Gray-White Matter Differentiation of Cervical Spinal Cord Using MRI: Comparison Between Gradient-Echo and Fast Spin-Echo T2-Weighted Sequences

PURPOSE. To compare the gray-white matter differentiation of the cervical spinal cord between using T2*-weighted gradient-echo (GRE) sequence and T2-weighted fast spin-echo (FSE) sequence. MATERIALS AND METHODS. We retrospectively analyzed the magnetic resonance (MR) data of 71 patients, in whom 37 patients were imaged on a 3 T scanner and 34 patients were imaged on a 1.5 T scanner. Axial T2*-weighted GRE images (3 T: multi-echo data image combination; 1.5 T: fast field echo) and T2-weighted FSE images of the cervical spinal cord were performed and compared. Two neuroradiologists independently assessed the scans and rated visual score on 3-point scales (grade 3, well distinguishable; grade 2, partially distinguishable; and grade 1, indistinguishable). A gray-white matter intensity ratio (G/W intensity ratio) was calculated for comparison between GRE and FSE sequences in each scanner group. RESULTS. In comparison with FSE sequence, GRE sequence provided higher visual score (3 T: grade 3, medium, p ＜ 0.010; 1.5 T: grade 2, medium, p ＜ 0.010) and G/W intensity ratio (3 T: 1.25 ± 0.08, p ＜ 0.010; 1.5 T: 1.40 ± 0.16, p ＜ 0.010) on both 3 T and 1.5 T MR systems. The 3 T-GRE sequence provided higher visual score (grade 3, p ＜ 0.010) but lower G/W intensity ratio (1.25 ± 0.08, p ＜ 0.010) than did the 1.5 T-GRE sequence. No significant difference of visual score or G/W intensity ratio was found between 3 T-FSE and 1.5 T-FSE sequences. CONCLUSION. The T2*-weighted GRE sequence provided better gray-white matter differentiation compared with T2- weighted FSE sequence in the cervical spinal cord MR imaging.