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American Journal of Neuroradiology 20:1931-1938 (11 1999)
© 1999 American Society of Neuroradiology

ARTICLE

A Comparison of MR Imaging with Fast-FLAIR, HASTE-FLAIR, and EPI-FLAIR Sequences in the Assessment of Patients with Multiple Sclerosis

Massimo Filippia, Maria A. Roccaa, Martin Wiessmanna, Silvia Menneaa, Mara Cercignania, Tarek A. Yousrya, Maria P. Sormania and Giancarlo Comia

a From the Neuroimaging Research (M.F., M.A.R., S.M., M.C., M.P.S.) and Clinical Trials (G.C.) Units, Department of Neuroscience, Scientific Institute Ospedale San Raffaele, University of Milan, Italy; and the Department of Neuroradiology, Klinikum Grosshadern, University of Munich, Germany (M.W., T.A.Y.).

BACKGROUND AND PURPOSE: Fast fluid-attenuated inversion-recovery (FLAIR) sequences are sensitive for detecting lesions in patients with multiple sclerosis (MS). More rapid fast-FLAIR imaging of the brain can be achieved by the concomitant use of half-Fourier acquisition single-shot turbo spin-echo (HASTE-FLAIR) and echo-planar imaging (EPI-FLAIR). The present study was performed in a large cohort of subjects to assess and compare the number and volume of brain lesions detected by the fast-FLAIR, HASTE-FLAIR, and EPI-FLAIR sequences in patients with MS.

METHODS: Fast-FLAIR, HASTE-FLAIR, and EPI-FLAIR sequences were obtained from 46 consecutive MS patients. Lesions seen on each type of sequence were counted and classified by consensus by two observers. Lesion volumes were measured using a semiautomated segmentation technique based on local thresholding.

RESULTS: The quality of the fast-FLAIR images was significantly better than that of HASTE-FLAIR and EPI-FLAIR images. Fast-FLAIR revealed significantly more lesions and higher lesion volumes than did HASTE-FLAIR and EPI-FLAIR. A similar number of large lesions was detected by the three sequences, but HASTE-FLAIR and EPI-FLAIR showed significantly fewer small and intermediate lesions than did fast-FLAIR. The number of lesions seen on HASTE-FLAIR and EPI-FLAIR images was similar.

CONCLUSION: HASTE-FLAIR and EPI-FLAIR sequences revealed as many large MS lesions as fast-FLAIR. Because their acquisition times are only a fraction of that needed for fast-FLAIR sequences, they may be useful for making a rapid diagnosis of MS in uncooperative patients. Their reduced ability to detect smaller lesions indicates that they should not be used as a routine approach to imaging patients with MS.




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Copyright © 2008 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X