Abstract
EVALUATION OF FAST FLUID-ATTENUATED INVERSION RECOVERY (FLAIR) MAGNETIC RESONANCE IMAGING (MRI) IN BRAIN TUMOURS

Kulbhushan Gupta*, Haroon Salaria and Pranav Pandoh

ABSTRACT

The study was done to quantify imaging characteristics of fast-FLAIR sequence compared with T1-post contrast and T2 sequences in brain tumours. It was also determined whether fast-FLAIR sequence influenced the predictive value of conventional magnetic resonance imaging (MRI) for tumour histology and surgical approach to tumour. We prospectively studied 25 patients with intracranial tumour detected on routine computed tomography (CT) examination requiring surgery. MRI was performed on a 1.5-T Siemens somatom system. MRI protocol consisting of conventional MRI study – T1 and T2 FSE, axial and coronal fast-FLAIR sequence and post contrast T1 weighted imaging was obtained. The results showed that in the intraaxial group of tumours (n=8), fast FLAIR sequence revealed statistically significant advantage over post contrast T1 and T2 weighted images in differentiating tumour from surrounding oedema (p < 0.05). Similarly fast FLAIR was clearly advantageous in differentiating normal brain from oedema when compared to either of the other two MRI sequences. In the extraaxial group (n=17), both T2 weighted and fast FLAIR sequences revealed higher signal intensity of tumour in comparison to post contrast T1 image (p < 0.01). In differentiating tumour from oedema both T2 weighted and fast FLAIR sequences were significantly superior to post contrast T1 but fast FLAIR was even superior to T2 weighted image(p < 0.05).In demarcating brain from oedema fast FLAIR was found to be superior to the other sequences and this difference was statistically highly significant. In no case did fast FLAIR imaging alter the MRI predicted tumour histology. In 8 out of 25 cases (32 %) fast FLAIR imaging did influence the surgical approach to tumour. The main conclusion of this study is fast FLAIR has clear advantage over conventional MRI sequences in demarcating tumour v/s oedema and brain v/s oedema in intracranial tumours especially gliomas associated with significant peritumoural oedema.

Keywords: Fast FLAIR; magnetic resonance imaging; computed tomography; tumours.


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