Fast spin-echo and fast fluid-attenuated inversion-recovery versus conventional spin-echo sequences for MR quantification of multiple sclerosis lesions.
OBJECTIVE
To compare fast spin-echo (FSE) and fast fluid-attenuated inversion recovery (FLAIR) sequences with conventional spin-echo (CSE) MR imaging in the quantification of the number and volume of multiple sclerosis lesions.


METHODS
In 30 patients with relapsing-remitting multiple sclerosis, we calculated the total number and volume of lesions detected with each of the three sequences using a semiautomated program.


RESULTS
On CSE sequences, we calculated a total of 2,583 lesions with a global volume of 836.3 cm3. With FSE sequences, we observed a 16% relative reduction in the number of lesions detected and a 25% relative reduction in global volume as compared with CSE. With fast FLAIR sequences, we detected a significantly lower number and volume of infratentorial lesions, whereas at the cortical/subcortical level the lesions were both more numerous and bulkier than on CSE sequences. Finally, we observed a higher lesion/white matter contrast, a significant reduction in time required for the quantification of lesion load, and a very low interobserver variability in favor of fast FLAIR sequences.


CONCLUSIONS
Despite its limitations in the detection of infratentorial lesions, the fast FLAIR sequence in conjunction with a semiautomated quantification program provides a reliable means to evaluate the total lesion burden in patients with MS.
Bastianello
S
S
Neuroradiological Section, University of Rome La Sapienza, Italy.
Bozzao
A
A
Paolillo
A
A
Giugni
E
E
Gasperini
C
C
Koudriavtseva
T
T
Millefiorini
E
E
Horsfield
M A
MA
Colonnese
C
C
Toni
D
D
Fiorelli
M
M
Pozzilli
C
C
Bozzao
L
L
D000328:Adult; D001921:Brain / Q000473:pathology*; D002531:Cerebellum / Q000473:pathology; D002540:Cerebral Cortex / Q000473:pathology; D015331:Cohort Studies; D004388:Dura Mater / Q000473:pathology; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000473:pathology; D015588:Observer Variation; D012008:Recurrence; D012075:Remission, Spontaneous; D015203:Reproducibility of Results