title: Comparing white matter lesions on T2 and FLAIR MRI in the Sydney Older Persons Study.
abstract: There is suggestion that magnetic resonance imaging (MRI) fluid-attenuated inversion recovery (FLAIR) sequence may be more accurate than T2 images in detecting white matter lesions (WML) in older people. Comparative ratings of these two image sequences have not been directly investigated in very old individuals to date. We compared the ratings of periventricular and deep WML on these two sequences in a sample of 111 community dwellers (mean age 85.5 years) using semiquantitative methods. Periventricular WML were as commonly detected on T2 as on FLAIR but were more severely rated on the latter sequence. No such bias was observed for the deep WML. With one exception, correlations between the two sets of measures were significant at the P < 0.001 level (range: 0.34-0.75). Intrarater reliability coefficients were moderate to excellent for most ratings. These results suggest that ratings performed on T2-weighted images to detect WML in very old individuals are very comparable with those performed on FLAIR images although FLAIR may allow a finer grading of periventricular lesions. Absence of FLAIR does not preclude the identification of WML in this population. These findings have clinical and epidemiological relevance where the acquisition of supplementary MRI data may not always be possible.
authors.affiliation: Centre for Education and Research on Ageing at Concord Hospital, Department of Medicine, The University of Sydney, Sydney, NSW, Australia. olivier@mit.edu
authors.forename: O
authors.initials: O
authors.lastname: Piguet
authors.forename: L J
authors.initials: LJ
authors.lastname: Ridley
authors.forename: D A
authors.initials: DA
authors.lastname: Grayson
authors.forename: H P
authors.initials: HP
authors.lastname: Bennett
authors.forename: H
authors.initials: H
authors.lastname: Creasey
authors.forename: T C
authors.initials: TC
authors.lastname: Lye
authors.forename: G Anthony
authors.initials: GA
authors.lastname: Broe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D011859:Radiography; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity