Reduced artefacts and improved assessment of hyperintense brain lesions with BLADE MR imaging in patients with neurofibromatosis type 1.

BACKGROUND: Assessment of small brain lesions in children is often compromised by pulsation, flow or movement artefacts. MRI with a rotating blade-like k-space covering (BLADE, PROPELLER) can compensate for these artefacts. OBJECTIVE: We compared T2-weighted FLAIR images that were acquired with different k-space trajectories (conventional Cartesian and BLADE) to evaluate the impact of BLADE technique on the delineation of small or low-contrast brain lesions. MATERIALS AND METHODS: The subject group comprised 26 children with neurofibromatosis type 1 (NF 1), who had been routinely scanned at 1.5 T for optic pathway gliomas with both techniques and who had the typical hyperintense brain lesions seen in NF 1. Four experienced radiologists retrospectively compared unlabelled 4-mm axial images with respect to the presence of artefacts, visibility of lesions, quality of contour and contrast. RESULTS: Both techniques were comparable in depicting hyperintense lesions as small as 2 mm independent of contrast and edge definition. Pulsation and movement artefacts were significantly less common with BLADE k-space trajectory. In 7 of 26 patients (27%), lesions and artefacts were rated as indistinguishable in conventional FLAIR, but not in BLADE FLAIR images. CONCLUSION: BLADE imaging significantly improved the depiction of lesions in T2-W FLAIR images due to artefact reduction especially in the posterior fossa.

Perspectives and limitations of parallel MR imaging at high field strengths.

In medical magnetic resonance imaging (MRI) imaging, it is standard practice to use MR scanners with a field strength of 1.5 Tesla. Recently, an ongoing trend towards higher field strengths can be observed, with a new potential clinical standard of 3.0 Tesla. High-field MR imaging, with its intrinsic higher signal-to-noise ratio (SNR), can enable new applications for MRI in medical diagnosis, or can serve to improve existing methods. The use of high field MRI is not without its limitations, however. Besides SNR, other unwanted effects increase with a higher field strength. Without correction, these high field problems can cause a serious loss in image quality. An elegant way to address these problems is the use of parallel imaging. In many clinical applications, parallel MRI (pMRI) is part of the standard protocol, as pMRI can enhance virtually every MRI application without necessarily affecting the contrast behavior of the underlying imaging sequence. In addition to the speed advantages offered by pMRI, the capability of parallel imaging to reduce significant high field-specific problems, thereby improving image quality, will be of major importance.