Diagnostic Utility of Contrast-Enhanced Fluid-Attenuated Inversion Recovery Magnetic Resonance Imaging in Intracranial Pathologies: Qualitative and Quantitative Analyses

Document Type : Original Article


The Departments of Radiology* and Neurosurgery**, Faculty of Medicine, Cairo University


Abstract Background: Intravenous MR contrast compounds are utilized to improve lesion identification and characterize dis-orders of the central nervous system. Our study is designed to assess the diagnostic utility of post-contrast FLAIR MRI brain in different intracranial diseases by comparing it with post-con-trast T1 sequence. Additionally, to assess the importance of the post-contrast FLAIR sequence using both qualitative and quan-titative metrics in various lesion locations. Aim of Study: The aim of this study is to compare the diag-nostic value of post-contrast FLAIR MRI brain to post-contrast T1 sequence in various intracranial pathologies and to evaluate the significance of post-contrast FLAIR sequence in various le-sions locations using qualitative and quantitative parameters. Patients and Methods: Using MRI, the brains of 50 peo-ple with neurological signs and symptoms were scanned. A post-contrast FLAIR sequence was added to post-contrast T1WI. We separated the lesions based on location into extra-ax-ial and intra-axial groups, and we categorized them etiological-ly into neoplastic, ischemic, inflammatory, and demyelinating groups. Using qualitative and quantitative assessments, we test-ed whether the lesions’ location impacted the effectiveness of the post-contrast FLAIR sequence.
Results: There were 50 cases in all, with different intrac-ranial pathologies. Our two observers detected that post-con-trast FLAIR showed better lesions definition, better detection of lesions enhancement as well as higher number of enhancing lesions compared to T1WI. Post-contrast FLAIR had a great-er CBR than CET1 detected by both observers. We discovered that post-contrast FLAIR had lower specificity (62.5%) than post-contrast T1WI (87.5%), but better sensitivity (78.6%) than post-contrast T1WI (64.3%). Extra axial lesions showed higher CEI than lesions of other location (mean CEI 152) with statisti-cally significant p-value of 0.037.
Conclusion: Post-contrast FLAIR sequence should be add-ed to CE T1W imaging in assessment of intracranial disorders. According to qualitative and quantitative evaluation, post-con-trast FIAIR was particularly effective at identifying extra-axial lesions.