Abstract
Fluid attenuated inversion recovery (FLAIR) is one of the most effective magnetic resonance imaging (MRI) sequences in the diagnosis of subarachnoid hemorrhage (SAH). However, sometimes false positive or false negative results can occur. One of the reasons that can lead to erroneous interpretation is artifacts. Especially when metallic artifact occurs, hyperintensity may be observed in the subarachnoid space, similar to SAH. Although FLAIR hyperintensities in the sulci can be detected in many serious diseases, they are not always pathological. Artifact related hyperintensities, especially in cases with severe headache, may be mistakenly evaluated as SAH by a clinician or radiologist who is not well-experienced in MRI. However, it is extremely important to recognise these artifact related hyperintensities, to make a correct diagnosis and to prevent unnecessary interventions. In order to achieve this, the evaluation of all radiological images, especially SWI and GRE, is critical. Both radiologists and clinicians evaluating neuroradiological examinations should be knowledgeable about this subject and show maximum attention.
In this report, we present the radiological images of 4 cases of pseudosubarachnoid hemorrhage, one of which was caused by conductive EEG gel and the other three due to braces artifacts, who were admitted to the hospital with headache.
Keywords
Magnetic resonance imaging Subarachnoid hemorrhage Subarachnoid space Cerebrospinal fluid Artifacts
Supporting Institution
yok
Project Number
-
Thanks
-
References
- 1. Stuckey SL, Goh TD, Heffernan T, Rowan D. Hyperintensity in the subarachnoid space on FLAIR MRI. AJR Am J Roentgenol 2007;189:913-21.
- 2. Hacein-Bey L, Mukundan G, Shahi K, Chan H, Tajlil AT. Hyperintense ipsilateral cortical sulci on FLAIR imaging in carotid stenosis: ivy sign equivalent from enlarged leptomeningeal collaterals. Clin Imaging 2014;38:314-7.
- 3. Morris JM, Miller GM. Increased signal in the subarachnoid space on fluid-attenuated inversion recovery imaging associated with the clearance dynamics of gadolinium chelate: a potential diagnostic pitfall. AJNR Am J Neuroradiol 2007;28:1964-7.
- 4. Maeda M, Yagishita A, Yamamoto T, Sakuma H, Takeda K. Abnormal hyperintensity within the subarachnoid space evaluated by fluid-attenuated inversion-recovery MR imaging: a spectrum of central nervous system diseases. Eur Radiol 2003;13 Suppl 4:L192-201.
- 5. Cianfoni A, Martin MG, Du J, Hesselink JR, Imbesi SG, Bradley WG, et al. Artifact simulating subarachnoid and intraventricular hemorrhage on single-shot, fast spin-echo fluid-attenuated inversion recovery images caused by head movement: A trap for the unwary. AJNR Am J Neuroradiol 2006;27:843-9.
- 6. Verma RK, Kottke R, Andereggen L, Weisstanner C, Zubler C, Gralla J, et al. Detecting subarachnoid hemorrhage: comparison of combined FLAIR/SWI versus CT. Eur J Radiol 2013;82:1539-45.
- 7. Cuvinciuc V, Viguier A, Calviere L, Raposo N, Larrue V, Cognard C, et al. Isolated acute nontraumatic cortical subarachnoid hemorrhage. AJNR Am J Neuroradiol 2010;31:1355-62.
Abstract
Project Number
-
References
- 1. Stuckey SL, Goh TD, Heffernan T, Rowan D. Hyperintensity in the subarachnoid space on FLAIR MRI. AJR Am J Roentgenol 2007;189:913-21.
- 2. Hacein-Bey L, Mukundan G, Shahi K, Chan H, Tajlil AT. Hyperintense ipsilateral cortical sulci on FLAIR imaging in carotid stenosis: ivy sign equivalent from enlarged leptomeningeal collaterals. Clin Imaging 2014;38:314-7.
- 3. Morris JM, Miller GM. Increased signal in the subarachnoid space on fluid-attenuated inversion recovery imaging associated with the clearance dynamics of gadolinium chelate: a potential diagnostic pitfall. AJNR Am J Neuroradiol 2007;28:1964-7.
- 4. Maeda M, Yagishita A, Yamamoto T, Sakuma H, Takeda K. Abnormal hyperintensity within the subarachnoid space evaluated by fluid-attenuated inversion-recovery MR imaging: a spectrum of central nervous system diseases. Eur Radiol 2003;13 Suppl 4:L192-201.
- 5. Cianfoni A, Martin MG, Du J, Hesselink JR, Imbesi SG, Bradley WG, et al. Artifact simulating subarachnoid and intraventricular hemorrhage on single-shot, fast spin-echo fluid-attenuated inversion recovery images caused by head movement: A trap for the unwary. AJNR Am J Neuroradiol 2006;27:843-9.
- 6. Verma RK, Kottke R, Andereggen L, Weisstanner C, Zubler C, Gralla J, et al. Detecting subarachnoid hemorrhage: comparison of combined FLAIR/SWI versus CT. Eur J Radiol 2013;82:1539-45.
- 7. Cuvinciuc V, Viguier A, Calviere L, Raposo N, Larrue V, Cognard C, et al. Isolated acute nontraumatic cortical subarachnoid hemorrhage. AJNR Am J Neuroradiol 2010;31:1355-62.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Case Report |
| Authors | |
| Project Number | - |
| Early Pub Date | December 26, 2022 |
| Publication Date | December 27, 2023 |
| Submission Date | August 10, 2022 |
| Published in Issue | Year 2023 Volume: 13 Issue: 4 |
