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Comment
. 2023 Aug 16;14(1):4913.
doi: 10.1038/s41467-023-40508-2.

The pitfalls of interpreting hyperintense FLAIR signal as lymph outside the human brain

Geir Ringstad  1   2 , Per Kristian Eide  3   4
Affiliations
Comment

The pitfalls of interpreting hyperintense FLAIR signal as lymph outside the human brain

Geir Ringstad et al. Nat Commun. .
No abstract available

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. CSF flow artifacts at FLAIR in the subarachnoid space.
a In their Figure 4a, Albayram et al. point at a linear hyperintensity at sagittal FLAIR in the suprasellar cistern and identify this as lymph. b Image from our same Prisma MRI scanner (Siemens, Erlangen) shows a similar phenomenon (arrow). c At T1 weighted MRI through the same section it becomes clear that the FLAIR hyperintensity is within the CSF compartment (arrows), not the dura itself, which in this region is constituted by the sellar diaphragm immediately adjacent to the upper border of the pituitary gland. This clearly indicates a flow artifact derived from CSF pulsations within the suprasellar cistern. d In their Figure 4f, Albayram et al. point at FLAIR hyperintensities (arrowheads) within the cerebellopontine angle cisternal spaces and identify them as lymph (axial section). e We reproduce similar findings (arrows) at our same MRI Prisma scanner (Siemens, Erlangen). Propagation of artifacts through the brain stem (blue arrows) in the same level (along the phase encoding direction), as also seen to a minor extent in d, is highly suggestive that these are CSF flow artifacts. f At T1 weighted MRI through the same imaging plane it becomes clear that the hyperintensities at FLAIR correspond to the CSF space (arrows), not the dura or cranial nerves.
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