• AJR Am J Roentgenol · Jan 2012

    Multicontrast single-slab 3D MRI to detect cerebral metastasis.

    • Weiwei Chen, Liang Wang, Wenzhen Zhu, Liming Xia, Jianpin Qi, Dingyi Feng, and Xin Luo.
    • Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, 1095 Jiefang Ave, Wuhan 430030, China. chenweiwei101205@gmail.com
    • AJR Am J Roentgenol. 2012 Jan 1; 198 (1): 27-32.

    ObjectiveThe purpose of this study was to evaluate the sensitivities and specificities of four single-slab 3D MRI sequences in the detection of cranial metastases: double inversion recovery (IR), T2 FLAIR, contrast-enhanced T2 FLAIR, and contrast-enhanced IR-prepared fast spoiled gradient-echo (FSPGR) sequences.Subjects And MethodsEighty-four patients underwent double IR and T2 FLAIR imaging using 3-T MRI. Then, 49 of 84 patients were randomly selected to undergo contrast-enhanced IR-prepared FSPGR before contrast-enhanced T2 FLAIR, and the other 35 patients underwent contrast-enhanced T2 FLAIR before contrast-enhanced IR-prepared FSPGR. Two experienced neuroradiologists reviewed the images by consensus on a workstation. Metastases were scored a negative, equivocal, or positive. For each metastasis, we recorded the anatomic area and size, and checked whether edema was present.ResultsA total of 210 cranial metastases in 56 of 84 patients were revealed. The sensitivities of double IR, T2 FLAIR, contrast-enhanced IR-prepared FSPGR, and contrast-enhanced T2 FLAIR sequences were 66.2%, 56.7%, 80.5%, and 99%, respectively. The specificities were 68.3%, 73%, 75.7%, and 82.4%. The areas under the receiver operating characteristic curve were 0.763, 0.709, 0.865, and 0.993. Contrast-enhanced T2 FLAIR imaging was found to have the highest sensitivity especially for detecting lesions in meninges (98.2%; p<0.0001) and gray matter (GM) (100%; p<0.0001). The double IR sequence was superior to the T2 FLAIR sequence for imaging metastases located in ependyma (81.8% vs 36.4%) and GM (66.7% vs 48.1%). Delayed enhancement did not affect the sensitivities of the contrast-enhanced T2 FLAIR and contrast-enhanced IR-prepared FSPGR sequences.ConclusionContrast-enhanced T2 FLAIR is the most sensitive sequence of the four MR sequences evaluated for the detection of cranial metastases despite its delay time after contrast enhancement.

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