ABSTRACT
Fluid Attenuated Inversion Recovery (FLAIR) MRI of brain is sensitive in detecting parenchymal lesions, extra axial lesions such as meningoencephalitis, and leptomeningeal tumoural disease. We wanted to compare gadolinium enhanced T2W FLAIR with PC-T1W (post contrast T1 weighted) MRI sequence in detection and evaluation of meningeal and parenchymal lesions. We also wanted to compare gadolinium enhanced T1W FLAIR with PC-T1W MRI sequence in detection and evaluation of meningeal and parenchymal lesions.METHODS65 patients with clinical diagnosis of cerebral meningitis or intracranial tumoural disease were scanned on 1.5 T 16 channel MRI scanner. A standard brain protocol was used, followed by PC-T1W and post contrast FLAIR, with PC-T1W MR preceding post contrast FLAIR. Images were assessed independently by 2 radiologists who marked the technique they thought had made the meningeal and parenchymal disease more conspicuous. In case of disagreement the radiologists made a consensus determination.RESULTSPC-T2 FLAIR showed better enhancement in 100% of the intra axial lesions compared to PC-T1W images. However, PC-T1 FLAIR showed better enhancement than PC-T1W images in only 81% of the same. PC-T2 FLAIR showed better enhancement in 100% of the extra-axial lesions compared to PC-T1W images. However, PC-T1 FLAIR showed less enhancement in all the extra axial lesions.CONCLUSIONSContrast enhanced T2 FLAIR MRI showed better enhancement of parenchymal and meningeal lesions. PC-T2 FLAIR detected more number of lesions when compared to PC-T1W, aided better delineation of extra-axial mass lesions due to superior enhancement, and had a better demarcated dural tail. Post-contrast T2 FLAIR images should be included in routine protocol for contrast MRI brain study.