The value of fast gradient-echo MR sequences in the evaluation of brain disease

One-hundred-fifteen patients thought to have intracranial disease were studied with various two-dimensional short repetition time, partial-flip-angle gradient-echo techniques: at 1.0 T, fast low-angle short (FLASH) at 10 degrees and 30 degrees and fast imaging with steady-state precession (FISP) at 60 degrees; at 1.5 T, FLASH 10 degrees, 30 degrees, and 60 degrees, FISP 60 degrees, and contrast-enhanced fast steady state at 60 degrees. These sequences were compared with a T2-weighted spin-echo sequence to determine the relative sensitivities of these techniques in detecting parenchymal lesions. Except for hemorrhagic lesions a substantial number of abnormalities were either not visible or poorly seen on the partial-flip-angle gradient-echo sequences. Minimizing echo time (6-9 msec) to decrease magnetic susceptibility effects did not improve lesion detection. Current usage of two-dimensional gradient-echo techniques for lesion detection is limited, except when calcification or hemorrhage is involved. Their utility may be expanded via the incorporation of three-dimensional techniques and IV contrast agents.