Is there a need for contrast-enhanced T1-weighted MRI of the spine after inconspicuous short tau inversion recovery imaging?
This is another interesting article on the importance and utility of the STIR sequence. As we already know in the pelvis, where a negative STIR sequence is unlikely to show disease on other sequences, this is another article in European Radiology that shows that in the presence of a normal STIR sequence, when looking for vertebral metastases, a contrast enhanced study will not show additional information.
Having said that, in patients with sclerotic metastases, it is important to understand that a plain T1W sequence must supplement the STIR sequence, which may sometimes be normal.
1 Comments:
I still feel the contrast enhanced scan may be important as subtle enhancement in the extradural space and any soft tissue component may be missed if there is only T2 weighted scan where the pathology may be masked in the CSF signal and it may be be difficult to pick up in STIR. In our experience one of the breast malignancy cases showed some abnormal enhancement in the contrast T1 sequence only and the STIR was absolutely normal. Of course the plain T1 scans are very important especially in the sclerotic metastases.
6:54 AM
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