Multi-shot echo-planar Flair imaging of brain tumors: comparison of spin-echo T1-weighted, fast spin-echo T2-weighted, and fast spin-echo Flair imaging

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Abstract

Multi-shot echo-planar fluid-attenuated inversion-recovery (EPI-Flair) was compared with spin-echo T1-weighted (SE-T1W), fast SE T2-weighted (FSE-T2W), and fast Flair (F-Flair) in imaging brain tumors. In 32 patients with various different brain tumors, three reviewers independently evaluated image quality. Two reviewers evaluated the image quality of precontrast EPI-Flair to be significantly better than that of precontrast SE-T1W. Two reviewers evaluated the image quality of postcontrast EPI-Flair as superior to that of postcontrast SE-T1W. Artifacts on postcontrast EPI-Flair were significantly more prominent than those on postcontrast F-Flair. Multi-shot EPI-Flair appeared to be superior to SE-T1W, and almost equivalent to FSE-T2W in terms of image quality.

Section snippets

Materials and methods

The brains of 32 consecutive patients with brain tumors were prospectively imaged on a clinical 1.5-T imager. All patients underwent EPI-Flair before and/or after contrast administration to compare EPI-Flair with other sequences. All tumors were diagnosed by removal of the tumor or biopsy after MR examinations. The tumors analyzed were five glioblastomas, six malignant astrocytomas, one malignant oligodendroglioma, one oligodendroglioma, one pilocytic astrocytoma, three medulloblastomas, three

Results

The results for image quality are shown in Table 2. Prior to administration of contrast material, precontrast EPI-Flair (EPI-Flair (−)) was evaluated to be significantly better than precontrast SE-T1W (SE-T1W (−)) by radiologists 2 and 3. EPI-Flair (−) more clearly revealed lesion conspicuity, delineation of edema, and margin definition (Fig. 1) than SE-T1W (−). There were no significant differences between FSE-T2W and EPI-Flair (−). Precontrast F-Flair (F-Flair (−)) was graded as being

Discussion

In the present study, EPI-Flair produced better images than SE-T1W (−) or SE-T1W (+) according to the evaluation of lesion conspicuity, margin definition, and delineation of edema for all radiologists. The presence of artifacts seen on the EPI-Flair (−) was more prominent that on the SE-T1W (−), while more prominent artifacts were observed on SE-T1W (+) compared with EPI-Flair (+). EPI-Flair appears to represent an alternative to SE-T1W for the depiction of brain tumors. Although artifacts on

Summary

EPI with a multi-shot technique is also a fast imaging technique, and it is more promising for higher resolution imaging than single-shot EPI. The purpose of this investigation was to determine whether EPI-Flair with a multi-shot technique could replace T1-weighted images with conventional SE sequence (SE-T1W), T2-weighted images with fast SE sequence (FSE-T2W), and fast Flair (F-Flair) images.

The brains of 32 consecutive patients with brain tumors were prospectively imaged on a clinical 1.5-T

Noriaki Tomura, M.D. is an associate professor at Akita University and chief of neuroradiology. He received Japanese board certification in radiology in 1986, Japanese board certification in nuclear medicine in 1992, and his M.D. degree in 1989 from Akita University. His research interests are primarily in diagnostic neuro-, head and neck radiology, and nuclear medicine of the brain.

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Noriaki Tomura, M.D. is an associate professor at Akita University and chief of neuroradiology. He received Japanese board certification in radiology in 1986, Japanese board certification in nuclear medicine in 1992, and his M.D. degree in 1989 from Akita University. His research interests are primarily in diagnostic neuro-, head and neck radiology, and nuclear medicine of the brain.

Koki Kato, M.D. is a staff radiologist at Akita University. He received Japanese board certification in nuclear medicine in 1997, Japanese board certification in radiology in 1998, and his M.D. degree in 2000 from Akita University. His research interests are primarily in diagnostic neuroradiology.

Satoshi Takahashi, M.D. is a staff radiologist at Akita University and chief of interventional radiology. He received Japanese board certification in radiology in 1990, and his M.D. degree in 2001 from Akita University. His research interests are primarily in neuroradiology and interventional neuroangiography.

Ryuji Sashi, M.D. is an instructor at Akita University. He received Japanese board certification in radiology in 1987, and his M.D. degree in 1990 from Akita University. His research interests are primarily in diagnostic radiology of the bone and soft tissues.

Jun-ichi Izumi, M.D. is a staff radiologist at Akita University. He received Japanese board certification in nuclear medicine in 2000, and Japanese board certification in radiology in 2001. His research interests are primaily in radiation therapy.

Komei Narita, R.T. is a supervisor of radiological technicians at Akita University. He is an expert of technology of MR imaging, especially in the field of the central nervous system.

Jiro Watarai, M.D. is a professor and chairman of radiology at Akita University. He received his M.D. degree in 1982 from Tohoku University. Japanese board certification in radiology in 1986, and Japanese board certification in nuclear medicine in 1997. He has worked over 30 years on developing radiation therapy and diagnostic radiology. His research interests are primarily in radiation therapy for head and neck tumors.

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