Sulcal Hyperintensity on FLAIR Images in Patients with Normal Cerebrospinal Fluid

Objective To investigate the clinical history and MR findings associated with sulcal hyperintensity on FLAIR images in patients without apparent CSF abnormality. Methods Three hundred consecutive MR imaging examinations were prospectively screened for patients with sulcal on FLAIR images of head. The distribution of sulcal hyperintensity on FLAIR images and associated abnormal MR findings were evaluated. Results Thirty (10.5%) of the 285 patients had sulcal hyperintensity associated with 16 cases masses (5.6%) and 14 cases vascular abnormalities (4.9%). Sulcal hyperintensity was frequently associated with the dirty CSF sign (66.7%) and abnormal contrast enhancement (95.0%). Conclusion Our study shows that sulcal hyperintensity on FLAIR imaging can occur in patients without apparent CSF abnormality. It is frequently associated with mass, vascular disease, abnormal vascular enhancement and dirty CSF sign.