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Contrast-enhanced flair imaging in the evaluation of infectious leptomeningeal diseases.
Eur J Radiol. 2006 Apr; 58(1):89-95.EJ

Abstract

PURPOSE

The purpose of our study was to compare contrast-enhanced fluid-attenuated inversion recovery (FLAIR) images with contrast-enhanced T1 weighted images for infectious leptomeningitis.

MATERIALS AND METHODS

We studied twenty-four patients with a clinical suspicion of infectious meningitis with unenhanced FLAIR, contrast-enhanced T1 weighted and contrast-enhanced FLAIR MR sequences. Twelve patients had cytologic and biochemical diagnosis of meningitis on cerebrospinal fluid (CSF) examination obtained 48 h before or after the MR study. Sequences were considered positive if abnormal signal was seen in the subarachnoid space (cistern or sulci) or along pial surface.

RESULTS

Twenty-seven examinations in 24 patients were performed. Of the 12 patients (thirteen studies) in whom cytology was positive, unenhanced FLAIR images were positive in six cases (sensitivity 46%), contrast-enhanced FLAIR images were positive in 11 (sensitivity 85%), and contrast-enhanced T1 weighted MR images were positive in 11 patients (sensitivity 85%). Of the 12 patients (14 studies) in whom cerebrospinal fluid study was negative, unenhanced FLAIR images were negative in 13, contrast-enhanced FLAIR images were negative in 11, and contrast-enhanced T1 weighted MR images were negative in eight. Thus, the specificity of unenhanced FLAIR, contrast-enhanced FLAIR and contrast-enhanced T1 weighted images was 93, 79 and 57%, respectively.

CONCLUSION

Our results suggest that post-contrast FLAIR images have similar sensitivity but a higher specificity compared to contrast-enhanced T1 weighted images for detection of leptomeningeal enhancement. It can be a useful adjunct to post-contrast T1 weighted images in evaluation of infectious leptomeningitis.

Authors+Show Affiliations

Department of Neuroradiology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore. parurad@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

eng

PubMed ID

16386866

Citation

Parmar, Hemant, et al. "Contrast-enhanced Flair Imaging in the Evaluation of Infectious Leptomeningeal Diseases." European Journal of Radiology, vol. 58, no. 1, 2006, pp. 89-95.
Parmar H, Sitoh YY, Anand P, et al. Contrast-enhanced flair imaging in the evaluation of infectious leptomeningeal diseases. Eur J Radiol. 2006;58(1):89-95.
Parmar, H., Sitoh, Y. Y., Anand, P., Chua, V., & Hui, F. (2006). Contrast-enhanced flair imaging in the evaluation of infectious leptomeningeal diseases. European Journal of Radiology, 58(1), 89-95.
Parmar H, et al. Contrast-enhanced Flair Imaging in the Evaluation of Infectious Leptomeningeal Diseases. Eur J Radiol. 2006;58(1):89-95. PubMed PMID: 16386866.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Contrast-enhanced flair imaging in the evaluation of infectious leptomeningeal diseases. AU - Parmar,Hemant, AU - Sitoh,Yih-Yian, AU - Anand,Pooja, AU - Chua,Violet, AU - Hui,Francis, Y1 - 2006/01/18/ PY - 2005/06/29/received PY - 2005/11/20/revised PY - 2005/11/22/accepted PY - 2006/1/3/pubmed PY - 2006/12/9/medline PY - 2006/1/3/entrez SP - 89 EP - 95 JF - European journal of radiology JO - Eur J Radiol VL - 58 IS - 1 N2 - PURPOSE: The purpose of our study was to compare contrast-enhanced fluid-attenuated inversion recovery (FLAIR) images with contrast-enhanced T1 weighted images for infectious leptomeningitis. MATERIALS AND METHODS: We studied twenty-four patients with a clinical suspicion of infectious meningitis with unenhanced FLAIR, contrast-enhanced T1 weighted and contrast-enhanced FLAIR MR sequences. Twelve patients had cytologic and biochemical diagnosis of meningitis on cerebrospinal fluid (CSF) examination obtained 48 h before or after the MR study. Sequences were considered positive if abnormal signal was seen in the subarachnoid space (cistern or sulci) or along pial surface. RESULTS: Twenty-seven examinations in 24 patients were performed. Of the 12 patients (thirteen studies) in whom cytology was positive, unenhanced FLAIR images were positive in six cases (sensitivity 46%), contrast-enhanced FLAIR images were positive in 11 (sensitivity 85%), and contrast-enhanced T1 weighted MR images were positive in 11 patients (sensitivity 85%). Of the 12 patients (14 studies) in whom cerebrospinal fluid study was negative, unenhanced FLAIR images were negative in 13, contrast-enhanced FLAIR images were negative in 11, and contrast-enhanced T1 weighted MR images were negative in eight. Thus, the specificity of unenhanced FLAIR, contrast-enhanced FLAIR and contrast-enhanced T1 weighted images was 93, 79 and 57%, respectively. CONCLUSION: Our results suggest that post-contrast FLAIR images have similar sensitivity but a higher specificity compared to contrast-enhanced T1 weighted images for detection of leptomeningeal enhancement. It can be a useful adjunct to post-contrast T1 weighted images in evaluation of infectious leptomeningitis. SN - 0720-048X UR - https://www.unboundmedicine.com/medline/citation/16386866/Contrast_enhanced_flair_imaging_in_the_evaluation_of_infectious_leptomeningeal_diseases_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0720-048X(05)00377-3 DB - PRIME DP - Unbound Medicine ER -