Learning objectives
1.
To carry out an approach to the diagnose algorithm of meningeal pathology with MR,
by describing the protocols and main manifestations of that pathology.
2.
To show,
with a practical point of view,
the affected patterns in MR and to provide clues in order to make a precise radiologic report.
3.
To check the cases reported in our hospital unit.
Background
I.
INTRODUCTION
Meningeal anatomy
The meninges that envelop the brain consist in three layers: the dura mater,
the arachnoid mater and the pia mater.
The outermost layer is the dura mater or pachymeninx which lies closest to the calvaria.
Epidural space is a potential space between the outer layer of the dura mater and the inner layer of the skull.
The middle element of the meninges is the arachnoid mater that is attached to the overlying dura mater with a virtual space between both layers,...
Imaging findings OR Procedure details
A 1.5 Tesla MRI was used to perform the exams.
The MR imaging protocol included systematically all the established sequences for brain examinations completed with sequences after gadolinium administration: axial T1 spin echo and T1-3D acquisition.
FLAIR and T1-FLAIR images and fat supression techniques were used in selected cases in which they were necessary.
Conclusion
In the differential diagnosis of meningeal pathology in MR,
identification of the pattern of presentation and associated findings,
together with the clinical history,
can give us the key to establishing the correct diagnosis or determine when biopsy or complementary studies are necessary.
References
Smirniotopoulos J,
Murphy F et al.
From the archives of the AFIP: Patterns of contrast enhancement in the brain and meninges.
Radiographics 2007; 27:525-551.
Tokumanu A,
Obata T et al.
Intracranial meningeal involvement in Churg-Strauss syndrome.
AJNR 2002; 23:221-224.
Hirota T,
Ishihara K.
Delayed post-contrast fluid-attenuated inversion recovery image for depicting meningeal carcinomatosis.
The British Journal of Radiology 2004; 77:528-531.
Galassi W,
Phuttharak W.
Intracranial meningeal disease: comparison of contrast-enhanced MR Imaging with fluid-attenuated inversion recovery and fat-suppressed T1-wieghted sequences.
AJNR 2005; 26:553-559.
Escott E....