Optimal Detection of Subtle Gadolinium Leakage in CSF with Heavily T2-Weighted Fluid-Attenuated Inversion Recovery Imaging.

W.M Freeze,R.W Van Hooren,W.M Palm,D.N Ter Weele,H.I.L Jacobs,J.F.A Jansen,E.I Hoff,W.H Backes,F.R Verhey

doi:10.3174/ajnr.a6145

Abstract

Pericortical enhancement on postcontrast FLAIR images is a marker for subtle leptomeningeal blood-brain barrier leakage. We explored the optimal FLAIR sequence parameters for the detection of low gadolinium concentrations within the CSF. On the basis of phantom experiments and human in vivo data, we showed that detection of subtle pericortical enhancement can be facilitated by using a relatively long TE. Future studies should choose their FLAIR sequence parameters carefully when assessing pericortical enhancement due to subtle blood-brain barrier leakage.

Highlights

All baseline foci of signal enhancement had remained stable with time, and one de novo leakage focus was detected on the regular pcFLAIR images acquired during the first scan ses-
In Vitro Experiment The results of our phantom experiments show 2 important concepts that facilitate the detection of low gadolinium concentrations within the CSF, namely the use of relatively long TEs and proper nulling of pure CSF
Pericortical enhancement is visible on postcontrast FLAIR images of a 68-year-old cognitively healthy female participant

Summary

Introduction

All baseline foci of signal enhancement had remained stable with time, and one de novo leakage focus was detected on the regular pcFLAIR images acquired during the first scan ses- Pericortical enhancement appeared visually more intense on all heavily T2-weighted pcFLAIR images comtween the follow-up participants in the baseline study (n ϭ 3) and pared with the regular pcFLAIR images.

Results

Conclusion