Diagnostic value of contrast-enhanced T2-weighted flair with fat saturation in leptomeningeal metastasis

WCRJ 2025; 12 : e2952
DOI: 10.32113/wcrj_202511_2952

  Topic: Diagnosis and cancer     Category:

Chao H.
Department of Radiology, Changzhou Cancer Hospital of Soochow University, Changzhou, China Close
, Chen W. W.
Department of Radiology, Changzhou Cancer Hospital of Soochow University, Changzhou, China Close
, Rui H. J.
Department of Radiology, Changzhou Cancer Hospital of Soochow University, Changzhou, China Close
, Xiao T. C.
Department of Radiology, Changzhou Cancer Hospital of Soochow University, Changzhou, China Close
, Zhang J.
Department of Radiology, Changzhou Cancer Hospital of Soochow University, Changzhou, China
zjzj125@163.com Close

Abstract

Objective: It is well-established that the fluid attenuated inversion recovery (FLAIR) sequence is superior for visualizing leptomeningeal lesions. However, in clinical practice, contrast-enhanced T1-weighted imaging (T1WI) is routinely used to image leptomeningeal metastasis (LM) because of its greater sensitivity and specificity. Potential misestimation may arise from interference by adjacent fat tissues. In this study, we aimed to compare the diagnostic efficacy of contrast-enhanced T1WI-Fat saturation (T1WI-FS) vs. contrast-enhanced T2WI-FLAIR-FS for detecting LM. 

Patients and Methods: Patients diagnosed with LM by either clinical evaluation or cerebrospinal fluid (CSF) cytology were included. Contrast-enhanced T1WI-FS and T2WI-FLAIR-FS were performed sequentially in all cases. 

Results: Contrast-enhanced T2WI-FLAIR-FS demonstrated superior LM visibility (p < 0.0001) and depicted lesions more clearly (p < 0.0001) than contrast-enhanced T1WI-FS. 

Conclusions: Contrast-enhanced T2WI-FLAIR-FS demonstrated superiority over contrast-enhanced T1WI-FS for LM imaging. 

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To cite this article

Chao H.
Department of Radiology, Changzhou Cancer Hospital of Soochow University, Changzhou, China Close
, Chen W. W.
Department of Radiology, Changzhou Cancer Hospital of Soochow University, Changzhou, China Close
, Rui H. J.
Department of Radiology, Changzhou Cancer Hospital of Soochow University, Changzhou, China Close
, Xiao T. C.
Department of Radiology, Changzhou Cancer Hospital of Soochow University, Changzhou, China Close
, Zhang J.
Department of Radiology, Changzhou Cancer Hospital of Soochow University, Changzhou, China
zjzj125@163.com Close
Diagnostic value of contrast-enhanced T2-weighted flair with fat saturation in leptomeningeal metastasis

WCRJ 2025; 12 : e2952
DOI: 10.32113/wcrj_202511_2952

Publication History

Submission date: 27 Jan 2025

Revised on: 31 Mar 2025

Accepted on: 18 Sep 2025

Published online: 07 Nov 2025