Use of fluid-attenuated inversion recovery (FLAIR) pulse sequences in perinatal hypoxic-ischaemic encephalopathy

Area of Science:

• Neurology
• Radiology
• Pediatrics

Background:

• Perinatal hypoxic-ischaemic encephalopathy (HIE) is a major cause of neonatal brain injury.
• Accurate imaging is crucial for diagnosis and management of HIE.

Purpose of the Study:

• To evaluate the diagnostic utility of fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) in pediatric patients with HIE.
• To compare FLAIR imaging with conventional T1 and T2 weighted spin echo sequences.

Main Methods:

• 13 patients (1 month to 3.6 years) with HIE underwent MRI using T1, T2, and FLAIR sequences on a 1.5 T unit.
• Radiologists qualitatively assessed lesion detection.
• Quantitative analysis of contrast and contrast-to-noise ratios was performed.

Main Results:

• FLAIR imaging demonstrated superior visualization of periventricular leukomalacia (PVL), cystic PVL, and subcortical lesions compared to T1 and T2 weighted images.
• FLAIR differentiated cystic lesions by signal intensity, unlike conventional sequences.
• Conventional sequences showed lesions as hypointense (T1) or hyperintense (T2) areas.

Conclusions:

• FLAIR sequences provide valuable diagnostic information in patients with perinatal hypoxic-ischaemic encephalopathy.
• FLAIR MRI enhances the detection and characterization of brain lesions associated with HIE.
• While highly useful, FLAIR was not diagnostic in all PVL cases.