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[Fast spin echo and fast fluid attenuated inversion recovery sequences in multiple sclerosis]
A Paolillo1, E Giugni, A Bozzao
1Dipartimento di Scienze Neurologiche, Università, La Sapienza, Roma.
La Radiologia Medica
|June 1, 1997
Summary
Fast fluid attenuated inversion recovery (fast-FLAIR) MRI sequences offer improved lesion detection and reduced quantitation time in multiple sclerosis (MS) studies compared to conventional spin echo (CSE). While FSE sequences detected fewer lesions, fast-FLAIR demonstrated better identification of cortical lesions and higher contrast.
Area of Science:
- Radiology and Imaging
- Neurology
- Medical Physics
Background:
- Accurate quantitation of multiple sclerosis (MS) lesion burden is crucial for disease monitoring and treatment efficacy.
- Conventional spin echo (CSE) MRI sequences are established but may have limitations in lesion detection and quantitation efficiency.
- Fast spin echo (FSE) and fast fluid attenuated inversion recovery (fast-FLAIR) are advanced MRI techniques offering potential improvements.
Purpose of the Study:
- To compare the efficacy of FSE and fast-FLAIR sequences against CSE in quantifying MS lesion burden.
- To evaluate interobserver variability, time efficiency, and lesion signal intensity across different MRI sequences.
- To assess the performance of these sequences in detecting lesions across various brain regions (infratentorial, white matter, cortical/subcortical).
Main Methods:
- A semiautomated lesion detection program was used to calculate the number and volume of MS lesions on CSE, FSE, and fast-FLAIR images from 38 remitting MS patients.
- Two expert observers independently analyzed the images, with interobserver differences, quantitation time, and lesion signal intensity (contrast-to-noise ratio) recorded.
- Lesions were classified by location: infratentorial, white matter, and cortical/subcortical.
Main Results:
- CSE identified 2970 lesions totaling 961.7 cm³. FSE detected significantly fewer (16.6%) and smaller (24.9%) lesions compared to CSE.
- Fast-FLAIR showed a nonsignificant overall reduction in lesion number (0.5%) and volume (4.8%) but significantly detected fewer infratentorial lesions while identifying more cortical/subcortical lesions.
- Fast-FLAIR demonstrated superior lesion-to-white matter contrast, significantly reduced quantitation time, and minimal interobserver variability.
Conclusions:
- Fast-FLAIR sequences are recommended for MS studies due to their ability to identify cortical/subcortical lesions, high contrast-to-noise ratio, and efficient semiautomated quantitation.
- Despite limitations with infratentorial lesions, fast-FLAIR offers advantages in lesion detection and analysis speed over CSE and FSE.
- The high interobserver agreement and time savings make fast-FLAIR a valuable tool for MS lesion burden assessment.