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Published on: November 20, 2015
T2-hyperintense foci on brain MR imaging
Monika Bekiesińska-Figatowska1
1Department of Diagnostic Imaging, Central Railway Hospital, Warsaw, Poland. m.figatowska@mp.pl
Background:
T2-hyperintense foci are one of the most frequent findings in cerebral magnetic resonance imaging (MRI). They can pose serious diagnostic problems which is reflected by their English name and abbreviation - UBOs (Unidentified Bright Objects).
Material/Methods:
Cerebral MRI results of 246 patients (134 females, 112 males), aged 2 -79 years, were analyzed. The examinations were done with the 0.5 and 1.5 T MRI scanners. T1-, PD or FLAIR and T2-weighted images were obtained. Diffusion-weighted imaging (DWI) was also performed in a high field system.
Results:
The following diagnoses were established: widened perivascular spaces in 11 cases, foci most probably associated with brain aging -21, with migraine -15, ischaemic changes -52, vasculitis -12, hypoxic-ischaemic changes -8, haemorrhagic foci -11, inflammatory changes -20, multiple sclerosis -50, central pontine and extrapontine myelinolysis -7, metastases -7, changes caused by radio-and chemotherapy - 8, lesions associated with neurometabolic diseases - 10, CNS degenerative diseases - 13, eclampsia - 1.
Conclusions:
MRI is a sensitive method of CNS focal lesions detection but is less specific as far as their differentiation is concerned. Particular features of the focal lesions on MR images (number, size, location, presence or lack of edema, reaction to contrast medium, evolution in time), as well as accompanying features (atrophy of particular brain structures, postcontrast enhancement of leptomeninges, coexistence of diffuse lesions, coexistence of spinal lesions) are the significant differentiating elements. However, they can not be considered in isolation from clinical data and other diagnostic tests results.
Insights
T2-hyperintense foci on cerebral MRI, also known as Unidentified Bright Objects (UBOs), are common but challenging to diagnose. Differentiating these lesions requires careful analysis of imaging features alongside clinical data.
Area of Science:
- Neuroimaging
- Radiology
- Neurology
Background:
- T2-hyperintense foci are frequent cerebral MRI findings, often termed Unidentified Bright Objects (UBOs).
- These lesions present diagnostic challenges due to their varied nature.
Purpose of the Study:
- To analyze the diagnostic utility of MRI in differentiating various T2-hyperintense foci in the brain.
- To identify key imaging features that aid in the differential diagnosis of UBOs.
Main Methods:
- Retrospective analysis of cerebral MRI scans from 246 patients (ages 2-79).
- Utilized 0.5T and 1.5T MRI scanners with T1-, PD, FLAIR, T2-weighted, and diffusion-weighted imaging (DWI).
Main Results:
- Diagnoses included ischaemic changes (52), multiple sclerosis (50), inflammatory changes (20), and brain aging (21), among others.
- Specific T2-hyperintense lesions were identified and quantified.
Conclusions:
- Cerebral MRI is sensitive for detecting focal CNS lesions but lacks specificity for differentiation.
- Lesion characteristics (size, location, edema, contrast enhancement, evolution) and accompanying features are crucial for diagnosis.
- Integration of imaging findings with clinical data and other test results is essential for accurate diagnosis.
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