American Journal of Neuroradiology 24:1863-1868, October 2003
© 2003 American Society of Neuroradiology
BRAIN
Relationship between the Concentration of Supplemental Oxygen and Signal Intensity of CSF Depicted by Fluid-Attenuated Inversion Recovery Imaging
a Section of Radiology, Santa Casa de Misericórdia de São Paulo, Brazil
b Section of Anesthesiology, Santa Casa de Misericórdia de São Paulo, Brazil
c Section of Radiology, Fleury Centro de Medicina Diagnóstica, Brazil
Address reprint requests to Flavio T. Braga, MD, Fleury Centro de Medicina Diagnóstica, Rua Cincinato Braga, 232, Paraiso, São Paulo SP 013333, Brazil
BACKGROUND AND PURPOSE: Prior reports have described increased signal intensity (SI) of CSF on fluid-attenuated inversion recovery (FLAIR) images of anesthetized patients receiving 100% O2. This appearance can simulate that of diseases. We evaluated the relationship between the concentration of inhaled O2 and the development of increased SI of CSF on FLAIR images.
METHODS: FLAIR was performed in 25 healthy volunteers breathing room air and 100% O2 through a face mask for 5, 10, and 15 minutes. MR imaging, including FLAIR imaging, was performed in 52 patients with no potential meningeal abnormalities under general anesthesia: 21 received an equal mixture of N2O and O2, and 31 received 100% O2. The SI of CSF in volunteers and patients was graded in several locations by using a three-point scale.
RESULTS: SI of CSF significantly increased (P < .05) in various locations, in both volunteers and patients breathing 100% O2, when compared with SI in the same volunteers breathing room air. Hyperintensity of CSF was not significantly different in volunteers receiving 100% O2 through a face mask compared with anesthetized patients receiving 100% O2 through a laryngeal airway or an endotracheal tube. No significant increase in SI occurred in patients receiving 50% O2, when compared with the SI of volunteers breathing room air.
CONCLUSION: Supplemental oxygen at 100% is a main cause of artifactual CSF hyperintensity on FLAIR images, regardless of the anesthetic drug used. This artifact does not develop when 50% O2 is administered.
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