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Contrast-Enhanced 3D-FLAIR Imaging of the Optic Nerve and Optic Nerve Head: Novel Neuroimaging Findings of Idiopathic Intracranial Hypertension.
AJNR Am J Neuroradiol. 2019 02; 40(2):334-339.AA

Abstract

BACKGROUND AND PURPOSE

The sensitivity of contrast-enhanced 3D-FLAIR has not been assessed in patients with idiopathic intracranial hypertension. The purpose of this study was to evaluate whether hyperintensity of the optic nerve/optic nerve head on contrast-enhanced 3D-FLAIR imaging is associated with papilledema in patients with idiopathic intracranial hypertension.

MATERIALS AND METHODS

A retrospective review was conducted from 2012 to 2015 of patients with clinically diagnosed idiopathic intracranial hypertension and age- and sex-matched controls who had MR imaging with contrast-enhanced 3D-FLAIR. Two neuroradiologists graded each optic nerve/optic nerve head on a scale of 0-3. This grade was then correlated with the Frisén Scale, an ophthalmologic scale used for grading papilledema from 0 (normal) to 5 (severe edema). To estimate the correlation between the MR imaging and Frisén scores, we calculated the Kendall τ coefficient.

RESULTS

Forty-six patients (3 men, 43 women) with idiopathic intracranial hypertension and 61 controls (5 men, 56 women) with normal findings on MR imaging were included in this study. For both eyes, there was moderate correlation between the 2 scales (right eye: τ = 0.47; 95% CI, 0.31-0.57; left eye: τ = 0.38; 95% CI, 0.24-0.49). Interreader reliability for MR imaging scores showed high interreader reliability (right eye: κ = 0.76; 95% CI, 0.55-0.88; left eye: κ = 0.87; 95% CI, 0.78-0.94). Contrast-enhanced 3D-FLAIR imaging correlates with the Frisén Scale for moderate-to-severe papilledema and less so for mild papilledema.

CONCLUSIONS

Hyperintensity of the optic nerve/optic nerve head on contrast-enhanced 3D-FLAIR is sensitive for the detection of papilledema in patients with idiopathic intracranial hypertension, which may be useful when prompt diagnosis is crucial.

Authors+Show Affiliations

From the Departments of Radiology (E.G., J.-P.J.Y., T.A.K.).Ophthalmology (R.K., N.M., Y.C.).Ophthalmology (R.K., N.M., Y.C.).Department of Biostatistics and Medical Informatics (C.L.).Ophthalmology (R.K., N.M., Y.C.).From the Departments of Radiology (E.G., J.-P.J.Y., T.A.K.). Psychiatry (J.-P.J.Y.), University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. Department of Biomedical Engineering (J.-P.J.Y.), College of Engineering. Neuroscience Training Program (J.-P.J.Y.), Wisconsin Institutes for Medical Research, University of Wisconsin-Madison, Madison, Wisconsin.From the Departments of Radiology (E.G., J.-P.J.Y., T.A.K.) tkennedy@uwhealth.org.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30679213

Citation

Golden, E, et al. "Contrast-Enhanced 3D-FLAIR Imaging of the Optic Nerve and Optic Nerve Head: Novel Neuroimaging Findings of Idiopathic Intracranial Hypertension." AJNR. American Journal of Neuroradiology, vol. 40, no. 2, 2019, pp. 334-339.
Golden E, Krivochenitser R, Mathews N, et al. Contrast-Enhanced 3D-FLAIR Imaging of the Optic Nerve and Optic Nerve Head: Novel Neuroimaging Findings of Idiopathic Intracranial Hypertension. AJNR Am J Neuroradiol. 2019;40(2):334-339.
Golden, E., Krivochenitser, R., Mathews, N., Longhurst, C., Chen, Y., Yu, J. J., & Kennedy, T. A. (2019). Contrast-Enhanced 3D-FLAIR Imaging of the Optic Nerve and Optic Nerve Head: Novel Neuroimaging Findings of Idiopathic Intracranial Hypertension. AJNR. American Journal of Neuroradiology, 40(2), 334-339. https://doi.org/10.3174/ajnr.A5937
Golden E, et al. Contrast-Enhanced 3D-FLAIR Imaging of the Optic Nerve and Optic Nerve Head: Novel Neuroimaging Findings of Idiopathic Intracranial Hypertension. AJNR Am J Neuroradiol. 2019;40(2):334-339. PubMed PMID: 30679213.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Contrast-Enhanced 3D-FLAIR Imaging of the Optic Nerve and Optic Nerve Head: Novel Neuroimaging Findings of Idiopathic Intracranial Hypertension. AU - Golden,E, AU - Krivochenitser,R, AU - Mathews,N, AU - Longhurst,C, AU - Chen,Y, AU - Yu,J-P J, AU - Kennedy,T A, Y1 - 2019/01/24/ PY - 2018/08/02/received PY - 2018/11/23/accepted PY - 2019/1/27/pubmed PY - 2020/3/3/medline PY - 2019/1/26/entrez SP - 334 EP - 339 JF - AJNR. American journal of neuroradiology JO - AJNR Am J Neuroradiol VL - 40 IS - 2 N2 - BACKGROUND AND PURPOSE: The sensitivity of contrast-enhanced 3D-FLAIR has not been assessed in patients with idiopathic intracranial hypertension. The purpose of this study was to evaluate whether hyperintensity of the optic nerve/optic nerve head on contrast-enhanced 3D-FLAIR imaging is associated with papilledema in patients with idiopathic intracranial hypertension. MATERIALS AND METHODS: A retrospective review was conducted from 2012 to 2015 of patients with clinically diagnosed idiopathic intracranial hypertension and age- and sex-matched controls who had MR imaging with contrast-enhanced 3D-FLAIR. Two neuroradiologists graded each optic nerve/optic nerve head on a scale of 0-3. This grade was then correlated with the Frisén Scale, an ophthalmologic scale used for grading papilledema from 0 (normal) to 5 (severe edema). To estimate the correlation between the MR imaging and Frisén scores, we calculated the Kendall τ coefficient. RESULTS: Forty-six patients (3 men, 43 women) with idiopathic intracranial hypertension and 61 controls (5 men, 56 women) with normal findings on MR imaging were included in this study. For both eyes, there was moderate correlation between the 2 scales (right eye: τ = 0.47; 95% CI, 0.31-0.57; left eye: τ = 0.38; 95% CI, 0.24-0.49). Interreader reliability for MR imaging scores showed high interreader reliability (right eye: κ = 0.76; 95% CI, 0.55-0.88; left eye: κ = 0.87; 95% CI, 0.78-0.94). Contrast-enhanced 3D-FLAIR imaging correlates with the Frisén Scale for moderate-to-severe papilledema and less so for mild papilledema. CONCLUSIONS: Hyperintensity of the optic nerve/optic nerve head on contrast-enhanced 3D-FLAIR is sensitive for the detection of papilledema in patients with idiopathic intracranial hypertension, which may be useful when prompt diagnosis is crucial. SN - 1936-959X UR - https://www.unboundmedicine.com/medline/citation/30679213/Contrast_Enhanced_3D_FLAIR_Imaging_of_the_Optic_Nerve_and_Optic_Nerve_Head:_Novel_Neuroimaging_Findings_of_Idiopathic_Intracranial_Hypertension_ L2 - http://www.ajnr.org/cgi/pmidlookup?view=long&pmid=30679213 DB - PRIME DP - Unbound Medicine ER -