THE ROLE OF MRI USING THE FLAIR POST-CONTRAST PULSE SEQUENCE IN THE DIAGNOSIS OF TRAUMATIC DAMAGE TO THE MENINGES WITHIN TRAUMATIC BRAIN INJURIES
IN PATIENTS WITH CONCUSSION
Medvedeva N.А.1, Serova N.S.2
1 - Bureau of Forensic Medicine of the Department of Health of the City of Moscow.
2 - Sechenov University. Moscow, Russia.
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urpose. To determine the capabilities of the FLAIR pulse sequence in the diagnosis of contrast enhancement of the meninges in victims with mild traumatic brain injury.
Materials and methods. The study included medical data of 29 victims who underwent a forensic medical examination for traumatic brain injury at the state budgetary healthcare institution of the city of Moscow "Bureau of Forensic Medical Examination of the Moscow City Health Department." All patients underwent contrast-enhanced magnetic resonance imaging performed in T1-weighted images in three planes with the addition of a FLAIR pulse sequence in the axial plane.
Results. Of 29 (n=29; 100%) individuals undergoing MRI within 48 hours of injury, abnormal meningeal enhancement on post-contrast FLAIR images was detected in 13 (n=13; 44.8%) cases. In 9 cases (n=9; 31%), pathological accumulation of membranes was detected exclusively in the FLAIR pulse sequence, while on post-contrast T1 the membranes remained intact. Thus, MRI using the FLAIR pulse sequence in detecting traumatic enhancement of the meninges in living victims with a mild form of TBI was: sensitivity (Se) – 44%; specificity (Sp) – 92%.
Discussion. The diagnosis of concussion is very difficult in the process of conducting a forensic medical examination, since there are no instrumental methods of confirmation. The clinical picture is often subjective, which also cannot be reliably assessed. The results of our work demonstrate the possibility of detecting the imaging sign of traumatic enhancement of the meninges using the FLAIR sequence after contrast administration.
Conclusion. The inclusion of a post-contrast FLAIR pulse sequence during MRI can be valuable in detecting imaging signs of mild TBI, and thereby significantly influence the determination of the severity of injury during a forensic examination.
Keywords: FLAIR-post MRI, concussion of the brain, traumatic brain injury, forensic medical examination of living persons.
Corresponding author: Medvedeva N.А., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript
For citation: Medvedeva N.А., Serova N.S. The role of MRI using the flair post-contrast pulse sequence in the diagnosis of traumatic damage to the meninges within traumatic brain injuries in patients with concussion. REJR 2023; 13(3):30-38. DOI: 10.21569/2222-7415-2023-13-3-30-38.
Received: 10.07.23 Accepted: 11.09.23