Brain Imaging: Comparison of T1 W FLAIR BLADE with conventional T1 W SE

Abstract Introduction Although T1 weighted spin echo (T1 W SE) images are widely used to study anatomical details and pathologic abnormalities of the brain, its role in delineation of lesions and reduction of artifacts has not been thoroughly investigated. BLADE is a fairly new technique that has been reported to reduce motion artifacts and improve image quality. Objective The primary objective of this study is to compare the quality of T1-weighted fluid attenuated inversion recovery (FLAIR) images with BLADE technique (T1 W FLAIR BLADE) and the quality of T1 W SE images in the MR imaging of the brain. The goal is to highlight the advantages of the two sequences as well as which one can better reduce flow and motion artifacts so that the imaging of the lesions will not be impaired. Materials and methods Brain examinations with T1 W FLAIR BLADE and T1 W SE sequences were performed on 48 patients using a 1.5 T scanner. These techniques were evaluated by two radiologists based on: a) a qualitative analysis i.e. overall image quality, presence of artifacts, CSF nulling; and b) a quantitative analysis of signal-to-noise ratios (SNR), contrast-to-noise ratios (CNR) and Relative Contrast. The statistical analysis was performed using the Kruskal-Wallis non-parametric system. Results In the qualitative analysis, BLADE sequences had a higher scoring than the conventional sequences in all the cases. The overall image quality was better on T1 W FLAIR BLADE. Motion and flow-related artifacts were lower in T1 W FLAIR BLADE. Regarding the SNR measurements, T1 W SE appeared to have higher values in the majority of cases, whilst T1 W-FLAIR BLADE had higher values in the CNR and Relative Contrast measurements. Conclusion T1 W FLAIR BLADE sequence appears to be superior to T1 W SE in overall image quality and reduction of motion and flow-pulsation artifacts as well as in nulling CSF and has been preferred by the clinicians. T1 W FLAIR BLADE may be an alternative approach in brain MRI imaging.