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MR imaging of the normal meninges: comparison of contrast-enhancement patterns on 3D gradient-echo and spin-echo
1Mallinckrodt Institute of Radiology (Jewish Hospital), Washington University School of Medicine, St. Louis, MO 63110.
Objective:
The purpose of this study was to determine the enhancement pattern of the normal meninges on T1-weighted three-dimensional Fourier transform gradient-echo (3DGE) MR images and to compare this pattern with that observed on conventional two-dimensional Fourier transform spin-echo (2DSE) images. This will serve as a basis for comparison when cases of suspected meningeal pathology are evaluated.
Subjects And Methods:
The appearance of the normal meninges after administration of gadopentetate dimeglumine was evaluated on 2DSE and 3DGE images in 69 patients who had no known or suspected meningeal abnormality. The total percentage of meningeal surface area that underwent contrast enhancement and the continuity of meningeal enhancement were evaluated at four anatomic levels.
Results:
In most patients, 2DSE images showed short segments (i.e., < 3 cm) of meningeal enhancement, with enhancement of less than 50% of total meningeal surface area. However, enhancement of 76-100% of total meningeal surface area was routinely observed on 3DGE images, with long segments (i.e., > 3 cm) or continuous patterns most frequently observed. The differences between 2DSE and 3DGE sequences were statistically significant for all regions that were assessed.
Conclusion:
Continuous meningeal enhancement or enhancement of long segments of normal meninges is routinely observed on contrast-enhanced 3DGE images; this appearance differs from those of enhanced 2DSE images and should not be interpreted as abnormal.
Insights
Contrast-enhanced 3DGE MRI routinely shows continuous meningeal enhancement in normal patients. This differs from 2DSE images and should not be mistaken for pathology.
Area of Science:
- Neuroradiology
- Medical Imaging
- Neuroscience
Background:
- Meningeal enhancement patterns on MRI are crucial for diagnosing pathology.
- Distinguishing normal enhancement from abnormal findings is essential for accurate diagnosis.
Purpose of the Study:
- To characterize normal meningeal enhancement on T1-weighted 3D Fourier transform gradient-echo (3DGE) MRI.
- To compare 3DGE findings with conventional 2D Fourier transform spin-echo (2DSE) MRI.
- To establish a baseline for evaluating suspected meningeal abnormalities.
Main Methods:
- Evaluated contrast enhancement of normal meninges in 69 patients using 2DSE and 3DGE MRI after gadopentetate dimeglumine administration.
- Assessed the percentage of enhanced meningeal surface area and enhancement continuity at four anatomical levels.
Main Results:
- 2DSE images showed limited meningeal enhancement (<50% surface area, short segments <3 cm).
- 3DGE images revealed extensive enhancement (76-100% surface area, long segments >3 cm or continuous).
- Statistically significant differences in enhancement patterns were observed between 2DSE and 3DGE sequences.
Conclusions:
- Continuous or long-segment meningeal enhancement is a normal finding on contrast-enhanced 3DGE MRI.
- This pattern differs from 2DSE imaging and should not be misinterpreted as pathological.
- Understanding these differences aids in the accurate interpretation of meningeal imaging studies.