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Improving Image Quality in Brain MRI Using Blade Sequences

P Mavroidis

P Mavroidis1,2*, E Lavdas3, S Kostopoulos3, D Glotsos3, V Roka4, T Topalzikis5, A Bakas3, G Oikonomou3, S Stathakis1, N Papanikolaou1, G Batsikas5, I Kaffes5, D Kechagias3, (1) University of Texas Health Science Center, UTHSCSA, San Antonio, TX, (2) Karolinska Institutet and Stockholm University, Stockholm, Sweden, (3) Techological Education Institute of Athens, Athens, Greece,(4) Health Center of Farkadona, Trikala, Greece,(5) IASO Thessalias Hospital, Larissa, Greece

SU-E-I-69 Sunday 3:00PM - 6:00PM Room: Exhibit Hall

Purpose: The purpose of this study is to compare two types of sequences for brain MR examination of uncooperative and cooperative patients. For each group of patients, the pairs of sequences that were compared were two T2-weighted (T2-W) fluid attenuated inversion recovery (FLAIR) sequences with different k-space trajectories (conventional Cartesian and BLADE) and two T2-TSE weighted (T2-W) with different k-space trajectories (conventional Cartesian and BLADE).

Methods: Twenty three consecutive unccoperative patients and forty four cooperative patients, who routinely underwent brain MRI examination, participated in the study. Both qualitative and quantitative analyses were performed based on the signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and relative contrast (ReCon) measures of normal anatomic structures. The qualitative analysis was performed by experienced radiologists. Also, the presence of motion artifacts, other artifacts (e.g. Gibbs, susceptibility artifacts, phase encoding from vessels) and pulsatile flow artifacts was evaluated.

Results: In the uncooperative group of patients, BLADE sequences were superior to the corresponding conventional sequences in all the cases. Furthermore, the differences were found to be statistically significant in almost all the cases. In the cooperative group of patients, BLADE sequences were superior to the conventional sequences with the differences of the CNR and ReCon values in nine cases being statistically significant. Furthermore, the BLADE sequences eliminated motion and other artifacts and T2 Flair BLADE sequences eliminated pulsatile flow artifacts.

Conclusion: BLADE sequences (T2 TSE and T2 Flair) should be used in brain MR examinations of uncooperative patients. In cooperative patients, T2 TSE BLADE sequences may be used as part of the routine protocol and orbital examinations. T2 Flair BLADE sequences may be used optionally in examinations of AVM, orbits, hemorrhages, ventricular lesions, lesions in the frontal lobe, periventricular lesions, lesions in regions close to artifacts and lesions in posterior fossa.

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