title: Reduction of motion, truncation and flow artifacts using BLADE sequences in cervical spine MR imaging.
abstract: OBJECTIVE
  To assess the efficacy of the BLADE technique (MR imaging with 'rotating blade-like k-space covering') to significantly reduce motion, truncation, flow and other artifacts in cervical spine compared to the conventional technique.
  
  
  METHODS
  In eighty consecutive subjects, who had been routinely scanned for cervical spine examination, the following pairs of sequences were compared: a) T2 TSE SAG vs. T2 TSE SAG BLADE and b) T2 TIRM SAG vs. T2 TIRM SAG BLADE. A quantitative analysis was performed using the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) measures. A qualitative analysis was also performed by two radiologists, who graded seven image characteristics on a 5-point scale (0: non-visualization; 1: poor; 2: average; 3: good; 4: excellent). The observers also evaluated the presence of image artifacts (motion, truncation, flow, indentation).
  
  
  RESULTS
  In quantitative analysis, the CNR values of the CSF/SC between TIRM SAG and TIRM SAG BLADE were found to present statistically significant differences (p < 0.001). Regarding motion and truncation artifacts, the T2 TSE BLADE SAG was superior compared to the T2 TSE SAG, and the T2 TIRM BLADE SAG was superior compared to the T2 TIRM SAG. Regarding flow artifacts, T2 TIRM BLADE SAG eliminated more artifacts than T2 TIRM SAG.
  
  
  CONCLUSIONS
  In cervical spine MRI, BLADE sequences appear to significantly reduce motion, truncation and flow artifacts and improve image quality. BLADE sequences are proposed to be used for uncooperative subjects. Nevertheless, more research needs to be done by testing additional specific pathologies.
authors.affiliation: Department of Medical Radiological Technologists, Technological Education Institute of Athens, Greece.
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Lavdas
authors.affiliation: Department of Radiological Sciences, University of Texas Health Sciences Center at San Antonio, San Antonio, TX, USA; Department of Medical Physics, Karolinska Institutet & Stockholm University, Stockholm, Sweden. Electronic address: mavroidis@uthscsa.edu.
authors.forename: Panayiotis
authors.initials: P
authors.lastname: Mavroidis
authors.affiliation: Department of Medical Instruments Technology, Technological Education Institute of Athens, Greece.
authors.forename: Spiros
authors.initials: S
authors.lastname: Kostopoulos
authors.affiliation: Department of Medical Instruments Technology, Technological Education Institute of Athens, Greece.
authors.forename: Constantin
authors.initials: C
authors.lastname: Ninos
authors.affiliation: Department of Medical Radiological Technologists, Technological Education Institute of Athens, Greece.
authors.forename: Aspasia-Dimitra
authors.initials: AD
authors.lastname: Strikou
authors.affiliation: Department of Medical Instruments Technology, Technological Education Institute of Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Glotsos
authors.affiliation: Department of Medical Radiological Technologists, Technological Education Institute of Athens, Greece.
authors.forename: Anna
authors.initials: A
authors.lastname: Vlachopoulou
authors.affiliation: Department of Medical Radiological Technologists, Technological Education Institute of Athens, Greece.
authors.forename: Georgia
authors.initials: G
authors.lastname: Oikonomou
authors.affiliation: 2nd Department of Radiology, General University Hospital ATTIKON, National and Kapodistrian University of Athens, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Economopoulos
authors.affiliation: Health Center of Farkadona, Trikala, Greece.
authors.forename: Violeta
authors.initials: V
authors.lastname: Roka
authors.affiliation: Center for Research and Technology Thessaly Trikala.
authors.forename: Georgios K
authors.initials: GK
authors.lastname: Sakkas
authors.affiliation: Department of Orthopaedic Surgery, IASO Thessalias Hospital, Larissa, Greece.
authors.forename: Antonios
authors.initials: A
authors.lastname: Tsagkalis
authors.affiliation: Department of Radiological Sciences, University of Texas Health Sciences Center at San Antonio, San Antonio, TX, USA.
authors.forename: Sotirios
authors.initials: S
authors.lastname: Stathakis
authors.affiliation: Department of Radiological Sciences, University of Texas Health Sciences Center at San Antonio, San Antonio, TX, USA.
authors.forename: Nikos
authors.initials: N
authors.lastname: Papanikolaou
authors.affiliation: Department of Medical Imaging, IASO Thessalias Hospital, Larissa, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Batsikas
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D016477:Artifacts; D002574:Cervical Vertebrae / Q000473:pathology*; D003287:Contrast Media / Q000737:chemistry; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009038:Motion; D015203:Reproducibility of Results; D059629:Signal-To-Noise Ratio; D055815:Young Adult
chemical_list: D003287:Contrast Media
keywords: Artifact reduction; BLADE sequences; Cervical spine MR imaging; Image quality