Contrast-enhancing patterns in the brain and meninges in magnetic resonance imaging (MRI): patophisiology, types and potential pitfalls

This poster is published under an open license. Please read the disclaimer for further details.

Congress:

ECR 2017

Poster Number:

C-0999

Type:

Educational Exhibit

Keywords:

Cancer, Contrast agent-other, MR, CNS

Authors:

C. Botía González, S. Torres del Río, C. Vázquez Ólmos, M. J. GAYÁN BELMONTE, A. P. Solano Romero, M. Huertas Moreno, A. García Chiclano, I. M. González Moreno, M. Tovar Pérez; Murcia/ES

DOI:

10.1594/ecr2017/C-0999

DOI-Link:

https://dx.doi.org/10.1594/ecr2017/C-0999

Fig. 1: Contrast-enhancing patterns in the brain and meninges in magnetic resonance...

Fig. 2: Normal contrast among different cerebral components.

Fig. 3: Effects of paramagnetic contrast agents on T1 relaxation curves.

Fig. 4: Mechanisms of enhancement after administration of intravenous gadolinium.

Learning objectives

To understand the mechanisms of contrast-enhancement in magnetic resonance imaging (MRI) in the central nervous system (CNS), provide an approach to intracranial pathology on the basis of their pattern, and discuss the potential pitfalls we must take into account when studying an enhancing intracranial lesion.

Background

Paramagnetic contrast agents are key for the study of CNS pathology, as they help us make a better assessment of the size, morphology and localization of many diseases. In our exhibit, we discuss the different patterns of enhancement in MRI of the brain and meninges, and explain the pathophysiology that lies in each kind of enhancement.

Findings and procedure details

I-Introduction a)Patophisiology of contrast-enhancement Paramagnetic contrast agents such as gadolinium are positive contrast agents used in MRI that have a strong effect on the T1-relaxation time, accelerating it, and providing higher contrast between different tissues. On t1-weighted brain MRI, water (cerebrospinal fluid (CSF)) appears darker than white matter, which is at the same time darker than grey matter (Fig.2). Brain and meningeal diseases usually contain free water, and thus, on non-enhanced MRI, their intensity will be intermediate between the CSF and the brain parenchyma. With...

Conclusion

It is very important for the radiologist to understand the pathophysiology that lies on the different contrast-enhancing patterns in the brain and meninges in MRI, and to recognize those situations on which enhancement is not a reliable feature to asses in intracranial pathology, as occurs in those brain tumours that are treated with antiangiogenics.

Personal information

References

Smirniotopoulos J, Murphy F, Rushing E, Rees J, Schroeder J. Patterns of contrast Enhancement in the Brain and Meninges. Radiographics. 2007;27(2):525-551. https://www.senr.org/wp-content/uploads/2015/05/Criterios_respuesta_Neuroon2011.pdf Rivera D. M., Puentes S., Caballero L., Resonancia magnética cerebral: secuencias básicas e interpretación Univ. Méd. Bogotá (Colombia), 52 (3): 292-306, julio-septiembre, 2011. Schild H. IRM hecha fácil (--bueno, casi). 1st ed. [Madrid]:Shering;1992.