PDF(Pubmed)
Abstract：
Objectives: Contrast-enhanced FLAIR fat-suppressed (CE-FLAIR-FS) imaging can potentially increase the diagnostic accuracy of uveal diseases and ultimately provide better patient management. This study aimed to determine the diagnostic value of CE-FLAIR-FS imaging versus contrast-enhanced T1-weighted imaging (CE-T1WI) in the assessment of pediatric patients with uveitis. Material and methods: Twenty-one children with uveitis who underwent whole brain magnetic resonance imaging (MRI), including CE-FLAIR-FS and CE-T1WI, were retrospectively included in the study. We evaluated the presence of uveal tract contrast enhancement with thickening, vitreous humor signal abnormality, and accompanying brain abnormalities. The uveal enhancement intensity was assessed semiquantitatively as mild, moderate, and marked uveitis compared to CE-T1WI and CE-FLAIR-FS images. Results: Panuveitis (61.9%) was the most frequent anatomic location, and most of them were idiopathic (47.6%). Of the 42 eyes with clinical uveitis, enhancement of the uveal tract was observed on CE-FLAIR-FS images in 21 eyes (50%), while in 5 eyes (11.9%) on CE-T1WI. The sensitivity of CE-FLAIR-FS in panuveitis was detected to be quite high (80.8%). The number of affected eyes and enhancement degree were found to be higher on CE-FLAIR-FS (p < 0.001). In assessing the severity of uveitis, CE-FLAIR-FS grades were significantly higher and more sensitive than CE-T1WI (p < 0.001, Z: -4.347). Three patients had vitreous abnormal signals on CE-FLAIR-FS images, but none on CE-T1WI. Conclusion: CE-FLAIR-FS plays a significant role in the diagnosis of pediatric uveitis, identifying the involvement and severity of the uveal inflammation and guiding the appropriate management. It would be beneficial to add it as a standard sequence to the routine MRI protocol for uveal pathologies.
摘要：
目标：对比增强的FLAIR脂肪抑制（CE-FLAIR-FS）成像可能会提高葡萄膜疾病的诊断准确性，并最终提供更好的患者管理。本研究旨在确定CE-FLAIR-FS成像与对比增强T1加权成像（CE-T1WI）在评估小儿葡萄膜炎患者中的诊断价值。材料和方法：21例葡萄膜炎患儿接受全脑磁共振成像（MRI），包括CE-FLAIR-FS和CE-T1WI，回顾性纳入研究。我们评估了葡萄膜对比增强与增厚的存在，玻璃体液信号异常,和伴随的大脑异常。葡萄膜增强强度半定量评估为轻度，中度,与CE-T1WI和CE-FLAIR-FS图像相比，有明显的葡萄膜炎。结果:全葡萄膜炎(61.9%)是最常见的解剖部位,其中大多数为特发性（47.6％）。在42只患有临床葡萄膜炎的眼睛中，在21眼（50％）的CE-FLAIR-FS图像上观察到葡萄膜增强，而在CE-T1WI上有5只眼睛（11.9%）。CE-FLAIR-FS在全葡萄膜炎中的敏感性很高（80.8％）。在CE-FLAIR-FS上发现受影响的眼睛数量和增强程度更高（p<0.001）。在评估葡萄膜炎的严重程度时，CE-FLAIR-FS等级显著高于CE-T1WI(p<0.001,Z:-4.347)。3例患者在CE-FLAIR-FS图像上有玻璃体异常信号，但没有在CE-T1WI。结论:CE-FLAIR-FS在小儿葡萄膜炎的诊断中具有重要作用。确定葡萄膜炎症的参与和严重程度，并指导适当的管理。将其作为标准序列添加到用于葡萄膜病理学的常规MRI协议将是有益的。
