MRI diagnosis of traumatic fornical injury. Investigation utilizing FLAIR Technique

We studied traumatic fornix injuries by using the fluid attenuated inversion recovery (FLAIR) technique which provides T2-weighted images without the unwanted influence of cerebrospinal fluid (CSF) signals. 5-21 days (average: 10.3) after injury, we performed MRI on 14 patients (mean age: 22.6 years) who were clinically diagnosed as having diffuse axonal injury (DAI). The mid-sagittal FLAIR images in seven of the 14 patients clearly revealed T2-prolonged fornix lesions and the concurrent corpus callosum lesions. The same fornix lesions, as detected by the spin echo technique, were blurred by the partial volume effects and motion artifacts derived from the surrounding CSF signals. The accompanying callosal lesions were mainly in the splenium. Of the seven patients with fornix injuries, three had T2-prolonged lesions in the septum pellucidum. With respect to the outcome, there was no difference between patients with and without fornix injury. In conclusion, the FLAIR technique is appropriate for detecting fornix injuries adjacent to the CSF space. (author)