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Optimal Detection of Subtle Gadolinium Leakage in CSF with Heavily T2-Weighted Fluid-Attenuated Inversion Recovery
W M Freeze1,2, D N Ter Weele3, W M Palm2
1From the Department of Psychiatry and Neuropsychology (W.M.F., R.W.v.H., H.I.L.J., F.R.V.), Maastricht University, School for Mental Health and Neuroscience, Alzheimer Centrum Limburg, Maastricht, the Netherlands.
Detecting subtle blood-brain barrier leakage using pericortical enhancement on postcontrast FLAIR images is improved with longer echo times (TE). Careful selection of FLAIR sequence parameters is crucial for accurate assessment.
Area of Science:
- Neuroradiology
- Magnetic Resonance Imaging
Background:
- Pericortical enhancement on postcontrast FLAIR indicates leptomeningeal blood-brain barrier leakage.
- Detecting subtle leakage requires optimized imaging parameters.
Purpose of the Study:
- To identify optimal FLAIR sequence parameters for detecting low gadolinium concentrations in cerebrospinal fluid (CSF).
- To enhance the detection of subtle pericortical enhancement.
Main Methods:
- Phantom experiments and human in vivo data were analyzed.
- Evaluation of various FLAIR sequence parameters, focusing on echo time (TE).
Main Results:
- A relatively long echo time (TE) facilitates the detection of subtle pericortical enhancement.
- Optimized FLAIR parameters improve sensitivity to low gadolinium concentrations in CSF.
Conclusions:
- Longer TE in FLAIR sequences is beneficial for detecting subtle blood-brain barrier leakage.
- Future research should carefully select FLAIR parameters for assessing pericortical enhancement.
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