Related Experiment Videos
Fast fluid-attenuated inversion-recovery MR of intracranial infections
K Tsuchiya1, S Inaoka, Y Mizutani
1Department of Radiology, Kyorin University School of Medicine, Mitaka, Tokyo, Japan.
Purpose:
To assess the usefulness of fast fluid-attenuated inversion-recovery (FLAIR) MR sequences in the diagnosis of intracranial infectious diseases.
Methods:
We compared fast FLAIR images with conventional spin-echo images (T1- and T2-weighted) obtained in 20 patients with infectious diseases (six with encephalitis, five with brain abscesses, three with meningitis, two with meningoencephalitis, two with Creutzfeldt-Jakob disease, one with epidural empyema, and one with cysticercosis). Two neuroradiologists independently reviewed the FLAIR images and compared them with the conventional spin-echo images, obtaining agreement in all patients.
Results:
FLAIR images of diagnostic quality were obtained in 18 patients. In two patients, FLAIR images were degraded by motion. Lesions in the patients with encephalitis and meningoencephalitis were better delineated on FLAIR images than on spin-echo images. FLAIR images clearly depicted lesions in the basal ganglia in both patients with Creutzfeldt-Jakob disease. In patients with brain abscess, meningitis, cysticercosis, and epidural empyema, FLAIR images provided no more information than conventional spin-echo images, and the lesions were seen better on postcontrast T1-weighted spin-echo images.
Conclusion:
Fast FLAIR images showed pathologic changes in intracranial infectious diseases better than or as well as conventional T2- and proton density-weighted spin-echo sequences. However, postcontrast T1-weighted spin-echo sequences resulted in better visibility of abscess, meningitis, cysticercosis, and epidural empyema than did FLAIR images.
Insights
Fast fluid-attenuated inversion-recovery (FLAIR) MRI sequences are useful for diagnosing encephalitis and Creutzfeldt-Jakob disease. However, conventional T1-weighted MRI is better for visualizing abscesses and meningitis.
Area of Science:
- Neuroradiology
- Infectious Diseases
- Magnetic Resonance Imaging
Background:
- Intracranial infectious diseases present diagnostic challenges.
- Magnetic Resonance Imaging (MRI) is crucial for diagnosing these conditions.
- Fast fluid-attenuated inversion-recovery (FLAIR) sequences offer potential advantages in image quality.
Purpose of the Study:
- To evaluate the diagnostic utility of fast FLAIR MRI sequences for intracranial infections.
- To compare the effectiveness of fast FLAIR with conventional spin-echo MRI sequences.
Main Methods:
- Twenty patients with various intracranial infectious diseases underwent fast FLAIR and conventional spin-echo MRI (T1- and T2-weighted).
- Two neuroradiologists independently reviewed and compared the images.
- Diagnostic quality and lesion delineation were assessed.
Main Results:
- Fast FLAIR MRI provided diagnostic quality images in 18 out of 20 patients.
- Lesions in encephalitis and meningoencephalitis were better seen on fast FLAIR.
- Fast FLAIR clearly depicted basal ganglia lesions in Creutzfeldt-Jakob disease.
- Conventional T1-weighted MRI with contrast was superior for visualizing abscesses, meningitis, cysticercosis, and epidural empyema.
Conclusions:
- Fast FLAIR MRI is effective for detecting pathologic changes in certain intracranial infections like encephalitis and Creutzfeldt-Jakob disease.
- Conventional T2- and proton density-weighted spin-echo sequences are comparable to fast FLAIR for some conditions.
- Postcontrast T1-weighted spin-echo sequences remain essential for optimal visualization of specific infections such as abscesses and meningitis.