TY - JOUR
T1 - CSF enhancement on post-contrast fluid-attenuated inversion recovery images; a systematic review
AU - Freeze, Whitney M.
AU - van der Thiel, Merel
AU - de Bresser, Jeroen
AU - Klijn, Catharina J. M.
AU - van Etten, Ellis S.
AU - Jansen, Jacobus F. A.
AU - van der Weerd, Louise
AU - Jacobs, Heidi I. L.
AU - Backes, Walter H.
AU - van Veluw, Susanne J.
N1 - Funding Information:
Catharina Klijn – Reports support from a clinical established investigator grant of The Netherlands Heart Foundation (grant number 2012T0770) and an ASPASIA grant from ZonMw (grant number 015008048).
Funding Information:
Susanne van Veluw – Reports support from NWO (VENI grant 91619021).
Publisher Copyright:
© 2020 The Authors
PY - 2020
Y1 - 2020
N2 - Cerebrospinal fluid (CSF) enhancement on T2-weighted post-contrast fluid-attenuated inversion recovery (pcT2wFLAIR) images is a relatively unknown neuroradiological marker for gadolinium-based contrast agent extravasation due to blood brain barrier (BBB) disruption. We systematically reviewed human studies reporting on CSF enhancement on pcT2wFLAIR images to provide a comprehensive overview of prevalence of this new biomarker in healthy and diseased populations as well as its etiology and optimal detection methodology. We extracted information on the prevalence of CSF enhancement, its vascular risk factor and neuroimaging correlates, and methodological attributes of each study. Forty-four eligible studies were identified. By pooling data, we found that the prevalence of CSF enhancement was 82% (95% confidence interval (CI) 80 89) in meningitis (4 studies, 65 patients), 73% (95%CI 62-81) in cases with (post-) acute intracerebral hemorrhage (2 studies, 77 cases), 64% (95% CI 54-73) in cases who underwent surgery for aneurysm treatment (2 studies, 99 patients), 40% (95% CI 30-51) in cases who underwent surgery for carotid artery disease treatment (3 studies, 76 patients), 27% (95% CI 25-30) in cases with acute ischemic stroke (9 studies, 1148 patients), 21% (95% CI 17-23) in multiple sclerosis (6 studies, 897 patients), and 13% (95% CI 7-21) in adult controls (4 studies, 112 cases). Presence of CSF enhancement was associated with higher age in eleven studies, with lobar cerebral micmbleeds in one study, and with cerebral atrophy in four studies. PcT2wFLAIR imaging represents a promising method that can provide novel perspectives on BBB leakage into CSF compartments, with the potential to reveal important new insights into the pathophysiological mechanisms of varying neurological diseases.
AB - Cerebrospinal fluid (CSF) enhancement on T2-weighted post-contrast fluid-attenuated inversion recovery (pcT2wFLAIR) images is a relatively unknown neuroradiological marker for gadolinium-based contrast agent extravasation due to blood brain barrier (BBB) disruption. We systematically reviewed human studies reporting on CSF enhancement on pcT2wFLAIR images to provide a comprehensive overview of prevalence of this new biomarker in healthy and diseased populations as well as its etiology and optimal detection methodology. We extracted information on the prevalence of CSF enhancement, its vascular risk factor and neuroimaging correlates, and methodological attributes of each study. Forty-four eligible studies were identified. By pooling data, we found that the prevalence of CSF enhancement was 82% (95% confidence interval (CI) 80 89) in meningitis (4 studies, 65 patients), 73% (95%CI 62-81) in cases with (post-) acute intracerebral hemorrhage (2 studies, 77 cases), 64% (95% CI 54-73) in cases who underwent surgery for aneurysm treatment (2 studies, 99 patients), 40% (95% CI 30-51) in cases who underwent surgery for carotid artery disease treatment (3 studies, 76 patients), 27% (95% CI 25-30) in cases with acute ischemic stroke (9 studies, 1148 patients), 21% (95% CI 17-23) in multiple sclerosis (6 studies, 897 patients), and 13% (95% CI 7-21) in adult controls (4 studies, 112 cases). Presence of CSF enhancement was associated with higher age in eleven studies, with lobar cerebral micmbleeds in one study, and with cerebral atrophy in four studies. PcT2wFLAIR imaging represents a promising method that can provide novel perspectives on BBB leakage into CSF compartments, with the potential to reveal important new insights into the pathophysiological mechanisms of varying neurological diseases.
KW - Blood brain barrier
KW - Fluid-attenuated inversion recovery
KW - Gadolinium
KW - Cerebrospinal fluid
KW - Neurological disease
KW - ACUTE REPERFUSION MARKER
KW - BRAIN-BARRIER DISRUPTION
KW - MIMICKING SUBARACHNOID HEMORRHAGE
KW - ISCHEMIC-STROKE PATIENTS
KW - LEPTOMENINGEAL ENHANCEMENT
KW - GADOLINIUM ENHANCEMENT
KW - SULCAL HYPERINTENSITY
KW - CEREBROSPINAL-FLUID
KW - FLAIR
KW - MRI
U2 - 10.1016/j.nicl.2020.102456
DO - 10.1016/j.nicl.2020.102456
M3 - (Systematic) Review article
C2 - 33053497
SN - 2213-1582
VL - 28
JO - NeuroImage: Clinical
JF - NeuroImage: Clinical
M1 - 102456
ER -