◽  
C.C. Basekim ◽  
M. Kantarci ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Sensitivity And Specificity ◽  
Magnetization Transfer ◽  
Mr Images ◽  
Imaging Studies ◽  
Flair Imaging ◽  
Contrast Enhanced ◽  
Highly Sensitive ◽  
Fluid Attenuated Inversion Recovery ◽  
Mr Sequences

Fluid-attenuated inversion recovery (FLAIR) imaging with contrast enhancement is highly sensitive for detecting subarachnoid space disease. We hypothesized that contrast-enhanced FLAIR imaging with magnetization transfer would offer superior sensitivity to contrast-enhanced T1-weighted MR imaging with magnetization transfer in detecting TB meningitis. Forty-four patients referred for suspected TB meningitis underwent MR imaging studies. The patients had either proven TB meningitis or negative TB meningitis. The MR imaging examinations included both contrast-enhanced FLAIR and T1-weighted MR images with magnetization transfers that were independently reviewed by two neuroradiologists. Each of the sequences was reviewed individually and separately and was assigned a score of positive or negative for TB meningitis. Of the 21 studies of patients with proven TB meningitis, nine were positive based on contrast-enhanced FLAIR images with magnetization transfer, and 13 were positive based on contrast-enhanced T1-weighted MR images with magnetization transfer. Of the 23 studies of patients without TB meningitis, 19 were negative based on contrast-enhanced FLAIR images, and 20 were negative based on contrast-enhanced T1-weighted MR images with magnetization transfer. The sensitivity and specificity for contrast-enhanced FLAIR images for detecting TB meningitis were 43% (nine of 21) and 82% (19 of 23), respectively. The sensitivity and specificity of contrast-enhanced T1-weighted MR images with magnetization transfer for detecting TB meningitis were 62% (13 of 21) and 87% (20 of 23), respectively. Contrast-enhanced FLAIR imaging with magnetization transfer is less sensitive than contrast-enhanced T1-weighted MR sequences with magnetization transfer in detecting TB meningitis.

scholarly journals Comparison of diffusion-weighted imaging and enhanced T1-weighted sequencing in patients with multiple sclerosis

2017 ◽  
Vol 30 (4) ◽  
pp. 347-351 ◽  
Author(s):  
Amin Abolhasani Foroughi ◽  
Roohollah Salahi ◽  
Alireza Nikseresht ◽  
Hora Heidari ◽  
Masoume Nazeri ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Contrast Enhancement ◽  
Three Dimensional ◽  
Contrast Imaging ◽  
Technical Parameters ◽  
Flair Sequence ◽  
Significant Difference ◽  
Mri Protocol ◽  
Weighted Sequences ◽  
The Brain

Introduction The purpose of this study was to assess whether demographic, brain anatomical regions and contrast enhancement show differences in multiple sclerosis (MS) patients with increased diffusion lesions (ID group) compared with diffusion restriction (DR group). Method MRI protocol comprised T1- and T2-weighted sequences with and without gadolinium (Gd), and sagittal three-dimensional FLAIR sequence, DWI and ADC maps were prospectively performed in 126 MS patients from January to December 2015. The investigation was conducted to evaluate differences in demographic, cord and brain regional, technical, and positive or negative Gd contrast imaging parameters in two groups of ID and DR. Statistical analysis was performed by using SPSS. Results A total of 9.6% of patients showed DR. In the DR group, 66.6% of the patients showed contrast enhancement of plaques, whereas 29.2% of the IR group showed enhancement of plaques. The most prevalent group was non-enhanced plaques in the ID group, followed by Gd-enhanced plaques in the ID group. Patients in the ID group (90.4%) were significantly more than in the DR group (9.6%). Out of the 40 patients with Gd-enhanced plaques, 80.5% was from the ID group and 19.5% from the DR group. Conclusion MRI of the brain, unlike of the cord, with Gd demonstrates significant difference in enhancement between the two groups ( p < 0.05). No significant difference was seen in demographic, cord and brain regional, and technical parameters, EDSS, disease duration, and attack rate as well as demographic and regional parameters between the ID and decrease diffusion groups ( p > 0.05).

scholarly journals Comparative study between double inversion recovery (DIR) and fluid-attenuated inversion recovery (FLAIR) MRI sequences for detection of cerebral lesions in multiple sclerosis

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Shaima Fattouh Elkholy ◽  
Marianne Abdallah Sabet ◽  
Mohammad Edrees Mohammad ◽  
Ramy Edward Ibrahim Asaad
Keyword(s):  
Multiple Sclerosis ◽  
Pulse Sequence ◽  
Brain Lesions ◽  
Inversion Recovery ◽  
Double Inversion Recovery ◽  
Cerebral Lesions ◽  
Flair Imaging ◽  
Flair Sequence ◽  
Scan Time ◽  
Significant Difference

Abstract Background Multiple sclerosis (MS) is a common chronic inflammatory demyelinating disorder more common in young adults. MS is characterized mainly with white matter (WM) affection; however, considerable gray matter (GM) involvement is also noted in many patients. MRI is used for diagnosis and follow up of the disease using different pulse sequences; FLAIR imaging provides the highest sensitivity in the detection of supratentorial, juxtacortical, and the periventricular lesions but is less sensitive in the posterior fossa. A double inversion recovery (DIR) pulse sequence was recently introduced to improve the visibility of GM lesions and especially cortical lesions. The aim of this study is to assess the role of DIR sequence in the detection of brain lesions in patients with MS compared to FLAIR sequence. Results DIR showed a significantly higher number of MS lesions in infratentorial region (2.9 ± 0.4 compared to 2.25 ± 0.3 in FLAIR) with a statistically significant difference (p = 0.002) and also in supratentorial periventricular regions (11.84 ± 8.07 in DIR and 11.31 ± 8.07 in FLAIR, p < 0.001). DIR imaging also demonstrated significantly more intracortical lesions (7.12 ± 1.2 compared to 1.4 ± 0.9 in FLAIR imaging) with a statistically significant difference (p < 0.001). On the other hand, corpus callosum lesions were significantly higher on FLAIR (0.84 ± 0.1) with respect to DIR imaging (0.68 ± 0.1) with a statistically significant difference in between (p = 0.025). Conclusion DIR is a powerful conventional MRI sequence for visualization of brain lesions in patients with MS and is superior to FLAIR sequence in detecting lesions in different locations, namely cortical, periventricular, and infratentorial regions; hence, DIR can be added to the MRI protocol of MS patients or even can replace FLAIR which would be of a good diagnostic value with only 80 s added to the scan time.

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