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Signal Intensity Ratio in Fluid Attenuation Inversion Recovery Sequences in Determining Cerebral Metastasis on Non-contrast-Enhanced Magnetic Resonance Imaging

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Abstract

Cerebral metastases are serious complications of systemic tumors. Ischemic lesions are the main differential diagnosis of cerebral metastasis. The aim of this study is to evaluate the efficiency of signal intensity ratio (SIR) in non-contrast-enhanced fluid attenuation inversion recovery (FLAIR) sequence in the detection of cerebral metastasis. Patients with brain metastasis and evaluated with brain MRI in our institution, between 2015 and 2017, were included in this study. Brain metastases were detected in contrast-enhanced fat-saturated T1-weighted images. In pre-contrast FLAIR sequences, signal intensities (SI) from metastasis, perilesional white matter, and, if present, ischemic lesion were measured. In all patients, normal white matter SI was recorded, and SI ratio (SIR = SI lesion/SI reference white matter) was calculated for standardization. A total of 59 patients with brain metastasis detected in contrast-enhanced brain MRI were included in this study. A significant difference was detected between mean metastasis SIR and mean ischemic SIR (P = 0.001); mean perilesional SIR and mean ischemic SIR (p = 0.033); minimum metastasis SIR and minimum perilesional SIR (P = 0.012); and maximum metastasis SIR and maximum ischemic SIR (p = 0.04). SIR of hyperintense lesions in FLAIR sequences may be helpful in differentiating brain metastasis from ischemic WM lesions, especially in patients contrast media is contraindicated.

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Authors and Affiliations

  1. Department of Radiology, Malatya Education and Research Hospital, Malatya, Turkey

    Dilek Sağlam

  2. Dr.Lütfi Kırdar Kartal Education and Research Hospital, İstanbul, Turkey

    Hediye Pınar Günbey

  3. Muş State Hospital, Muş, Turkey

    Serap Yücel

  4. Department of Radiology, Ondokuz Mayıs University, Samsun, Turkey

    Aslı Tanrıvermiş Sayıt, Kerim Aslan & Lütfi İncesu

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  1. Dilek Sağlam
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  2. Hediye Pınar Günbey
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  4. Aslı Tanrıvermiş Sayıt
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  5. Kerim Aslan
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  6. Lütfi İncesu
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Contributions

Dilek Sağlam: acquisition, analysis and interpretation of data, drafting the work, final approval, and agreement for all aspects of the work

Hediye Pınar Günbey: acquisition, analysis and interpretation of data, drafting the work, final approval, and agreement for all aspects of the work

Serap Yücel: acquisition, analysis and interpretation of data, drafting the work, final approval, and agreement for all aspects of the work

Aslı Tanrıvermiş Sayıt: acquisition, analysis and interpretation of data, drafting the work, final approval, and agreement for all aspects of the work

Kerim Aslan: acquisition, analysis and interpretation of data, drafting the work, final approval, and agreement for all aspects of the work

Lütfi İncesu: acquisition, analysis and interpretation of data, drafting the work, final approval, and agreement for all aspects of the work

Corresponding author

Correspondence to Dilek Sağlam.

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Granted from Ondokuz Mayıs University Clinical Research Ethical Committee (study number:2016/367).

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The authors declare no competing interests.

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This article is part of the Topical Collection on Imaging

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Sağlam, D., Günbey, H.P., Yücel, S. et al. Signal Intensity Ratio in Fluid Attenuation Inversion Recovery Sequences in Determining Cerebral Metastasis on Non-contrast-Enhanced Magnetic Resonance Imaging. SN Compr. Clin. Med. 4, 27 (2022). https://doi.org/10.1007/s42399-021-01089-7

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  • DOI: https://doi.org/10.1007/s42399-021-01089-7

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