Value Of Gadolinium-Enhanced Dual Echo Fast Or Turbo Spin Echo MR Imaging In Revealing Enhancing Intracranial Lesions

Objective To investigate the value of gadolinium-enhanced dual echo fast or turbo spin echo [DF (T) SE]-T1WI and mixed weighted image (MWI) in revealing enhancing intracranial lesions. Methods The abilities of DF (T) SE-T1WI and MWI, F (T) SE-T1WI, fFLAIR-T1WI and T2WI, SE-T1WI with and without MT saturation pulse for the detection of concentrations of Gd-DTPA in CSF or normal saline, typical multiple sclerosis plaque or 70% fresh hard-boiled egg whites, and normal white matter or pure hard-boiled egg whites were analyzed and compared by using theoretical-analysis and phantom study respectively and then the preliminary clinical investigation was implemented. Results MWI and fFLAIR-T2WI showed the highest sensitivity for the detection of mild enhancing lesions with long T1 and T2 relaxation times and demonstrated no or minimal enhancement of vessels with slow flow as did T1WIs. postcontrast MWI showed superior enhancement in lesions with relatively long T1 and T2 values. All T1WIs offered equal advantages over both MWI and fFLAIR-T2WI in revealing enhancing intracranial lesions with short T2 value. Conclusion MWI provides improved detectability of faintly enhancing lesions with long T2 value and has minimal interference from flow-related artifacts as compared with T1WIs. The T1WI and MWI obtained simultaneously with DF (T) SE sequence each supplements and enriches the other and have the potential to replace the SE-T1WI with and without MT pulse for detection of enhancing lesions in the brain.