MR fluid-attenuated inversion recovery imaging as routine brain T2-weighted imaging

We tried to investigate if magnetic resonance (MR) fluid-attenuated inversi on recovery (FLAIR) imaging can be used as a routine brain screening examin ation instead of spin-echo T2-weighted imaging. Three hundred and ninety-fo ur patients with clinically suspected brain diseases were randomly selected and examined with both brain MR FLAIR and T2-weighted imaging on the axial plane. These two imaging techniques were evaluated by two neuroradiologist s as to which imaging was better for routine brain T2-weighted imaging. In 123 of 394 cases (31%), FLAIR imaging was superior to spin-echo T2-weighted imaging. Especially in cases with inflammatory diseases, traumatic disease s and demyelinating diseases, FLAIR imaging was particularly useful. Small lesions bordering cerebrospinal fluid (CSF) are often detected only by FLAI R imaging. In 259 cases (66%), including 147 normal cases (37%), they were equally evaluated. Only in 12 cases (3%) was conventional T2-weighted imagi ng superior to FLAIR imaging. Cerebrovascular lesions like cerebral aneurys m and Moyamoya disease could not be detected on FLAIR images because these structures a ere obscured by a low signal from the CSF. Also, because old i nfarctions tend to appear as low signal intensity on FLAIR images, the cond ition was sometimes hard to detect. Finally, FLAIR imaging could be used as routine brain T2-weighted imaging instead of conventional spin-echo T2-wei ghted imaging if these vascular lesions were watched. (C) 1999 Elsevier Sci ence Ireland Ltd. All rights reserved.