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Lumbar Spine Imaging-Sagittal Plane: T1 FLAIR BLADE with and Without Parallel Imaging Is Superior Than T1 Turbo Spin Echo

E Lavdas1*, M Papaioannou2 , A Tsikrika3 , E Pappas4 , G Sakkas5 , V Roka6 , S Kostopoulos7 , S Stathakis8 , N Papanikolaou9 , P Mavroidis10 , (1) University of West Attica, Athens, ,(2) Animus Kyanoys Stavros, Larissa, ,(3) General University Hospital of Larissa, Larissa, ,(4) Animus Kyanoys Stavros, Larissa, ,(5) University of Thessaly, Trikala, ,(6) Health Center of Farkadona, Trikala, ,(7) University of West Attica, Athens, ,(8) University Of Texas Health, San Antonio, TX, (9) University of Texas HSC SA, San Antonio, TX, (10) Univ North Carolina, Chapel Hill, NC


(Sunday, 7/14/2019) 4:30 PM - 5:00 PM

Room: Exhibit Hall | Forum 8

Purpose: To compare the quality of the T1-weighted fluid attenuated inversion recovery (FLAIR) BLADE sequence (T1W-FLAIR BLADE), with and without parallel imaging, with the quality of T1 turbo spin echo (T1 TSE) sequence regarding the sagittal plane imaging of lumbar spine with MR.

Methods: The T1W-FLAIR BLADE (with and without parallel imaging) and T1 TSE sequences were applied on 44 patients to visualize lumbar-spine (L-spine) using a 1.5T scanner. These techniques were evaluated by two radiologists through a) a qualitative analysis i.e. overall image quality, CSF nulling, and b) a quantitative analysis of signal-to-noise ratios (SNR), contrast-to-noise ratios (CNR) and relative contrast (ReCon).

Results: In the quantitative analysis, the T1W-FLAIR BLADE sequence had statistically better SNR value (p<0.001) in most tissues (e.g. bone marrow, spinal cord, fat tissue and CSF nulling. Regarding the CNR comparisons, T1 FLAIR BLADE had better results in all of the cases. More specifically, the results showed significant statistical difference between bone marrow/disc (<0.001), CSF/spinal cord (<0.01), nerve root/fat tissue (p<0.005), CSF/bone marrow (p<0.001), CSF/disc (p<0.001) and disc/fat tissue (p<0.005). Better SNR and CNR values were also observed in the comparison between the T1W-FLAIR BLADE images with parallel imaging against those of the T1 TSE sequence. The qualitative analysis showed that the T1W-FLAIR BLADE had better overall image quality and contrast between tissues as well as better CSF nulling.

Conclusion: T1 FLAIR BLADE sequence had higher SNRs for spinal cord, greater CSF nulling, greater CNRs for spinal cord–CSF with better visualization of disc–cord and cord–CSF interfaces. Also, the T1W-FLAIR BLADE sequence was superior to T1 TSE in overall image quality, reduction of motion artifacts and effective nulling of CSF signal. T1W-FLAIR BLADE is preferred by the clinicians and may be an alternative approach to lumbar spine imaging.


MRI, Quantitative Imaging, Pulse Sequences


IM- MRI : Quantitative imaging/analysis

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