Subarachnoid space disease: diagnosis with fluid-attenuated inversion-recovery MR imaging and comparison with gadolinium-enhanced spin-echo MR imaging--blinded reader study.

Singer, Michael Bliss; Atlas, Susan J.; Drayer, B P

doi:10.1148/radiology.208.2.9680570

Cited by 142 publications

(70 citation statements)

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“…This type of lymphoma extends along the Virchow Robin space, so may be identified as an intradural extraaxial lesion by fluidattenuated inversion recovery imaging. 41) Hypertrophy of the posterior longitudinal ligament, which is located on the ven tral side of the spinal cord, appears isointense to the cord on T 1 weighted imaging and is only slightly enhanced by GdDTPA administration as a thin irregular venous plexus in the lesion. Hypertrophy of the ligamentum flavum, which is located on the dorsal side of the spinal cord, shows similar findings to hypertrophy of the posterior longitudinal liga ment without enhancement.…”

Section: Resultsmentioning

confidence: 99%

Review of Spinal Epidural Cavernous Hemangioma

Aoyagi¹,

Kojima²,

Kasai³

2003

Neurol. Med. Chir.(Tokyo)

118

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The characteristics of spinal epidural cavernous hemangioma without primary origin in the vertebral bone were evaluated in 54 patients including our new case. The 36 male and 18 female patients were aged 5 to 78 years (mean 47 years). Most lesions were in the thoracic spine (80%) and on the dorsal side of the spinal cord (93%). The clinical course was mostly slowly progressive, with myelopathy in 33% at onset and 83% at admission. The lesion appeared isointense to the spinal cord on T 1 weighted imaging, and isointense or slightly hypointense to the cerebrospinal fluid on T 2 weighted imaging. Lesion without hemorrhage showed prominent homogeneous enhancement after administration of gadoliniumdiethylenetriaminepentaacetic acid because of the sinusoidal channel structure. Heter ogeneous enhancement was caused by hematoma and/or posthemorrhagic degeneration. The differen tial diagnosis of this disease includes metastatic tumor, Ewing's sarcoma, chordoma, eosinophilic granuloma, sarcoidosis, lipoma, hypertrophy of the posterior longitudinal ligament or the ligamentum flavum, meningioma, and neurinoma. The relationships between clinical course and surgery or outcome suggest that early diagnosis and total removal of the lesion before massive lesional bleeding occurs are necessary for a good outcome.

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Section: Resultsmentioning

confidence: 99%

Review of Spinal Epidural Cavernous Hemangioma

Aoyagi¹,

Kojima²,

Kasai³

2003

Neurol. Med. Chir.(Tokyo)

118

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“…This conclusion was based upon improved sensitivity of MRI for lesion detection from 99.5% using FLAIR images alone to 99.6% after inclusion of postcontrast sequences. Previous studies in humans also have suggested that negative FLAIR images may eliminate the need for gadolinium‐enhanced T1W images in the diagnosis of intracranial infections,17 leptomeningeal disease,18 and in the detection of intracranial tumors 19, 20. However, a critical review of the human literature concluded that despite the widespread use of MR contrast media, no rigorous studies existed to establish a solid evidence base for their application in human medicine 1…”

Section: Discussionmentioning

confidence: 99%

Exclusion of a Brain Lesion: Is Intravenous Contrast Administration Required after Normal Precontrast Magnetic Resonance Imaging?

Ives

Rousset

Heliczer

et al. 2014

Veterinary Internal Medicne

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BackgroundNo evidence‐based guidelines are available for the administration of gadolinium‐based contrast media to veterinary patients.ObjectiveTo investigate whether administration of intravenous (IV) contrast media alters the likelihood of identifying a brain lesion in dogs and cats.AnimalsFour hundred and eighty‐seven client‐owned animals referred for investigation of intracranial disease.MethodsTwo reviewers retrospectively analyzed precontrast transverse and sagittal T1‐weighted (T1W), T2‐weighted, and fluid‐attenuated inversion recovery low‐field MRI sequences from each patient for the presence of a clinically relevant brain lesion. All sequences subsequently were reviewed in the same manner with additional access to postcontrast T1W images.ResultsOf the 487 precontrast MRI studies, 312 were judged to be normal by 1 or both reviewers. Of these 312 studies, a previously undetected lesion was identified in only 6 cases (1.9%) based on changes observed on postcontrast sequences. Final diagnoses included meningoencephalitis of unknown origin (n = 1), feline infectious peritonitis (n = 1), and neoplasia (n = 2). All 4 of these cases had persistent neurological deficits suggestive of an underlying brain lesion. Contrast enhancement observed in the 2 other cases was considered falsely positive based on the results of further investigations.Conclusions and Clinical ImportanceIn patients with normal neurological examination and normal precontrast MRI, the subsequent administration of IV gadolinium‐based contrast media is highly unlikely to disclose a previously unidentified lesion, calling into question the routine administration of contrast media to these patients. However, administration still should be considered in animals with persistent neurological deficits suggestive of an underlying inflammatory or neoplastic brain lesion.

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“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14] This relies on the fact that FLAIR imaging is designed to null the normal CSF signal intensity, and any alteration in the CSF results in an increased signal intensity in the CSF. Postgadolinium FLAIR imaging has also shown hyperintensity in the SAS in patients with pathologies that are not specific to the SAS but rather disrupt the blood-brain barrier.…”

Section: Discussionmentioning

confidence: 99%

Increased Signal in the Subarachnoid Space on Fluid-Attenuated Inversion Recovery Imaging Associated with the Clearance Dynamics of Gadolinium Chelate: A Potential Diagnostic Pitfall

Morris¹,

Miller²

2007

American Journal of Neuroradiology

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BACKGROUND AND PURPOSE:Hyperintense CSF in the subarachnoid space (SAS) on fluid-attenuated inversion recovery (FLAIR) imaging has been reported in numerous pathologic conditions, including subarachnoid hemorrhage, meningitis, meningeal carcinomatosis, superior sagittal thrombosis, adjacent tumors, status epilepticus, and stroke. It has also been reported in otherwise healthy patients undergoing anesthesia with supplemental oxygen. We present a series of 11 patients with hyperintense CSF signal intensity in the SAS on FLAIR imaging after previous administration of gadolinium chelate.

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Subarachnoid space disease: diagnosis with fluid-attenuated inversion-recovery MR imaging and comparison with gadolinium-enhanced spin-echo MR imaging--blinded reader study.

Cited by 142 publications

References 0 publications

Review of Spinal Epidural Cavernous Hemangioma

Review of Spinal Epidural Cavernous Hemangioma

Exclusion of a Brain Lesion: Is Intravenous Contrast Administration Required after Normal Precontrast Magnetic Resonance Imaging?

Increased Signal in the Subarachnoid Space on Fluid-Attenuated Inversion Recovery Imaging Associated with the Clearance Dynamics of Gadolinium Chelate: A Potential Diagnostic Pitfall

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