| Objective:The purpose of this study is to compare the application of three-dimensional volume enhancement and T2-FLAIR enhancement in the diagnosis of meningitis and meningeal metastases,to compare the display of meningeal lesions between the two sequences,and to evaluate the diagnostic efficacy of the two sequences on meningitis and meningeal metastases,and to explore the clinical value and significance of the two sequences in the diagnosis of meningeal lesions.Methods:80 patients with simple meningeal lesions or intracranial lesions involving meninges were all from Chifeng Municipal Hospital from June 2020 to December2022,including 49 males and 31 females,aged from 1 to 82 year-old,with an average age of(55 ±16)years.All patients were finally diagnosed by cerebrospinal fluid examination(CSF)and clinical final diagnosis.80 patients without meningitis or meningeal metastasis confirmed by diagnostic criteria were selected,including 44 males and 36 females,with an average age of(52 ±5)years.All patients underwent plain MRI,three-dimensional volume enhancement and T2-FLAIR enhancement sequence.The image quality of the patients in the group should meet the diagnostic criteria.After completing the plain scan,all patients underwent three-dimensional volume scan and T2-FLAIR enhanced scan,and the two scanning methods were performed randomly and alternately.The MRI signs of meningeal lesions on different sequences were collected and analyzed,and the signal,shape,distribution and enhancement degree were recorded,so as to compare the display rate of three-dimensional volume enhancement and T2-FLAIR enhancement on meningeal lesions,and evaluate the diagnostic efficacy of the two sequences used alone and in combination for meningitis and meningeal metastasis.Results:1.A total of 80 patients were collected,including 36 cases of meningitis,33 cases of meningeal metastasis,and 11 cases of meningeal abnormalities caused by other intracranial lesions(3 cases of meningeal thickening after operation,2 cases of meningeal thickening caused by arteriovenous fistula,2 cases of meningeal thickening caused by epidural effusion,2 cases of meningeal thickening caused by cerebral hemorrhage,1 case of meningeal thickening caused by acoustic neuroma and1 case of meningeal thickening caused by glioma).The display rate of meningeal lesions and leptomeningeal lesions was 96% and 98% respectively with enhanced T2-FLAIR sequence,which was higher than that of enhanced three-dimensional volume sequence,and the difference was statistically significant(P < 0.05).In the display rate of dural lesions was93%,there was no significant difference between the enhanced T2-FLAIR sequence and the enhanced three-dimensional volume sequence(P > 0.05).2.On enhanced T2-FLAIR sequence,the signal contrast ratio(contrastratio,CR)and contrast signal-to-noise ratio(contrastsignal-to-noiseratio,CNR)of lesion / normal white matter were 0.81(0.52,1.38),14.89(8.98,25.62),0.17(-0.15,0.54),5.00(-3.31,21.08),respectively;The difference was statistically significant(P < 0.05).3.In the diagnosis of meningeal metastases: 1 the sensitivity of enhanced three-dimensional volume sequence was 61%,the specificity was 85%,the false negative rate was 39%,the false positive rate was 15%,the positive predictive value was 76.9%,the negative predictive value was 72.3%,the consistency was 74%,2 the sensitivity of enhanced T2-FLAIR sequence was 94%,the specificity was 87.5%,the false negative rate was 6%,and the false positive rate was 12.5%.The positive predictive value was 86.1%,the negative predictive value was 94.5%,and the consistency was 90.4%.3 The sensitivity of the combination of the two in the diagnosis of meningeal metastases was 97.6%,and the specificity was 74.3%;there was a significant difference in sensitivity between the two sequences in the diagnosis of meningeal metastases(P < 0.05).4.In the diagnosis of meningitis: 1 the sensitivity of enhanced three-dimensional volume sequence was 56%,the specificity was 85%,the false negative rate was 44%,the false positive rate was 15%,the positive predictive value was 76.9%,the negative predictive value was 68%,the consistency was 66.7%,2 the sensitivity of enhanced T2-FLAIR sequence was 97%,the specificity was 90%,the false negative rate was 3%,the false positive rate was10%,and the positive predictive value was 89.7%.The negative predictive value was 97.3%.3 The sensitivity of the combination of the two in the diagnosis of meningitis was 98.6%,and the specificity was 76.5%;there was a significant difference in sensitivity between the two sequences in the diagnosis of meningitis(P < 0.05).5.The consistency of the two sequences in the diagnosis of meningitis was analyzed by Kappa test: the consistency of Kappa=0.400;in the diagnosis of meningeal metastases:Kappa=0.450,indicating that the two sequences were moderately consistent in the diagnosis of meningitis and meningeal metastases(P < 0.05).Conclusion:Both enhanced T2-FLAIR and enhanced 3D volume sequences can be used as sequences for the diagnosis of meningitis and meningeal metastases.Enhanced T2-FLAIR sequence has more advantages in displaying leptomeningeal lesions.Enhanced T2-FLAIR sequence is more sensitive in the diagnosis of meningitis and meningeal metastases.The combination of the two sequences can further improve the sensitivity in the diagnosis of meningeal lesions. |
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