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FLAIR MR imaging for diagnosing intracranial meningeal carcinomatosis
K Tsuchiya1, S Katase, A Yoshino
1Department of Radiology, Kyorin University School of Medicine, 6-20-2, Shinkawa, Mitaka, Tokyo 181-8611, Japan.
Objective:
The purpose of this study was to compare unenhanced and contrast-enhanced fluid-attenuated inversion recovery (FLAIR) imaging with other sequences to visualize meningeal carcinomatosis.
Materials And Methods:
Unenhanced FLAIR images were compared with spin echo T2-weighted and contrast-enhanced FLAIR images in five patients with documented meningeal carcinomatosis and four patients with suspected meningeal carcinomatosis. Comparisons were also made between contrast-enhanced T1-weighted and FLAIR images.
Results:
In six patients, the unenhanced FLAIR images showed areas of abnormal hyperintensity within the sulci that were not noted on the spin-echo T2-weighted images. In all patients, the contrast-enhanced FLAIR images also showed meningeal enhancement, periventricular enhancement, or both. The contrast-enhanced T1-weighted and FLAIR images were equivalent in their depiction of abnormal enhancement in five of the nine patients; contrast-enhanced FLAIR images were superior in three patients.
Conclusion:
Unenhanced FLAIR images are of more value than spin-echo T2-weighted images for the diagnosis of intracranial meningeal carcinomatosis. Contrast-enhanced FLAIR images can sometimes surpass contrast-enhanced T1-weighted images in their quality.