Contrast-enhanced MR Imaging of the Brain Using T1-weighted FLAIR with BLADE Compared with a Conventional Spin-echo Sequence

The BLADE and PROPELLER (periodically rotated overlapping parallel lines with enhanced reconstruction) techniques have been proposed to reduce the effect of head motion. Preliminary results have shown that BLADE also reduces pulsation artifacts from venous sinuses. The purpose of this study was to compare T1-weighted FLAIR acquired with BLADE (T1W-FLAIR BLADE) and T1-weighted spin-echo (T1W-SE) for the detection of contrast enhancement in a phantom and in patients with suspected brain lesions and to compare the degree of flow-related artifacts in the patients. A phantom filled with diluted Gd-DTPA was scanned in addition to 27 patients. In the phantom study, the peak contrast-to-noise ratio of T1W-FLAIR BLADE was larger than that of T1W-SE, and the position of the peak was shifted to a lower concentration. In patients, the degree of flow-related artifacts was significantly higher in T1W-SE. Among the 27 patients, 9 had metastatic tumor, and 18 did not. On a patient-by-patient basis, the sensitivity and specificity for the detection of metastatic lesions on axial T1W-SE were 100% and 55.6% respectively, while on axial T1W-FLAIR BLADE they were 100% and 100%. T1W-FLAIR BLADE seems to be capable of replacing T1W-SE, at least for axial post-contrast imaging to detect brain metastases.