Investig Magn Reson Imaging.  2018 Jun;22(2):86-93. 10.13104/imri.2018.22.2.86.

Comparison of Contrast-Enhanced T2 FLAIR and 3D T1 Black-Blood Fast Spin-Echo for Detection of Leptomeningeal Metastases

Affiliations
  • 1Department of Radiology, Ewha Womans University College of Medicine, Seoul, Korea. aahng77@yuhs.ac
  • 2Department of Radiology, Yonsei University, College of Medicine, Seoul, Korea.

Abstract

PURPOSE
Imaging plays a significant role in diagnosing leptomeningeal metastases. However, the most appropriate sequence for the detection of leptomeningeal metastases has yet to be determined. This study compares the efficacies of contrast-enhanced T2 fluid attenuated inversion recovery (FLAIR) and contrast-enhanced 3D T1 black-blood fast spin echo (FSE) imaging for the detection of leptomeningeal metastases.
MATERIALS AND METHODS
Tube phantoms containing varying concentrations of gadobutrol solution were scanned using T2 FLAIR and 3D T1 black-blood FSE. Additionally, 30 patients with leptomeningeal metastases were retrospectively evaluated to compare conspicuous lesions and the extent of leptomeningeal metastases detected by T2 FLAIR and 3D T1 black-blood FSE.
RESULTS
The signal intensities of low-concentration gadobutrol solutions (< 0.5 mmol/L) on T2 FLAIR images were higher than in 3D T1 black-blood FSE. The T2 FLAIR sequences exhibited significantly greater visual conspicuity scores than the 3D T1 black-blood sequence in leptomeningeal metastases of the pial membrane of cistern (P = 0.014). T2 FLAIR images exhibited a greater or equal extent (96.7%) of leptomeningeal metastases than 3D T1 black-blood FSE images.
CONCLUSION
Because of its high sensitivity even at low gadolinium concentrations, contrast-enhanced T2 FLAIR images delineated leptomeningeal metastases in a wider territory than 3D T1 black-blood FSE.

Keyword

Leptomeningeal metastases; Black-blood; Contrast-enhanced T2 FLAIR
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