American Journal of Roentgenology, Vol 162, 1199-1204, Copyright © 1994 by American Roentgen Ray Society
MR detection of white matter disease of the brain in patients with HIV infection: fast spin-echo vs conventional spin-echo pulse sequences
EM Olson, JF Healy, WH Wong, DC Youmans and JR Hesselink
Department of Radiology, University of California, San Diego Medical Center 92103-8756.
OBJECTIVE. Although fast spin-echo images and slower spin-echo images have
similar contrast characteristics, the two techniques have not yet been
shown to be equivalent in all aspects of brain imaging. To determine if the
two sequences are equivalent, we compared detection of white matter
lesions, image quality, and artifact degradation on fast spin-echo and
spin-echo proton density-weighted and T2-weighted MR images of the brain in
prospectively selected patients who were seropositive for HIV. SUBJECTS AND
METHODS. Fast spin-echo and spin- echo MR images of the brain were obtained
in 153 consecutive subjects. The images were reviewed independently by
three experienced neuroradiologists. The size, number, and location of
white matter lesions were compared for the two techniques. Image quality,
motion artifact, CSF flow artifact, and gray-white matter differentiation
were graded on a five-point scale. RESULTS. No statistical difference was
found in gray-white matter differentiation. Overall image quality, CSF flow
artifacts, and motion artifacts were slightly worse on the fast spin-echo
images (p < .05). Although some variability existed in the detection of
lesions less than 5 mm in diameter, the differences was small, and all
larger lesions were detected by both techniques. Agreement between fast
spin-echo and conventional spin-echo techniques was nearly exact with
respect to characterizing findings in brain as either normal or abnormal.
CONCLUSIONS. Fast spin-echo and spin-echo MR of the brain produce images of
similar quality and show white matter lesions equally well. These results
support the replacement of slower, conventional spin-echo pulse sequences
with faster fast spin-echo sequences.