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(Radiology. 1999;212:793-798.)
© RSNA, 1999

Neuroradiology

Brain Lesions: When Should Fluid-attenuated Inversion-Recovery Sequences Be Used in MR Evaluation?1

Tomoko Okuda, MD, Yukunori Korogi, MD, Yoshinori Shigematsu, MD, Takeshi Sugahara, MD, Toshinori Hirai, MD, Ichiro Ikushima, MD, Luxia Liang, MD and Mutsumasa Takahashi, MD

1 From the Department of Radiology, Kumamoto University School of Medicine, 1-1-1 Honjo, Kumamoto 860, Japan. From the 1997 RSNA scientific assembly. Received February 13, 1998; revision requested April 15; final revision received December 16; accepted March 16, 1999. Address reprint requests to T.O.

PURPOSE: To compare qualitatively and quantitatively the contrast of brain lesions detected with fluid-attenuated inversion-recovery (FLAIR) and intermediate-weighted sequences at magnetic resonance (MR) imaging.

MATERIALS AND METHODS: In this prospective study, 47 patients suspected of having a brain lesion underwent MR imaging with FLAIR, intermediate-weighted, and T2-weighted sequences. Qualitative assessment was performed of lesion conspicuity, detection, overall image artifact, and additional clinical information. Contrast and contrast-to-noise ratio (CNR) were calculated between lesions and the normal brain or cerebrospinal fluid (CSF).

RESULTS: FLAIR images were equal to intermediate-weighted images for overall lesion conspicuity and detection but were associated more often with image artifacts. Lesion-to-background contrast was significantly higher on FLAIR than on intermediate-weighted images. FLAIR images failed to demonstrate multiple sclerosis (MS) plaques located in the basal ganglia and brain stem.

CONCLUSION: Although FLAIR images provided additional information in some cases, they did not have distinct advantages over intermediate-weighted images. When cases of MS are evaluated, intermediate-weighted images are preferable to FLAIR images. Except in cases of MS, either FLAIR or intermediate-weighted sequences should be added to T2-weighted sequences at MR imaging.

Index terms: Basal ganglia, MR, 14.121411, 14.121413, 15.121416 • Brain, diseases, 14.30, 14.76, 14.871, 15.30, 15.76, 15.871 • Brain, ischemia, 14.76, 15.76 • Brain, neoplasms, 14.30, 15.30 • Brain stem, MR, 15.121411, 15.121413, 15.121416 • Magnetic resonance (MR), pulse sequences, 18.121411, 18.121413, 18.121416 • Sclerosis, multiple, 18.871




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