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Fluid-attenuated inversion recovery vascular hyperintensities are not visible using 3D CUBE FLAIR sequence

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Abstract

Objective

Fluid-attenuated inversion recovery (FLAIR) vascular hyperintensities (FVH), initially described on 2D FLAIR images, are a useful imaging marker in patients with acute ischaemic stroke. We aimed to compare the sensitivity of the 3D CUBE FLAIR sequence with 2D FLAIR for the detection of FVH.

Methods

Forty-seven consecutive patients admitted for a suspected stroke were explored by 2D and 3D CUBE FLAIR MR sequences at 1.5 and 3 T. Three blinded readers assessed FVH defined as hyperintensities within cerebral arteries. Location of FVH, acute brain infarct and arterial stenosis were also assessed. 2D images were compared with 3D images for the detection of FVH. Agreement between readers was assessed.

Results

Of the 47 patients, 21 FVHs were observed on 2D FLAIR images of 15 patients (11 with acute brain infarct and 11 with an arterial stenosis). No FVH was visualised on 3D CUBE FLAIR images for either proximal or distal locations. Agreement between readers was excellent.

Conclusion

FVHs are not visible using 3D CUBE FLAIR images. This study suggests that, in suspected acute ischaemic stroke, the assessment of FVH should only be performed on conventional 2D FLAIR images.

Key Points

• Fluid-attenuated inversion recovery (FLAIR) vascular hyperintensities (FVH) are of neuroradiological importance.

• FVHs are useful imaging markers in patients with an acute ischaemic stroke.

• FVHs are not visible using 3D CUBE FLAIR images.

• Assessment of FVH should be performed on conventional 2D FLAIR images.

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Abbreviations

ACA:

Anterior cerebral artery

AICA:

Anterior inferior cerebellar artery

CSF:

Cerebrospinal fluid

FLAIR:

Fluid-attenuated inversion recovery

FVH:

Fluid-attenuated inversion recovery vascular hyperintensities

MCA:

Middle cerebral artery

PCA:

Posterior cerebral artery

PICA:

Posterior inferior cerebellar artey

rtPA:

Recombinant tissue plasminogen activator

SCA:

Superior cerebellar artery

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Acknowledgments

Cecile Rabrait is an employee of General Electric.

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Authors and Affiliations

  1. Department of Radiology, Hôpital Saint Joseph, Paris, France

    Jérôme Hodel, Mathieu Rodallec, Sophie Gerber, Samir Benadjaoud & Marc Zins

  2. Department of Neuroradiology, CHRU Roger Salengro, Lille, France

    Jérôme Hodel, Xavier Leclerc & Jean-Pierre Pruvo

  3. Department of Radiology, Centre Cardiologique du Nord, Saint Denis, France

    Mathieu Rodallec

  4. Department of Neuroradiology, Fondation Ophtalmologique Rothschild, Paris, France

    Raphael Blanc

  5. Department of Neurology, CHRU Roger Salengro, Lille, France

    Olivier Outteryck

  6. GE Healthcare, Clinical Science Development Group, Buc, France

    Cécile Rabrait

  7. Department of Neurology, Hôpital Saint Joseph, Paris, France

    Mathieu Zuber

  8. Service de Radiologie, Hôpital Saint Joseph, 186, rue Raymond Losserand, Paris, France

    Jérôme Hodel

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  1. Jérôme Hodel
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  2. Xavier Leclerc
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Correspondence to Jérôme Hodel.

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Hodel, J., Leclerc, X., Rodallec, M. et al. Fluid-attenuated inversion recovery vascular hyperintensities are not visible using 3D CUBE FLAIR sequence. Eur Radiol 23, 1963–1969 (2013). https://doi.org/10.1007/s00330-013-2796-z

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  • DOI: https://doi.org/10.1007/s00330-013-2796-z

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