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. 2022 Apr 15;12(2):63-70.
eCollection 2022.

Contrast-enhanced weighted-T1 and FLAIR sequences in MRI of meningeal lesions

Saeid Roozpeykar  1 , Maryam Azizian  2 , Zohreh Zamani  3 , Marjan Rahimi Farzan  4 , Hossein Abdollahi Veshnavei  5 , Nooshin Tavoosi  5 , Arash Toghyani  6 , Amirhossein Sadeghian  7 , Mahdieh Afzali  8
Affiliations

Contrast-enhanced weighted-T1 and FLAIR sequences in MRI of meningeal lesions

Saeid Roozpeykar et al. Am J Nucl Med Mol Imaging. .

Abstract

Magnetic resonance imaging (MRI) is widely used in meningeal lesions due to rapid and accurate diagnosis and prevention of serious complications. The aim of the present study was to compare these two sequences after injection of a contrast agent into meningeal lesions. This is a descriptive-analytical study that was performed in 2018-2020 on patients referred to the radiology ward with detection of any meningeal involvements in the MRI images. In addition to T1-W, FLAIR sequence imaging was also performed. Images were initially evaluated by two expert radiologists and a neurologist. The diagnostic values of the sequences were compared. Overall, a total number of 147 patients with meningeal lesions in their brain MRI entered the study. 57.1% of cases (84 patients) had an infectious etiology and 42.9% (63 patients) had a tumoral etiology. T1-W images without contrast were able to diagnose 78 cases of meningitis (92.8% of them), and FLAIR sequences could diagnose 82 patients (97.6% of them). Without contrast injection on MRI, the diagnostic value of T1-W sequence was higher than FLAIR sequence for tumoral lesions (P < 0.01). The enhancement degree of T1-W was higher for tumoral findings (P < 0.01). In contrast, the enhancement degree of the FLAIR sequence was higher for infectious findings, which was also statistically significant (P = 0.015). FLAIR sequences had 92% sensitivity and 85% specificity for diagnosis of brain inflammatory diseases. Similar analysis showed that T1 sequence had 82% sensitivity and 73% specificity for diagnosis of brain inflammatory diseases.

Keywords: FLAIR; MRI; T1-W; meningeal lesions.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Brain MRI showing a tumoral lesion. The points indicate large tumor lesions (glioblastoma multiform (GBM)) in T1-weighted MRI. Heterogeneous lesions containing central necrotic and severe vasogenic edema in the environment in the right fronto-temporal lobe could be observed. The midline shift due to severe increased intracranial pressure is also observed.
Figure 2
Figure 2
Brain metastasis demonstrated by T1-wighted MRI. Brain metastasis due to breast cancer indicated by T1-weighted MRI. Homogenous enhancement in the left parietal lobe could be observed.
Figure 3
Figure 3
Evaluation of sensitivity and specificity of FLAIR and T1 sequences for diagnosis of brain inflammatory diseases. Right line: FLAIR sequence; blue line: T1 sequence.
See this image and copyright information in PMC

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