title: Effective performance of T(1)-weighted FLAIR Imaging with BLADE in pediatric brains.
abstract: OBJECTIVE
  In magnetic resonance imaging of the brain, BLADE is used to compensate for head motion. The technique focuses mainly on acquisition of T(2)-weighted or contrast-enhanced T(1)-weighted images in adults; its utility for nonenhanced T(1)-weighted imaging in children is not well established. We compared the quality of T(1)-weighted fluid-attenuated inversion recovery brain imaging with BLADE (T(1)-FLAIR-BLADE) to that of conventional spin-echo T(1)-weighted imaging (T(1)-SE) in pediatric patients who cannot stay still during MR imaging.
  
  
  METHODS
  Our investigation included a volunteer study and a retrospective clinical study. Six healthy adult volunteers underwent scanning to compare the contrast of T(1)-SE, T(1)-weighted fluid-attenuated inversion recovery imaging (T(1)-FLAIR), and T(1)-FLAIR-BLADE at both 1.5 and 3 tesla. Comparison was based on scores assigned independently by 2 blinded observers and by calculated contrast-to-noise ratio. The clinical study included 20 children who underwent both T(1)-SE and T(1)-FLAIR-BLADE at either 1.5 (n = 9) or 3 T (n = 11). On each sequence, 2 blinded observers independently scored visualization of the cerebral gyri and contrast between gray and white matter. We compared scores between sequences separately for 1.5 and 3T using Wilcoxon signed-rank tests.
  
  
  RESULTS
  At both 1.5 and 3T, contrast was better using T(1)-FLAIR and T(1)-FLAIR-BLADE than T(1)-SE in volunteers, and overall scores were significantly higher with T(1)-FLAIR-BLADE (P < 0.05) than T(1)-SE in the clinical study.
  
  
  CONCLUSIONS
  T(1)-FLAIR-BLADE may be superior to T(1)-SE in demonstrating brain structures in children who cannot stay still and may be used to supplement or replace T(1)-SE when T(1)-SE is insufficient for patient motion.
authors.affiliation: Department of Radiology, Kanagawa Children's Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama 232-8555, Japan. yaz.tachibana@radio.email.ne.jp
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Tachibana
authors.forename: Tetsu
authors.initials: T
authors.lastname: Niwa
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Kwee
authors.forename: Taro
authors.initials: T
authors.lastname: Takahara
authors.forename: Kouki
authors.initials: K
authors.lastname: Kusagiri
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Nagaoka
authors.forename: Reiko
authors.initials: R
authors.lastname: Watanabe
authors.forename: Noriko
authors.initials: N
authors.lastname: Aida
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology*; D001927:Brain Diseases / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity