Assessment of sedated pediatric brain with 3D-FLAIR sequence at 3T MRI.

Autor: Ozcan UA; Department of Radiology, Acibadem University School of Medicine, Istanbul, Turkey. Electronic address: umit.ozcan@acibadem.edu.tr., Isik U; Department of Pediatrics, Division of Pediatric Neurology, Acibadem University School of Medicine, Istanbul, Turkey., Ozpinar A; Oregon Health and Science University School of Medicine, Portland, OR, USA., Baykan N; Department of Anesthesiology, Acibadem University School of Medicine, Istanbul, Turkey., Dincer A; Department of Radiology, Acibadem University School of Medicine, Istanbul, Turkey.
Jazyk: angličtina
Zdroj: Brain & development [Brain Dev] 2015 May; Vol. 37 (5), pp. 495-500. Date of Electronic Publication: 2014 Oct 02.
DOI: 10.1016/j.braindev.2014.08.008
Abstrakt: Background and Purpose: In sedated pediatric brains, 2D-FLAIR causes increased signal intensity of the cerebrospinal fluid (CSF) leading to false-positive diagnoses. Our aim is to determine whether increased CSF signal intensity is observed on 3D-FLAIR images.
Methods: In this institutional review board-approved study, a 2-year retrospective analysis of our MRI database was conducted which revealed 48 sedated pediatric patients with normal cranial MRI findings and 3D-FLAIR sequence. One adult volunteer was imaged before and after O2 inhalation with 2D and 3D-FLAIR sequences. The hyperintensity in the subarachnoid spaces and basal cisterns were quantified as follows: 0: artifact free; 1: homogeneous minimal CSF signal; 2: abnormal CSF signal. Inter-observer agreement was assessed with kappa agreement analysis.
Results: Grade 0 and grade 1 signals were observed at inferior to Liliequist membrane (LLQ) in 48/48 and 0/48 cases; prepontine cistern 47/48 and 1/48; superior to LLQ 26/48 and 22/48; 4th ventricle 16/48 and 32/48; 3rd ventricle 34/48 and 14/48; lateral ventricle 3/48 and 45/48; subarachnoid space 36/48 and 12/48, respectively. No patients showed grade 2 signal. Inter-observer agreement was 0.81-1. In the volunteer, after O2 inhalation, grade 2 signal intensity was evident on 2D-FLAIR however; 3D-FLAIR did not show any signal increase.
Conclusions: In sedated pediatric brains, 3D-FLAIR suppresses CSF signal, and enables reliable assessment free from CSF artifacts.
(Copyright © 2014 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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