MR DETECTION OF WHITE-MATTER DISEASE OF THE BRAIN IN PATIENTS WITH HIV-INFECTION - FAST SPIN-ECHO VS CONVENTIONAL SPIN-ECHO PULSE SEQUENCES

OBJECTIVE. Although fast spin-echo images and slower spin-echo images have similar contrast characteristics, the two techniques have not yet been shown to be equivalent in all aspects of brain imaging. To deter mine if the two sequences are equivalent, we compared detection of whi te matter lesions, image quality, and artifact degradation on fast spi n-echo and spin-echo proton density-weighted and T2-weighted MR images of the brain in prospectively selected patients who were sero-positiv e for HIV. SUBJECTS AND METHODS. Fast spin-echo and spin-echo MR image s of the brain were obtained in 153 consecutive subjects. The images w ere reviewed independently by three experienced neuroradiologists. The size, number, and location of white matter lesions were compared for the two techniques. Image quality, motion artifact, CSF flow artifact, and gray-white matter differentiation were graded on a five-point sca le. RESULTS. No statistical difference was found in gray-white matter differentiation. Overall image quality, CSF flow artifacts, and motion artifacts were slightly worse on the fast spin-echo images (p < .05). Although some variability existed in the detection of lesions less th an 5 mm in diameter, the difference was small, and all larger lesions were detected by both techniques. Agreement between fast spin-echo and conventional spin-echo techniques was nearly exact with respect to ch aracterizing findings in brain as either normal or abnormal.CONCLUSION S. Fast spin-echo and spin-echo MR of the brain produce images of simi lar quality and show white matter lesions equally well. These results support the replacement of slower, conventional spin-echo pulse sequen ces with faster fast spin-echo sequences.