对比增强液体衰减反转恢复成像在儿童柔脑膜疾病中的应用

Contrast-enhanced fluid-attenuated inversion recovery imaging for leptomeningeal disease in children.

作者信息

Griffiths Paul D, Coley Stuart C, Romanowski Charles A J, Hodgson Tim, Wilkinson Iain D

机构信息

Unit of Academic Radiology, University of Sheffield, England.

出版信息

AJNR Am J Neuroradiol. 2003 Apr;24(4):719-23.

PMID:12695212

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8148663/

Abstract

BACKGROUND AND PURPOSE

To develop an MR imaging method that improves detection of leptomeningeal disease when compared with the current reference standard, contrast-enhanced T1-weighted imaging.

METHODS

We investigated the cases of 10 children who were at high risk of intracranial leptomeningeal disease (Sturge-Weber syndrome and medulloblastoma). The cases of Sturge-Weber syndrome were investigated by using one MR imaging examination, and the cases of medulloblastoma were investigated by using four MR imaging examinations performed over 18 months. In all cases, contrast-enhanced fluid-attenuated inversion recovery (FLAIR) images were acquired in addition to the routine sequences. The parameters of the FLAIR sequence were chosen to maximize the T1 component of the signal intensity, to maximize detection of leptomeningeal enhancement. We made subjective and objective assessments of the presence and extent of leptomeningeal disease as shown on contrast-enhanced T1-weighted images and contrast-enhanced FLAIR images.

RESULTS

In three of the four cases of Sturge-Weber syndrome, the T1 and FLAIR sequences showed comparable extent of leptomeningeal enhancement. For one child, FLAIR images showed unexpected bilateral disease and more extensive leptomeningeal enhancement on the clinically suspected side. In four of six cases of medulloblastoma, no leptomeningeal enhancement was shown on any examinations during the 18-month period. In two cases, FLAIR images showed more extensive leptomeningeal enhancement when compared with T1-weighted images.

CONCLUSION

Contrast-enhanced FLAIR imaging seems to improve detection of leptomeningeal disease when compared with routine contrast-enhanced T1-weighted imaging. This seems to be partly because of suppression of signal intensity from normal vascular structures on the surface of the brain by FLAIR, which allows easier visualization of abnormal leptomeninges. We think that these findings can be extrapolated to the investigation of leptomeningeal disease of all causes and at all ages.

摘要

背景与目的

开发一种磁共振成像（MR）方法，与当前参考标准对比增强T1加权成像相比，能更好地检测软脑膜疾病。

方法

我们研究了10例颅内软脑膜疾病高危儿童（斯特奇-韦伯综合征和髓母细胞瘤）的病例。对斯特奇-韦伯综合征病例进行了一次MR成像检查，对髓母细胞瘤病例在18个月内进行了四次MR成像检查。在所有病例中，除常规序列外，还采集了对比增强液体衰减反转恢复（FLAIR）图像。选择FLAIR序列参数以最大化信号强度的T1成分，以最大程度地检测软脑膜强化。我们对对比增强T1加权图像和对比增强FLAIR图像上显示的软脑膜疾病的存在和范围进行了主观和客观评估。

结果

在4例斯特奇-韦伯综合征病例中的3例中，T1和FLAIR序列显示的软脑膜强化范围相当。对于1名儿童，FLAIR图像显示出意外的双侧疾病，且临床怀疑侧的软脑膜强化更广泛。在6例髓母细胞瘤病例中的4例中，在18个月期间的任何检查中均未显示软脑膜强化。在2例病例中，与T1加权图像相比，FLAIR图像显示的软脑膜强化更广泛。