MR imaging of the brain with a T1-weighted fluid-attenuated inversion recovery sequence: Comparison with conventional T1-weighted spin echo sequence

T1-weighted spin-echo (T1SE) images are widely used as a standard sequence to study the anatomy of the brain. They may demonstrate signal changes characteristic of certain pathologic abnormalities. However, the image contrast is not sufficient to differentiate white from gray matter and to delineate most pathologic lesions. We tried to improve lesion conspicuity with comparable acquisition time with T1-weighted fluid-attenuated inversion recovery (T1FLAIR) sequence. T1-weighted fluid-attenuated inversion recovery (T1FLAIR) sequence is the fast inversion recovery (FLAIR) sequence coupled an inversion recovery (IR) preparation pulse and a fast spin echo (FSE) readout with interleaved data acquisition. Ninetynine patients underwent T1SE and T1FLAIR during the same imaging session. The following features on T1-weighted images performed using T1FLAIR and T1SE sequences were compared quantitatively: individual signal intensity of gray matter, white matter, CFS, lesion, edema and noise; white matter-gray matter Contrast (SIwhite matter-SI gray matter), White matter-gray matter contrast-to-noise ratio (CNR) (SIwhite matter-SIgray matter / noise) and contrast ratio (SIwhite matter-SI gray matter / SIwhite matter); white matter-CSF contrast, CNR and contrast ratio; white matter-lesion contrast, CNR, and contrast ratio; lesion-CSF contrast, CNR and contrast ratio; white matter-edema contrast, CNR and contrast ratio. T1FLAIR yielded better gray matter-white matter contrast and white matter-CSF contrast and CNR than T1SE did. Lesion conspicuity on T1FLAIR was also superior to that on T1SE, especially within the white matter. T1FLAIR can provide superior gray-white matter contrast and improve lesion conspicuity with comparable acquisition time.