title: Effectiveness of 3D T2-Weighted FLAIR FSE Sequences with Fat Suppression for Detection of Brain MR Imaging Signal Changes in Children.
abstract: T2-weighted FLAIR can be combined with 3D-FSE sequences with isotropic voxels, yielding higher signal-to-noise ratio than 2D-FLAIR. Our aim was to explore whether a T2-weighted FLAIR-volume isotropic turbo spin-echo acquisition sequence (FLAIR-VISTA) with fat suppression shows areas of abnormal brain T2 hyperintensities with better conspicuity in children than a single 2D-FLAIR sequence.
  
  
  
  One week after a joint training session with 20 3T MR imaging examinations (8 under sedation), 3 radiologists independently evaluated the presence and conspicuity of abnormal areas of T2 hyperintensities of the brain in FLAIR-VISTA with fat suppression (sagittal source and axial and coronal reformatted images) and in axial 2D-FLAIR without fat suppression in a test set of 100 3T MR imaging examinations (34 under sedation) of patients 2-18 years of age performed for several clinical indications. Their agreement was measured with weighted κ statistics.
  
  
  
  Agreement was "substantial" (mean, 0.61 for 3 observers; range, 0.49-0.69 for observer pairs) for the presence of abnormal T2 hyperintensities and "fair" (mean, 0.29; range, 0.23-0.38) for the comparative evaluation of lesion conspicuity. In 21 of 23 examinations in which the 3 radiologists agreed on the presence of abnormal T2 hyperintensities, FLAIR-VISTA with fat suppression images were judged to show hyperintensities with better conspicuity than 2D-FLAIR. In 2 cases, conspicuity was equal, and in no case was conspicuity better in 2D-FLAIR.
  
  
  
  FLAIR-VISTA with fat suppression can replace the 2D-FLAIR sequence in brain MR imaging protocols for children.
authors: From the "Mario Serio" Department of Experimental and Clinical Biomedical Sciences (M.M., A.B.), University of Florence, Florence, Italy m.mascalchi@dfc.unifi.it.|Structural and Functional Neuroradiology Research Unit (M.M.).
authors: M
authors: 0000-0002-5537-2982
authors: M
authors: Mascalchi
authors: From the "Mario Serio" Department of Experimental and Clinical Biomedical Sciences (M.M., A.B.), University of Florence, Florence, Italy.
authors: A
authors: 0000-0003-4169-2042
authors: A
authors: Bianchi
authors: Diagnostic Radiology (M.B., P.G., M.R.T., D.D., C.D.).
authors: M
authors: 0000-0002-3917-8581
authors: M
authors: Basile
authors: Diagnostic Radiology (M.B., P.G., M.R.T., D.D., C.D.).
authors: P
authors: 0000-0003-2243-5593
authors: P
authors: Gulino
authors: Diagnostic Radiology (M.B., P.G., M.R.T., D.D., C.D.).
authors: M R
authors: 0000-0003-0321-6176
authors: MR
authors: Trifan
authors: Diagnostic Radiology (M.B., P.G., M.R.T., D.D., C.D.).
authors: D
authors: 0000-0002-5519-2551
authors: D
authors: Difeo
authors: Neurology Unit and Laboratories (E.B.), Meyer Children's Hospital, Florence, Italy.
authors: E
authors: 0000-0002-5683-1941
authors: E
authors: Bartolini
authors: Diagnostic Radiology (M.B., P.G., M.R.T., D.D., C.D.).
authors: C
authors: 0000-0001-8003-067X
authors: C
authors: Defilippi
authors: Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi" (S.D.), University of Bologna, Cesena, Italy.
authors: S
authors: 0000-0001-8778-7819
authors: S
authors: Diciotti
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging*; D002648:Child; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging / Q000379:methods*; D059629:Signal-To-Noise Ratio