title: Decreased CSF-flow artefacts in T2 imaging of the cervical spine with periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER/BLADE).
abstract: BACKGROUND
  The cervical spine is prone to artefacts in T2 MR-imaging due to patient movements and cerebrospinal fluid flow. The periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER/BLADE) acquisition method was developed to reduce motion artefacts. We sought to determine if T2-BLADE is superior to T2-TSE with conventional k-space reading.
  
  
  METHODS
  Twenty-five patients were examined using a 1.5 T MR-scanner. T2-weighted imaging of the cervical spine in sagittal and axial orientation using conventional or BLADE k-space reading was performed. Spinal cord, subarachnoid space, vertebrae and discs were evaluated by two independent observers using a scale from 0 (non-diagnostic) to 3 (excellent). Interobserver correlation was assessed as Cohen's kappa. Results of Mann-Whitney U test with p < 0.05 were regarded as significant. Furthermore, the investigators were asked for subjective evaluation in consensus.
  
  
  RESULTS
  Overall interobserver accuracy of κ = 0.91 was obtained. Comparison of sagittal images showed better values for all investigated structures in T2-BLADE: spinal cord (TSE/BLADE: 1.52/2.04; p < 0.001), subarachnoid space (1.36/2.06; p < 0.001) and vertebrae/discs (1.66/2.86; p < 0.001). Comparison of axial images showed better values in T2-BLADE for spinal cord (1.68/1.86; p = 0.149) and vertebrae/discs (1.0/1.96: p < 0.001) while subarachnoid space was better to be evaluated in conventional T2-TSE (1.94/1.12; p < 0.001). In sagittal orientation, motion- and CSF-flow artefacts were reduced in T2-BLADE. In axial orientation, however, CSF-flow artefacts were pronounced in T2-BLADE.
  
  
  CONCLUSIONS
  The image quality of the sagittal T2-BLADE sequences was significantly better than the T2-TSE and acquired in less time. In axial orientation, increased CSF-flow artefacts may reduce accuracy of structures in the subarachnoid space.
authors.affiliation: Department of Neuroradiology, University Clinic, Friedrich-Schiller-University, Jena, Germany. andreas.ragoschke-schumm@med.uni-jena.de
authors.forename: Andreas
authors.initials: A
authors.lastname: Ragoschke-Schumm
authors.forename: Peter
authors.initials: P
authors.lastname: Schmidt
authors.forename: Julia
authors.initials: J
authors.lastname: Schumm
authors.forename: Georg
authors.initials: G
authors.lastname: Reimann
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Mentzel
authors.forename: Werner A
authors.initials: WA
authors.lastname: Kaiser
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Mayer
mesh_terms: D000328:Adult; D000368:Aged; D016477:Artifacts; D002555:Cerebrospinal Fluid / Q000166:cytology*; D002574:Cervical Vertebrae / Q000473:pathology*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012399:Rotation; D012680:Sensitivity and Specificity; D013122:Spinal Diseases / Q000473:pathology*
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