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Inicio Radiología (English Edition) FLAIR hyperintensity in the subarachnoid space: Main differentials
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Vol. 66. Issue 1.
Pages 78-89 (January - February 2024)
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Vol. 66. Issue 1.
Pages 78-89 (January - February 2024)
Article from a resident
FLAIR hyperintensity in the subarachnoid space: Main differentials
Hiperintensidad en secuencia FLAIR del LCR en el espacio subaracnoideo: diagnósticos diferenciales
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J. Miranda Bautista
Corresponding author
mirandabautistajuan@gmail.com

Corresponding author.
, I. Garrido Morro, P. Fernández García, I. Herrera Herrera
Servicio de Radiodiagnóstico, HGU Gregorio Marañón, Madrid, Spain
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Table 1. Summary table of the main causes of signal hyperintensity in the subarachnoid space on FLAIR imaging.
Abstract

The fluid-attenuated inversion recovery (FLAIR) sequence forms part of the vast majority of current diagnostic protocols for brain MRI. This sequence enables the suppression of the signal from cerebrospinal fluid, facilitating the detection of disease involving the subarachnoid space. The causes of hyperintensity in the arachnoid space in this sequence can be divided into two main categories: hyperintensity due to disease and hyperintensity due to artifacts. Hyperintensity due to tumors, inflammation, vascular disease, or hypercellularity of the cerebrospinal fluid or hematic contents is well known. However, numerous other non-pathological conditions, mainly due to artifacts, that are also associated with this finding are a potential source of diagnostic errors.

Keywords:
Subarachnoid space
Hyperintensity
FLAIR sequence
Cerebrospinal fluid
Magnetic resonance imaging
Abbreviations:
CNS
CSF
DLGT
DWI
FLAIR
HaNDL
LVM
SAH
SAS
SWI
TE
TI
TR
Resumen

La secuencia fluid attenuated inversion recovery (FLAIR) forma parte hoy en día de la gran mayoría de protocolos diagnósticos de RM cerebral. Esta secuencia de inversión-recuperación permite una supresión de la señal del líquido cefalorraquídeo, lo que facilita la detección de enfermedad que afecta al espacio subaracnoideo. Las causas de hiperintensidad del líquido cefalorraquídeo en esta secuencia pueden subdividirse en 2 grandes grupos, las patológicas y las debidas a artefactos. Son bien conocidas la etiología tumoral, la inflamatoria, la vascular o las debidas a hipercelularidad del líquido cefalorraquídeo o a ocupación por contenido hemático. Sin embargo, existen numerosas condiciones no patológicas, principalmente debidas a artefactos, que se relacionan con este hallazgo constituyendo una potencial fuente de errores diagnósticos.

Palabras clave:
Espacio subaracnoideo
Hiperintensidad
Secuencia FLAIR
Líquido cefalorraquídeo
Resonancia magnética

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