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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 23:393-399, March 2002
© 2002 American Society of Neuroradiology

BRAIN

Influence of Imaging Parameters on High-Intensity Cerebrospinal Fluid Artifacts in Fast-FLAIR MR Imaging

Hsiu-Mei Wu^a,c, David M. Yousem^a, Hsiao-Wen Chung^d,e, Wan-Yuo Guo^b,c, Cheng-Yen Chang^b,c and Cheng-Yu Chen^e

^a Department of Radiology, Johns Hopkins University, Baltimore, MD
^b the Department of Radiology, Veterans General Hospital-Taipei, Taiwan, ROC
^c the Department of Radiology, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
^d the Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan, ROC
^e the Department of Radiology, Tri-Service General Hospital, Nei-Hu, Taipei, Taiwan, ROC

Address reprint requests to Hsui-Mei Wu, MD, Department of Radiology, Veterans General Hospital-Taipei, No. 201, Section 2, Shih-Pai Road, Taipei, Taiwan 112, ROC

BACKGROUND AND PURPOSE: High-intensity CSF artifacts at the basal cisterns on MR images are often seen when a fast fluid-attenuated inversion recovery (FLAIR) technique is used. We investigated the influences of four optional fast-FLAIR sequence parameters on the high-intensity CSF artifacts.

METHODS: A total of 377 patients (age range, 1 week to 91 years; mean 40.6 years; 186 female, 191 male) were examined with axial fast-FLAIR images obtained (TR/TE_eff/TI, 8800/133/2200) with a 1.5-T system during 6 months. The effects of the optional addition of inferior inflow saturation (thickness, 80 mm), section flow compensation, and tailored radiofrequency (TRF) pulses, plus the choice of interleaving acquisition factors of 2 or 3, were evaluated for the presence of high-intensity CSF artifacts on the fast-FLAIR images. Two radiologists independently reviewed the fast-FLAIR images in 76 patients; afterward, a single observer reviewed the remainder of the images.

RESULTS: The interobserver agreement rate in 76 cases was more than 90percnt;. The use of TRF and/or three interleaving acquisitions resulted in a substantial reduction in the incidence of high-intensity CSF artifacts from about 80percnt; to 40percnt; (P < .05, two-sample two-sided Z test). Inferior inflow saturation and section flow compensation did not significantly improve image quality (P > .05). The results were consistent with the image quality ranking obtained in five healthy volunteers.

CONCLUSION: The appropriate choice of sequence parameters in fast-FLAIR imaging reduces the incidence of high-intensity CSF artifacts that are frequently encountered in the presence of rapid CSF flow.

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