International Journal of Clinical & Medical Imaging | OMICS International | Editorial Board
Home  |  Journals  |  Conferences |   Membership  |   FAQ's
Join  |  Contact  |   Sitemap  |                
OMICS Group Inc

International Journal of Clinical & Medical Images

ISSN: 2376-0249 Open Access

Contrast FLAIR Imaging may be Best Detectable for Leptomeningitis

Other Art Works

Image 01 Image 02
Image 03 Image 04
Image 05 Image 06
Image 07 Image 08
Image 09 Image 10
Image 11 Image 12
Image 13 Image 14
Image 15 Image 16
Image 17 Image 18
Image 19 Image 20
Image 21 Image 22
Image 23 Image 24
Image 25 Image 26
Image 27 Image 28
Image 29 Image 30

A woman in her early 50 s presented with headache, dizziness, and a high fever. Lumbar puncture showed an initial pressure of 210 mmHg, with 313 white cells/mm3 (90% polymorphonuclear leukocytes), a protein concentration of 198 mg/dl, and a glucose concentration of 74 mg/dl (serum glucose concentration, 199 mg/dl). The consciousness was clear, with meningeal and cerebellar signs. Cerebrospinal fluid (CSF) culture confirmed nocardia resistant to trimethoprim/sulfamethoxazole. The patient underwent 1.5-T magnetic resonance imaging (MRI) (Magnetom Sonata A.G., Siemens, Erlangen, Germany), using turbo spinecho sequences for T2-weighted images (T2WI) (TR 4000 ms; TE 91 ms), T1-weighted images (T1WI) (TR 492 ms; TE 9.4 ms), and fluid-attenuated inversion recovery (FLAIR) images (TR 10000 ms; TE 125 ms). Cranial MRI showed a ring-enhancing abscess and acute infarcts in the left cerebellum and medulla. Enlarged ventricles and some areas of leptomeningeal enhancement were evident. After the injection of gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA 0.1 mmol/kg), contrast T1WI (TR 492 ms; TE 9.4 ms) and subsequent contrast FLAIR images (TR 10000 ms; TE 125 ms) were obtained. Enhancements of the leptomeninges were more apparent on contrast FLAIR images (panel d; arrow) than on contrast T1WI images (panel b). High signal intensity in the same lesions on contrast FLAIR images was more evident than that on non-contrast FLAIR images (panel c). Increased high signal intensity of the same lesion was absent on T2WI images (panel a). Contrast FLAIR images are especially useful for the detection of meningeal lesions that border the cerebrospinal fluid (CSF) [1].