CLINICAL USEFULNESS OF CONTRAST-ENHANCED MP-RAGE OF THE BRAIN

Our purpose was to evaluate the usefulness of a 3D T1-weighted gradien t-echo sequence (MP-RAGE) in clinical practice. We prospectively exami ned 200 patients with a variety of neurological disorders and symptoms . We compared lesion conspicuity and contrast enhancement on MP-RAGE i mages with conventional gadolinium-enhanced spin-echo (SE) T1-weighted images. Both the original MP-RAGE data and the reformatted images wer e characterised by improved differentiation between grey and white mat ter. More lesions were found on the 3D series, in both patients with n eoplastic and nonneoplastic disease. Contrast enhancement of small oed ematous lesions affecting the white matter in demyelinating disease wa s less obvious. Multiplanar reformatting, which can be realised in any desired plane and surface rendering with sophisticated segmentation a lgorithms superbly displayed the underlying anatomical relationships b etween lesions and normal brain structures. Excellent spatial resoluti on, the absence of posterior fossa artefacts and equivalent contrast e nhancement resulted in an increased number of space-occupying lesions being found on the MP-RAGE images. Thus contrast-enhanced MP-RAGE is a n alternative to conventional SE imaging in the investigation of intra cranial masses. Although the total number of lesions found in patients with demyelinating disease was significantly higher on MP-RAGE, demon stration of blood-brain-barrier breakdown in active lesions was less o bvious.