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AJNR - American Journal of Neuroradiology

Published ahead of print on March 5, 2008
doi: 10.3174/ajnr.A0971

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Hyperecho-Turbo Spin-Echo Sequences at 3T: Clinical Application in Neuroradiology

R.H. Tetzlaff^a,b, I. Mader^a, W. Küker^c, J. Weber^a, S. Ziyeh^a,d, A. Schulze-Bonhage^e, J. Hennig^f and M. Weigel^f

^a Department of Neuroradiology, Neurocenter of the University Hospital Freiburg, Freiburg, Germany
^b Department of Radiology, German Cancer Research Center, Heidelberg, Germany
^c Department of Neuroradiology, John Radcliffe Hospital, Oxford, UK
^d Institute for Diagnostic Radiology, Freiburg, Germany
^e Epilepsy Center, University Hospital Freiburg, Freiburg, Germany
^f Department of Radiology and Medical Physics, University Hospital Freiburg, Freiburg, Germany

View larger version (24K): [in this window] [in a new window]   Fig 1. The basic principle of TSE180° and hyperTSE. A sketch of the radio-frequency (RF) of the refocusing pulses applying flip angles ref is shown with time in TSE180° (upper graph) and hyperTSE (lower graph). In TSE180°, a constant ref = 180° is used, whereas in hyperTSE, ref is varied along the echo train. The box indicates the echo written in the center of the k-space, which corresponds to the respective TE. Note that the hyperTSE uses a substantial later echo than the TSE180°. exec indicates excitation pulse.

View larger version (163K): [in this window] [in a new window]   Fig 2. Representative regions of interest. A, Regions of interest for gray matter obtained from the frontal and temporal lobes (arrows). An average of the measurements was calculated. B, Region of interest for white matter obtained from the genu of the corpus callosum (arrow). C, Region of interest for CSF obtained from the frontal horn of the left ventricle (arrow). D, Region of interest for the SD of noise obtained from the noise in the upper left quadrant of the image.

View larger version (27K): [in this window] [in a new window]   Fig 3. Linear regression analysis and 95% predictive interval of single values between contrast to noise of pathology in hyperTSE and TSE180° (r = 0.93, P = .001). Three outliers are marked in gray. hTSE indicates hyperTSE.

View larger version (132K): [in this window] [in a new window]   Fig 4. A, hyperTSE (hTSE). B, TSE180°. Note the gliosis in the white and gray matter of the left temporal lobe after trauma. In both sequences, the hyperintense findings are clearly visible.

View larger version (109K): [in this window] [in a new window]   Fig 5. A, hyperTSE (hTSE). B, TSE180°. The left hippocampus is atrophic and has increased signal intensity attributed to hippocampal sclerosis (arrows). This finding was confirmed by surgery. The right hippocampus shows the typical dentation, and the particular layers are visible on both sequences.

View larger version (121K): [in this window] [in a new window]   Fig 6. A, HyperTSE (hTSE). B, TSE180°. A right mesiotemporal cavernoma (arrows) consisting of a hypointense hemosiderin rim and a central hyperintense matrix containing methemoglobin is clearly depicted in both sequences. It is important that both parts of blood degradation products are depicted; this depiction was successful for both sequences. The diagnosis was confirmed by surgery.