Reduction of CSF and blood flow artifacts on FLAIR images of the brain with k-space reordered by inversion time at...

Our purpose was to test a new variant of the fluid-attenuated inversion-recovery (FLAIR) sequence that was designed to reduce CSF and blood flow artifacts by use of a non-slice-selective inversion pulse and k-space reordered by inversion time at each slice position (KRISP).

With the KRISP FLAIR sequence, the slice order was cycled so that each inversion time (TI) was associated with a region of k-space rather than a particular slice, and the effective inversion time (TI(eff)) was chosen to null the signal from CSF. Scans were obtained with both conventional and KRISP FLAIR sequences. Studies were performed in 20 adult patients with a variety of brain diseases. Images were evaluated for artifacts from patient motion, CSF, and blood flow, and scored on a four-point scale. The conspicuity of the cortex, meninges, ventricular system, brain stem, and cerebellum was evaluated, as was lesion number and conspicuity.

The KRISP FLAIR sequence showed more patient motion artifacts but had a pronounced advantage over the conventional sequence in control of CSF artifacts around the foramen of Munro, in the third ventricle, aqueduct, and fourth ventricle, as well as in the basal cisterns and around the brain stem and cerebellum. Blood flow artifacts from the internal carotid, basilar, and vertebral arteries were also much better controlled. Spurious high signal in the sylvian branches of the middle cerebral artery was eliminated. The meninges, cortex, ventricular system, brain stem, and cerebellum were better seen due to improved artifact suppression and an edge enhancement effect.

The KRISP FLAIR sequence can suppress CSF and blood flow artifacts and improve the conspicuity of the meninges, cortex, brain stem, and cerebellum. Its major disadvantage is its duration, which may be reducible with a fast spin-echo version.