Sulcal Hyperintensity on Fluid-Attenuated Inversion Recovery MR Images in Patients Without Apparent Cerebrospinal Fluid Abnormality
Toshiaki Taoka1,2,
William T. C. Yuh1,
Matthew L. White1,
Jerome P. Quets1,
Joan E. Maley1 and
Toshihiro Ueda1
1
Department of Radiology, Magnetic Resonance Imaging Center, University of Iowa
College of Medicine, 200 Hawkins Dr., Iowa City, IA 52242.
2
Present address: Department of Radiology, Nara Medical University, 840 Shijo,
Kashihara, Nara, 634-8522 Japan.
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Fig. 1A. —54-year-old woman with large meningioma. Unenhanced
fluid-attenuated inversion recovery image (TR/TEeff, 8000/108;
inversion time, 2000 msec; echo train length, 8) shows hyperintensity
(arrows) in sulcal space of both hemispheres, whereas cerebrospinal
fluid in lateral ventricle shows hypointensity.
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Fig. 1B. —54-year-old woman with large meningioma. Contrast-enhanced MR
image (TR/TE, 500/20) shows some linear enhancement (arrows) along
gyri, which suggests leptomeningeal enhancement.
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Fig. 2A. —77-year-old man with acute middle cerebral artery stroke
(main lesion of infarction is not shown). Unenhanced fluid-attenuated
inversion recovery image (TR/TEeff, 8000/108; inversion time, 2000
msec; echo train length, 8) shows hyperintensity (arrow) in sulcal
space of left frontal lobe.
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Fig. 2B. —77-year-old man with acute middle cerebral artery stroke
(main lesion of infarction is not shown). Contrast-enhanced MR image (TR/TE,
500/20) shows linear enhancement (arrow) along surface of gyri, which
occupy almost entire sulcal space.
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Fig. 2C. —77-year-old man with acute middle cerebral artery stroke
(main lesion of infarction is not shown). T2-weighted image
(TR/TEeff range, 8000/90-100; echo train length, 8) shows slight
hypointensity (arrow) in corresponding sulcus.
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Fig. 2D. —77-year-old man with acute middle cerebral artery stroke
(main lesion of infarction is not shown). Unenhanced T1-weighted image (TR/TE,
500/20) shows relatively slight hyperintensity (arrow) in
corresponding sulcus compared with other sulci.
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Fig. 2E. —77-year-old man with acute middle cerebral artery stroke
(main lesion of infarction is not shown). Gradient-echo
T2*-weighted image (250/15; flip angle, 20°) shows mild
hypointensity (arrow) in involved sulci. This is likely caused by
focal magnetic inhomogeneity from content (deoxyhemoglobin) of blood pool due
to alteration of hemodynamics and suggests venous congestion.
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Fig. 3A. —74-year-old woman with sagittal sinus thrombosis. Unenhanced
fluid-attenuated inversion recovery image (TR/TEeff, 8000/108;
inversion time, 2000 msec; echo train length, 8) shows hyperintensity in
superior sagittal sinus due to venous thrombosis. Almost all cortical sulci of
both hemispheres show hyperintensity especially in right occipital region
(arrows).
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Fig. 3B. —74-year-old woman with sagittal sinus thrombosis.
Contrast-enhanced MR image (TR/TE, 450/20) shows gyral enhancement in right
occipital region (arrows).
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Fig. 3C. —74-year-old woman with sagittal sinus thrombosis. T2-weighted
image (TR/TEeff, 8000/90; echo train length, 8) shows
hyperintensity in superior sagittal sinus (arrows) likely due to
venous thrombosis
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Fig. 3D. —74-year-old woman with sagittal sinus thrombosis. Unenhanced
T1-weighted image (TR/TE, 450/20) shows relative hyperintensity in
corresponding cortical sulci (arrows) compared with that shown in
lateral ventricles.
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Fig. 4A. —34-year-old man with dural arteriovenous fistula. Unenhanced
fluid-attenuated inversion recovery (FLAIR) image (TR/TEeff,
8000/108; inversion time, 2000 msec; echo train length, 8) before treatment
shows slight sulcal hyperintensity in right temporal lobe
(arrow).
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Fig. 4B. —34-year-old man with dural arteriovenous fistula.
Contrast-enhanced MR image (TR/TE, 500/20) before treatment shows multiple
serpentine hypointense structures in right temporal lobe as compared with
contralateral side before embolization, most likely representing high-flow
vasculature of arteriovenous shunt.
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Fig. 4C. —34-year-old man with dural arteriovenous fistula. Unenhanced
FLAIR image (TR/TEeff, 8000/108; inversion time, 2000 msec; echo
train length, 8) after treatment shows that sulcal hyperintensity becomes more
extensive after embolization (arrows).
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Fig. 4D. —34-year-old man with dural arteriovenous fistula.
Contrast-enhanced MR image (TR/TE, 500/20) after treatment shows enhanced
vessels suggesting slow-flowing blood vessels. Hypointense vessels on
contrast-enhanced MR image (B) before treatment become hyperintense
with vascular enhancement after embolization (arrows), suggesting
alteration of hemodynamics.
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Copyright © 2001 by the American Roentgen Ray Society.
