Purpose: In magnetic resonance imaging of the brain, BLADE is used to compensate for head motion. The technique focuses mainly on acquisition of T(2)-weighted or contrast-enhanced T(1)-weighted images in adults; its utility for nonenhanced T(1)-weighted imaging in children is not well established. We compared the quality of T(1)-weighted fluid-attenuated inversion recovery brain imaging with BLADE (T(1)-FLAIR-BLADE) to that of conventional spin-echo T(1)-weighted imaging (T(1)-SE) in pediatric patients who cannot stay still during MR imaging.
Materials and methods: Our investigation included a volunteer study and a retrospective clinical study. Six healthy adult volunteers underwent scanning to compare the contrast of T(1)-SE, T(1)-weighted fluid-attenuated inversion recovery imaging (T(1)-FLAIR), and T(1)-FLAIR-BLADE at both 1.5 and 3 tesla. Comparison was based on scores assigned independently by 2 blinded observers and by calculated contrast-to-noise ratio. The clinical study included 20 children who underwent both T(1)-SE and T(1)-FLAIR-BLADE at either 1.5 (n = 9) or 3 T (n = 11). On each sequence, 2 blinded observers independently scored visualization of the cerebral gyri and contrast between gray and white matter. We compared scores between sequences separately for 1.5 and 3T using Wilcoxon signed-rank tests.
Results: At both 1.5 and 3T, contrast was better using T(1)-FLAIR and T(1)-FLAIR-BLADE than T(1)-SE in volunteers, and overall scores were significantly higher with T(1)-FLAIR-BLADE (P < 0.05) than T(1)-SE in the clinical study.
Conclusion: T(1)-FLAIR-BLADE may be superior to T(1)-SE in demonstrating brain structures in children who cannot stay still and may be used to supplement or replace T(1)-SE when T(1)-SE is insufficient for patient motion.