title: Novel application of T1-weighted BLADE sequences with fat suppression compared to TSE in contrast-enhanced T1-weighted imaging of the neck: cutting-edge images?
abstract: OBJECTIVE
  To evaluate if the use of BLADE sequences might overcome some limitations of magnetic resonance imaging (MRI) in the extracranial head and neck, which is a diagnostically challenging area with a variety of artifacts and a broad spectrum of potential lesions.
  
  
  METHODS
  After informed consent and Institutional Review Board approval, two different BLADE sequences with (BLADE IR) and without inversion pulse (BLADE) were compared to turbo-spin echo (TSE) with fat saturation for coronal T1-weighted postcontrast imaging of the extracranial head and neck region in 40 individuals of a routine patient collective. Visual evaluation of image sharpness, motion artifacts, vessel pulsation, contrast of anatomic structures, contrast of pathologies to surrounding tissue as well as BLADE-specific artifacts was performed by two experienced, independent readers. Statistical evaluation was done by using the Wilcoxon test.
  
  
  RESULTS
  Both BLADE and BLADE IR were significantly superior to TSE regarding pulsation artifacts and delineation of thoracic structures. TSE provided better results concerning contrast muscle/fat tissue and contrast lymph nodes/fat. More important, it showed significantly better contrast of several lesions, facilitating the detection of patient pathology.
  
  
  CONCLUSIONS
  T1-weighted coronal imaging of the extracranial head and neck region is demanding. T1-weighted BLADE sequences still have drawbacks in anatomical contrast and lesion detection but offer possibilities to achieve reasonable image quality in difficult cases with a variety of artifacts.
authors.affiliation: Institute of Radiology, University Medical Center Regensburg, Regensburg, Germany. thomas.finkenzeller@klinikum-nuernberg.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Finkenzeller
authors.forename: Niels
authors.initials: N
authors.lastname: Zorger
authors.forename: Thomas
authors.initials: T
authors.lastname: Kühnel
authors.forename: Christian
authors.initials: C
authors.lastname: Paetzel
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schuierer
authors.forename: Christian
authors.initials: C
authors.lastname: Stroszczynski
authors.forename: Claudia
authors.initials: C
authors.lastname: Fellner
mesh_terms: D000273:Adipose Tissue; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016477:Artifacts; D003287:Contrast Media / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009068:Movement; D009333:Neck / Q000473:pathology*; D011446:Prospective Studies
chemical_list: D003287:Contrast Media