Cerebrospinal fluid (CSF) enhancement on T2-weighted post-contrast fluid-attenuated inversion recovery (pcT2wFLAIR) images is a relatively unknown neuroradiological marker for gadolinium-based contrast agent extravasation due to blood–brain barrier (BBB) disruption. We systematically reviewed human studies reporting on CSF enhancement on pcT2wFLAIR images to provide a comprehensive overview of prevalence of this new biomarker in healthy and diseased populations as well as its etiology and optimal detection methodology. We extracted information on the prevalence of CSF enhancement, its vascular risk factor and neuroimaging correlates, and methodological attributes of each study. Forty-four eligible studies were identified. By pooling data, we found that the prevalence of CSF enhancement was 82% (95% confidence interval (CI) 80–89) in meningitis (4 studies, 65 patients), 73% (95%CI 62–81) in cases with (post-) acute intracerebral hemorrhage (2 studies, 77 cases), 64% (95% CI 54–73) in cases who underwent surgery for aneurysm treatment (2 studies, 99 patients), 40% (95% CI 30–51) in cases who underwent surgery for carotid artery disease treatment (3 studies, 76 patients), 27% (95% CI 25–30) in cases with acute ischemic stroke (9 studies, 1148 patients), 21% (95% CI 17–23) in multiple sclerosis (6 studies, 897 patients), and 13% (95% CI 7–21) in adult controls (4 studies, 112 cases). Presence of CSF enhancement was associated with higher age in eleven studies, with lobar cerebral microbleeds in one study, and with cerebral atrophy in four studies. PcT2wFLAIR imaging represents a promising method that can provide novel perspectives on BBB leakage into CSF compartments, with the potential to reveal important new insights into the pathophysiological mechanisms of varying neurological diseases.

T2加权造影后减毒反转恢复（pcT2wFLAIR）图像上的脑脊液（CSF）增强是基于血脑屏障（BBB）破坏的g基造影剂外渗的相对未知的神经放射标记。我们系统地回顾了关于pcT2wFLAIR图像上脑脊液增强的人类研究报告，以全面概述这种新生物标记在健康和患病人群中的流行情况，以及其病因学和最佳检测方法。我们提取了有关脑脊液增强的患病率，其血管危险因素和神经影像相关性以及每项研究的方法学属性的信息。确定了四十四项合格的研究。通过合并数据，我们发现，在脑膜炎（4个研究，65例患者）中，脑脊液增强的患病率为82％（95％置信区间（CI）80-89），在（后）病例中，CSF增强的患病率为73％（95％CI 62-81）。急性脑出血（2个研究，77例），接受动脉瘤治疗手术的患者（2个研究，99例），64％（95％CI 54-73），接受动脉瘤治疗的患者40％（95％CI 30-51）接受手术治疗颈动脉疾病（3例研究，76例患者），其中急性缺血性中风病例中有27％（95％的CI 25–30）（9例，1​​148例患者），21％（95％的CI 17–23）。多发性硬化症（6项研究，897例患者）和成人对照组中的13％（95％CI 7–21）（4项研究，112例）。在11项研究中，脑脊液增强的存在与较高的年龄相关；在一项研究中，与大叶脑微出血相关；在四项研究中，与脑萎缩相关。