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The Added Value of Double Dose Gadolinium Enhanced 3D T2 Fluid-Attenuated Inversion Recovery for Evaluating Small Brain Metastases

 Sung Jun Ahn  ;  Tae-Sub Chung  ;  Jong-Hee Chang  ;  Seung-Koo Lee 
 YONSEI MEDICAL JOURNAL, Vol.55(5) : 1231-1237, 2014 
Journal Title
Issue Date
Adult ; Aged ; Brain Neoplasms/pathology* ; Contrast Media*/administration & dosage ; Female ; Gadolinium*/administration & dosage ; Humans ; Imaging, Three-Dimensional ; Magnetic Resonance Imaging/methods* ; Male ; Middle Aged ; Retrospective Studies ; Signal-To-Noise Ratio
CNS ; MR-imaging ; metastases
PURPOSE: Single dose gadolinium (Gd) enhanced fluid-attenuated inversion recovery (FLAIR) is helpful for visualizing superficial parenchymal metastases. However, the usefulness of FLAIR with a higher dose of Gd is uncertain. The aim of our study was two-folds: first, to prove that the signal to noise ratio (SNR) of small brain metastases is higher than large brain metastases on double-dose (DD) enhanced FLAIR and, second, to explore the added value of DD Gd enhanced FLAIR in relation to T1 GRE for evaluating small brain metastases. MATERIALS AND METHODS: For the first purpose, 50 pairs of small (2 mm<diameter≤5 mm) and large brain metastases (diameter>5 mm) were included. The difference in the SNR and contrast ratio (CR) between small and large metastases on DD Gd-enhanced 3D T2 FLAIR was compared by Wilcoxon signed-rank tests. For the second purpose, a total of 404 small metastases were included. The diagnostic sensitivities between 3D T1 gradient echo (GRE) alone and combined results of 3D T1 GRE and 3D T2 FLAIR were compared with McNemar test. RESULTS: The SNR and CR of small brain metastases were significantly higher than those of large brain metastases (p<0.001). In qualitative analysis, the diagnostic sensitivities for small brain metastases were significantly higher for 3D T1 GRE plus 3D T2 FLAIR than 3D T1 GRE alone regardless of scan time (p<0.001). CONCLUSION: Small brain metastases showed higher signal intensity than large brain metastases on the DD Gd enhanced 3D T2 FLAIR images. DD Gd enhanced 3D T2 FLAIR imaging may have a complementary role to 3D T1 GRE for evaluating small brain metastases.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Ahn, Sung Jun(안성준) ORCID logo https://orcid.org/0000-0003-0075-2432
Lee, Seung Koo(이승구) ORCID logo https://orcid.org/0000-0001-5646-4072
Chang, Jong Hee(장종희) ORCID logo https://orcid.org/0000-0003-1509-9800
Chung, Tae Sub(정태섭)
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