Fluid-attenuated inversion-recovery MR imaging of gliomatosis cerebri

Magnetic resonance imaging has been shown to be the most sensitive imaging modality in the assessment of gliomatosis cerebri. Recent studies have shown that fluid-attenuated inversion-recovery (FLAIR) is a valuable MR sequence in the delineation of cerebral pathologies including intra-axial tumors. However, no data are available about the role of this novel technique in the assessment of gliomatosis lesions. The purpose of this study was therefore to evaluate the diagnostic potential of FLAIR MR imaging in patients with suspected gliomatosis cerebri. Seven patients suspected of having lesions of gliomatosis cerebri were examined by T1-weighted spin echo (SE), T2-weighted fast spin echo (FSE), and FLAIR MR imaging with identical slice parameters. T1 and FLAIR were repeated after contrast media administration. Delineation and extent of gliomatosis were the primary parameters of the image analysis. The FLAIR imaging clearly delineated the extent of gliomatosis lesions in all patients. Due to the suppression of cerebrospinal fluid, the delineation was superior to conventional T2-weighted FSE images. Especially the detection and delineation of cortical spread and the infiltration of the corpus callosum was best seen on FLAIR images. The FLAIR MR imaging is a valuable diagnostic modality in the assessment of patients with gliomatosis cerebri. Due to its better delineation of tumor spread, it was found to be the imaging method of choice and should therefore be integrated into the MR imaging protocol of these patients.