title: Improvement of image quality using BLADE sequences in brain MR imaging.
abstract: The purpose of this study is to compare two types of sequences in brain magnetic resonance (MR) examinations of uncooperative and cooperative patients. For each group of patients, the pairs of sequences that were compared were two T2-weighted (T2-W) fluid attenuated inversion recovery sequences with different k-space trajectories (conventional Cartesian and BLADE) and two T2-TSE weighted with different k-space trajectories (conventional Cartesian and BLADE). Twenty-three consecutive uncooperative patients and 44 cooperative patients, who routinely underwent brain MR imaging examination, participated in the study. Both qualitative and quantitative analyses were performed based on the signal-to-noise ratio, contrast-to-noise ratio (CNR), and relative contrast (ReCon) measures of normal anatomic structures. The qualitative analysis was performed by experienced radiologists. Also, the presence of motion, other (e.g., Gibbs, susceptibility artifacts, phase encoding from vessels) artifacts and pulsatile flow artifacts was evaluated. In the uncooperative group of patients, BLADE sequences were superior to the corresponding conventional sequences in all the cases. Furthermore, the differences were found to be statistically significant in almost all the cases. In the cooperative group of patients, BLADE sequences were superior to the conventional sequences with the differences of the CNR and ReCon values in nine cases being statistically significant. Furthermore, BLADE sequences eliminated motion and other artifacts and T2 FLAIR BLADE sequences eliminated pulsatile flow artifacts. BLADE sequences (T2-TSE and T2 FLAIR) should be used in brain MR examinations of uncooperative patients. In cooperative patients, T2-TSE BLADE sequences may be used as part of the routine protocol and orbital examinations. T2 FLAIR BLADE sequences may be used optionally in examinations of AVM, orbits, haemorrhages, ventricular lesions, lesions in the frontal lobe, periventricular lesions, lesions in regions close to artifacts and lesions in posterior fossa.
authors.affiliation: Department of Medical Radiological Technologists, Techological Education Institute of Athens, Greece.
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Lavdas
authors.forename: Panayiotis
authors.initials: P
authors.lastname: Mavroidis
authors.forename: Spiros
authors.initials: S
authors.lastname: Kostopoulos
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Glotsos
authors.forename: Violeta
authors.initials: V
authors.lastname: Roka
authors.forename: Theofilos
authors.initials: T
authors.lastname: Topalzikis
authors.forename: Athanasios
authors.initials: A
authors.lastname: Bakas
authors.forename: Georgia
authors.initials: G
authors.lastname: Oikonomou
authors.forename: Nikos
authors.initials: N
authors.lastname: Papanikolaou
authors.forename: Georgios
authors.initials: G
authors.lastname: Batsikas
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kaffes
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Kechagias
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D016477:Artifacts; D001921:Brain / Q000473:pathology*; D003287:Contrast Media / Q000494:pharmacology; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009038:Motion; D011673:Pulsatile Flow; D059629:Signal-To-Noise Ratio; D055815:Young Adult
chemical_list: D003287:Contrast Media