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[FLAIR images of cerebral and brain stem infarction]
H Tsurushima1, K Meguro, M Wada
1Department of Neurosurgery, Tsukuba Medical Center Hospital, Japan.
Abstract:
FLAIR (fluid-attenuated inversion recovery) images are MR images obtained with an inversion recovery sequence having a long inversion time (TI) and a long echo time (TE). We examined 47 cases (56 graphics) of lacunar infarction (LI), 28 cases (32 graphics) of cortical infarction (CI) and 16 cases (23 graphics) of stem infarction (SI) with a FLAIR sequence having a repetitive time (TR) of 6500 msec, a TI of 1700 msec and a TE of 110 msec, and compared these graphics with T2-weighted images by spin-echo sequence (TR 2500 msec, TE 90 msec). LI and CI were better demonstrated with FLAIR images than with conventional T2-weighted images. FLAIR images were very useful in detecting lesions adjacent to the lateral ventricles and the cerebral sulci in particular, because the cerebrospinal fluid signals in the lateral ventricles and the cerebral sulci were low-intensity, with brain tissue appearing as high-intensity areas. In a number of old infarctions, FLAIR images revealed cystic structures, constructed out of internal low-intensity areas and peripheral high-intensity areas. These structural changes suggested that FLAIR images can provide information on pathological changes.
Insights
Fluid-attenuated inversion recovery (FLAIR) MRI enhances visualization of lacunar and cortical infarctions. FLAIR imaging offers superior detection of lesions near ventricles and sulci, aiding in pathological change assessment.
Area of Science:
- Radiology
- Neuroimaging
- Magnetic Resonance Imaging
Context:
- Magnetic Resonance Imaging (MRI) is crucial for diagnosing cerebrovascular diseases.
- Conventional T2-weighted MRI sequences have limitations in visualizing certain types of brain lesions.
- Fluid-attenuated inversion recovery (FLAIR) is an advanced MRI technique.
Purpose:
- To evaluate the efficacy of FLAIR MRI in detecting and characterizing different types of cerebral infarctions.
- To compare the diagnostic performance of FLAIR images with conventional T2-weighted images for lacunar infarction (LI), cortical infarction (CI), and stem infarction (SI).
Summary:
- FLAIR MRI sequences with specific parameters (TR 6500 ms, TI 1700 ms, TE 110 ms) were used to examine 47 cases of LI, 28 of CI, and 16 of SI.
- FLAIR images demonstrated superior visualization of LI and CI compared to T2-weighted images (TR 2500 ms, TE 90 ms).
- The technique excels in detecting lesions adjacent to lateral ventricles and cerebral sulci due to suppressed cerebrospinal fluid signal intensity, highlighting brain tissue as high-intensity areas. FLAIR also revealed cystic changes in old infarctions, suggesting its utility in assessing pathological alterations.
Impact:
- FLAIR MRI provides enhanced detection of lacunar and cortical infarctions.
- The technique improves lesion conspicuity near cerebrospinal fluid spaces, aiding in diagnosis.
- FLAIR imaging offers valuable insights into the pathological evolution of infarctions.