Brain hemorrhage: evaluation with fast spin-echo and conventional dual spin-echo images

Signal intensity of blood products on proton-density- and T2-weighted images obtained with spin-echo (SE) and fast SE (FSE) sequences was evaluated in 15 patients with central nervous system hemorrhage to determine the extent of differences between the two techniques when signal loss from magnetic susceptibility effects in hemorrhagic lesions is considered. Within operator-defined regions of interest, signal intensity of hemorrhage, iron-containing nuclei, white matter, scalp fat, and noise was measured along the phase-encoding direction. Hemosiderin, deoxyhemoglobin, and iron-containing nuclei had slightly higher signal intensity on FSE images than on SE images, but the differences were not statistically significant. Signal intensity of methemoglobin was similar with both sequences, whereas that of scalp fat was higher on FSE images. Signal intensity measurements for most tissues studied were comparable, but the signal-to-noise ratios with FSE imaging were less than those with SE imaging. Although paramagnetic blood products may show slightly higher signal intensity with FSE imaging, contrast with the two sequences was comparable and lesion conspicuity was nearly identical.