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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

ReplyLetter

Reply:

T.A. Kennedy
American Journal of Neuroradiology July 2019, 40 (7) E37; DOI: https://doi.org/10.3174/ajnr.A6094
T.A. Kennedy
aDepartment of Radiology, Division of Neuroradiology University of Wisconsin School of Medicine and Public Health Madison, Wisconsin
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  • ORCID record for T.A. Kennedy

We appreciate the thoughtful comments shared by De Bernardo et al regarding our recent publication exploring the use of contrast-enhanced 3D-FLAIR imaging in the evaluation of patients with idiopathic intracranial hypertension (IIH).1 In their comments, the authors of the response wished to raise awareness of how patients with IIH could be serially monitored with sonography as a more sensitive and cost-effective technique to evaluate optic nerve edema compared with contrast-enhanced MR imaging.

We would like to highlight, however, that the overarching objective of our report was to evaluate the sensitivity of contrast-enhanced 3D-FLAIR imaging in patients for the initial (and sometimes opportunistic) diagnosis of IIH, as opposed to serial and longitudinal imaging of these patients. In patients presenting a priori with headaches and blurred vision, it is important to evaluate the brain to rule out other causes of elevated intracranial pressure, and a head MR imaging without and with contrast remains the standard of care to evaluate this patient population.2 Our investigation identified a moderate correlation between the Frisén Scale and findings seen on contrast-enhanced 3D-FLAIR, particularly in patients with higher grades of papilledema. Once a diagnosis of IIH has been clinically established, sonography may play a role in follow-up as the authors suggest.

REFERENCES

  1. 1.
    1. Golden E,
    2. Krivochenitser R,
    3. Mathews N, et al
    . Contrast-enhanced 3D-FLAIR imaging of the optic nerve and optic nerve head: novel neuroimaging findings of idiopathic intracranial hypertension. AJNR Am J Neuroradiol 2019;40:334–39 doi:10.3174/ajnr.A5937 pmid:30679213
  2. 2.
    American College of Radiology. ACR Appropriateness: Headache. (https://acsearch.acr.org/docs/69482/Narrative/. )Accessed May 10, 2019.
  • © 2019 by American Journal of Neuroradiology
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