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Research ArticlePediatrics

Effectiveness of 3D T2-Weighted FLAIR FSE Sequences with Fat Suppression for Detection of Brain MR Imaging Signal Changes in Children

M. Mascalchi, A. Bianchi, M. Basile, P. Gulino, M.R. Trifan, D. Difeo, E. Bartolini, C. Defilippi and S. Diciotti
American Journal of Neuroradiology December 2016, 37 (12) 2376-2381; DOI: https://doi.org/10.3174/ajnr.A4915
M. Mascalchi
aFrom the “Mario Serio” Department of Experimental and Clinical Biomedical Sciences (M.M., A.B.), University of Florence, Florence, Italy
bStructural and Functional Neuroradiology Research Unit (M.M.)
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A. Bianchi
aFrom the “Mario Serio” Department of Experimental and Clinical Biomedical Sciences (M.M., A.B.), University of Florence, Florence, Italy
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M. Basile
cDiagnostic Radiology (M.B., P.G., M.R.T., D.D., C.D.)
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P. Gulino
cDiagnostic Radiology (M.B., P.G., M.R.T., D.D., C.D.)
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M.R. Trifan
cDiagnostic Radiology (M.B., P.G., M.R.T., D.D., C.D.)
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D. Difeo
cDiagnostic Radiology (M.B., P.G., M.R.T., D.D., C.D.)
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E. Bartolini
dNeurology Unit and Laboratories (E.B.), Meyer Children's Hospital, Florence, Italy
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C. Defilippi
cDiagnostic Radiology (M.B., P.G., M.R.T., D.D., C.D.)
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S. Diciotti
eDepartment of Electrical, Electronic, and Information Engineering “Guglielmo Marconi” (S.D.), University of Bologna, Cesena, Italy.
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Abstract

BACKGROUND AND PURPOSE: T2-weighted FLAIR can be combined with 3D-FSE sequences with isotropic voxels, yielding higher signal-to-noise ratio than 2D-FLAIR. Our aim was to explore whether a T2-weighted FLAIR–volume isotropic turbo spin-echo acquisition sequence (FLAIR-VISTA) with fat suppression shows areas of abnormal brain T2 hyperintensities with better conspicuity in children than a single 2D-FLAIR sequence.

MATERIALS AND METHODS: One week after a joint training session with 20 3T MR imaging examinations (8 under sedation), 3 radiologists independently evaluated the presence and conspicuity of abnormal areas of T2 hyperintensities of the brain in FLAIR-VISTA with fat suppression (sagittal source and axial and coronal reformatted images) and in axial 2D-FLAIR without fat suppression in a test set of 100 3T MR imaging examinations (34 under sedation) of patients 2–18 years of age performed for several clinical indications. Their agreement was measured with weighted κ statistics.

RESULTS: Agreement was “substantial” (mean, 0.61 for 3 observers; range, 0.49–0.69 for observer pairs) for the presence of abnormal T2 hyperintensities and “fair” (mean, 0.29; range, 0.23–0.38) for the comparative evaluation of lesion conspicuity. In 21 of 23 examinations in which the 3 radiologists agreed on the presence of abnormal T2 hyperintensities, FLAIR-VISTA with fat suppression images were judged to show hyperintensities with better conspicuity than 2D-FLAIR. In 2 cases, conspicuity was equal, and in no case was conspicuity better in 2D-FLAIR.

CONCLUSIONS: FLAIR-VISTA with fat suppression can replace the 2D-FLAIR sequence in brain MR imaging protocols for children.

ABBREVIATION:

VISTA
volume isotropic turbo spin-echo acquisition
  • © 2016 by American Journal of Neuroradiology
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American Journal of Neuroradiology: 37 (12)
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M. Mascalchi, A. Bianchi, M. Basile, P. Gulino, M.R. Trifan, D. Difeo, E. Bartolini, C. Defilippi, S. Diciotti
Effectiveness of 3D T2-Weighted FLAIR FSE Sequences with Fat Suppression for Detection of Brain MR Imaging Signal Changes in Children
American Journal of Neuroradiology Dec 2016, 37 (12) 2376-2381; DOI: 10.3174/ajnr.A4915

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Effectiveness of 3D T2-Weighted FLAIR FSE Sequences with Fat Suppression for Detection of Brain MR Imaging Signal Changes in Children
M. Mascalchi, A. Bianchi, M. Basile, P. Gulino, M.R. Trifan, D. Difeo, E. Bartolini, C. Defilippi, S. Diciotti
American Journal of Neuroradiology Dec 2016, 37 (12) 2376-2381; DOI: 10.3174/ajnr.A4915
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