[Indirect MR arthrography in the diagnosis of lesions of the labrum glenoidale]

PURPOSE

It has been shown that intravenous administration of contrast media produces an MR arthrographic effect without the need for intraarticular injection. This is the first study evaluating this new technique of indirect MR arthrography in the diagnosis of glenoid labrum tears.

METHODS

28 patients with clinically suspected labral injuries were prospectively investigated (1.5 Tesla, flexible surface coil). A plain MR examination of the shoulder (transverse and oblique-coronal orientation, T1-weighted spin- [TE/TR 15/675], proton density- and T2*-weighted gradient echo [TE/TR/Flip 14,32/600/30 degrees] sequences) and indirect MR arthrography (transverse and oblique-coronal orientation, fat-suppressed T1-weighted spin-echo sequences [TE/TR 15/675], intravenous injection of gadopentetate dimeglumine [0.1 mmol/kg], followed by 10-15 min of joint movement) were performed. Results were confirmed by arthroscopy and/or open surgery.

RESULTS

Indirect MR arthrography significantly improved delineation of the glenoid labrum and hyaline cartilage (p < 0.05). Sensitivity and specificity of indirect MR arthrography in the diagnosis of labral injuries were 90% and 89%, compared to 79% and 67% of the native MR examination.

CONCLUSION

Indirect MR arthrography is a promising non-invasive technique in the evaluation of the glenoid labrum.

[MRI dacryocystography after applying gadolinium-containing eyedrops]

PURPOSE

To determine the efficacy of MRI for the lacrimal drainage system after conjunctival application of gadolinium-DTPA solution.

MATERIAL AND METHODS

MRI dacryocystography of 32 nasolacrimal duct systems was performed in 16 patients additional to digital subtraction dacryocystography. The gadolinium solution was prepared by diluting the commercially available gadolinium-DTPA (Magnevist, Schering AG, Berlin) 1:10 in sterile saline solution. 3 x 2 drops of this contrast medium were instilled bilaterally immediately before MRI scanning.

RESULTS

MRI dacryocystography provided detailed information on the nasolacrimal duct system in all 32 cases. In 16 cases localisation and functional degree of nasolacrimal duct obstruction or stenosis was determined reliably. In 15 cases normal nasolacrimal duct system showed no contrast enhancement. In one case stenosis of the canaliculus was observed.

CONCLUSION

MRI dacryocystography provides detailed morphological soft tissue information of the lacrimal drainage system. Local conjunctival application of gadolinium solution allows functional tests of the lacrimal duct system in patients suffering from epiphora.

[Disorders of water- and electrolyte balance in a triathlon. 2 case reports and review of the literature]

Triathlon is an increasingly popular sport. The number of active triathletes in Switzerland has increased greatly in recent years. We report two participants of the Zürcher Euroman. Triathlon 1995, who presented with clinically significant water and electrolyte disturbance. The race took place on a hot day and both athletes ingested large amounts of hypoosmolar fluids during and in case 1, after the competition. Case 1 was a 27 year old woman who developed generalized seizures one hour after finishing the race. She had confusion which persisted for several hours. The initial serum sodium concentration was 118 mmol/L. Case 2 was a 29 year old man who collapsed during the triathlon and was confused for hours afterwards. He presented with a serum sodium concentration of 120 mmol/L. Both patients had massive polyuria (first hour urine output of 900 ml, and 1300 ml respectively) that decreased in parallel with the normalization of the serum sodium. The pathophysiology, differential diagnosis and therapy of electrolyte and water disturbances in triathletes is discussed in relation to our two cases and the literature is reviewed.

Routine molecular genotyping of HLA-B27 in spondyloarthropathies overcomes the obstacles of serological typing and reveals an increased B *2702 frequency in ankylosing spondylitis

OBJECTIVE

To evaluate the reproducibility and reliability of polymerase chain reaction (PCR) in HLA-B27 typing compared to the conventionally used microlymphocytotoxicity test (MLCT). To determine the HLA-B27 subtype frequencies (B*2701-B*2709) in patients with HLA-B27 associated disease and healthy persons using sequence specific oligonucleotides (SSO).

METHODS

398 consecutive patients were HLA-B27 typed by MLCT and PCR. Subtyping by SSO was performed in 142 patients with HLA-B27 associated disease [ankylosing spondylitis (AS) n = 38, reactive arthritis 44, undifferentiated spondyloarthropathy (uSpA) 45, psoriatic arthritis 15] and 125 healthy HLA-B27 controls.

RESULTS

MLCT identified 61 HLA-B27 positive patients (15.3%); PCR identified 78 positive patients (19.6%). MLCT gave false negative results for 8 patients (2.0%) and false positives for a further 7 (1.8%). Only subtypes B*2702 and B*2705 were present in patients and controls. Overall frequencies of B*2702 in patients and controls were 14.1 and 9.6%, respectively. The B*2702 frequency was significantly (pcorr. < 0.04) higher in AS (23.7%) and lower in uSpA (6.7%) patients.

CONCLUSION

HLA-B27 typing by PCR is reliable and reproducible and therefore recommended for routine typing. It overcomes the obstacles of serological typing, i.e., equivocal results and cross-reactivity. In addition, subtype frequencies (B*2702 and B*2705) are equally distributed among patients and controls, although subtype B*2702 seems to be more frequent in AS and less so in uSpA.

Lack of association between an interleukin-1 receptor antagonist gene polymorphism and ulcerative colitis

BACKGROUND

Recently, the association of a polymorphism in the gene coding for the anti-inflammatory cytokine interleukin-1 receptor antagonist with ulcerative colitis has been reported. This was interpreted as a possible genetic predisposition for severity of the inflammatory response.

AIMS

To examine this polymorphism in a southern German population.

SUBJECTS

The study included 234 healthy controls, 57 patients with ulcerative colitis, including 31 patients with pancolitis, 44 first degree healthy relatives of patients with ulcerative colitis, and 65 patients with Crohn's disease.

METHODS

Genotypes were determined by a polymerase chain reaction amplification of the intron 2 fragment harbouring a variable number of tandem repeat nucleotide sequences. Amplification products were separated on a 2% agarose gel.

RESULTS

The allele frequency for allele 2 was 27% in healthy controls, 28% in Crohn's disease, and 21% in patients with ulcerative colitis. The same allele frequency (21%) was found in a subgroup of patients with ulcerative colitis affecting the whole colon. Thus for allele 2 as well as for all other alleles, genotypes, or carriage rates no significant differences were found compared with controls. All allele frequencies in the control population were similar to those in earlier studies.

CONCLUSIONS

No association of a polymorphism in the interleukin-1 receptor antagonist gene with ulcerative colitis could be identified in this southern German population. The findings of an earlier study reporting an increased frequency of allele 2, particularly in patients with pancolitis, could not be confirmed.

[Shortening of the measurement time by 1H-MR turbo spectroscopic imaging of the brain]

PURPOSE

Development of a new technique for reduction of measurement time in 1H-MR spectroscopic imaging of the brain. Optimisation of the sequence parameters in volunteer and in patient examinations and comparison to the results obtained with conventional 2 D-SI.

METHODS

Examination of 20 healthy volunteers and 5 patients in a 1.5 T whole-body MR system. In "turbo-spectroscopic imaging" (TSI) sequences, a train of spin-echo signals with different phase encoding is acquired after each 90 degrees excitation. 32 x 32 matrix elements covered a field of view of 20 cm, and additional volume selection was performed by double spin echo excitation. Measurement duration 9 min with acquisition of four phase encoding steps per TR interval, whereas the corresponding 2 D-SI sequence (TR/TE 2000/272 ms) took 30 min.

RESULTS

The TSI data sets yielded maps of the regional distribution of metabolite concentrations with a quality comparable to the 2 D-SI results. Signal homogeneity and delineation of brain lesions, however, were superior in conventional spectroscopic imaging. The T2 relaxation of the metabolites required a reduced sampling interval for each phase-encoded echo, and hence the frequency resolution of the corresponding TSI spectra was not always sufficient for separating choline and creatine signals.

CONCLUSION

With measurement durations < 10 min the TSI technique allows in clinical studies a combination with single-voxel MRS for accurate quantification and with a diagnostic MRI within a total examination time of less than one hour.

Progression of left ventricular hypertrophy does not change the sarcoplasmic reticulum calcium store in the spontaneously hypertensive rat heart

The spontaneously hypertensive rat (SHR) is characterized by elevated blood pressure and the development of left ventricular hypertrophy. During compensatory hypertrophy in the SHR, (26 weeks) when baseline contractile function is normal or increased, the inotropic response to beta-adrenergic stimulation is impaired. We recently showed by electron probe microanalysis (EPMA) that the amount of Ca2+ stored in the sarcoplasmic reticulum (SR) following sympathetic stimulation is not decreased in the 26-week-old SHR heart. However, with disease progression, cardiac function declines further in the SHR and the response to beta-adrenergic stimulation is more impaired. To determine whether a decreased availability of SR Ca2+ is responsible for the severely depressed inotropic response in the older SHR, we used EPMA to measure directly the amount of Ca2+ stored in the SR following activation of the beta-adrenergic pathway in papillary muscles from 76-week-old SHR and Wistar-Kyoto (WKY) controls. In order to determine if there are other alterations in ion homeostasis, we also compared elemental content of A-band and mitochondria. Papillary muscles from 76-week-old SHR and WKY were stimulated by 10 microM isoproterenol and then rapidly frozen during relaxation. The elemental content of the junctional SR. A-band and mitochondria was measured by EPMA. We observed no significant difference in SR Ca2+ content between SHR and WKY. There was also no strain-dependent difference in mitochondrial or A-band Ca2+. Overall, these results indicate that the impaired response to beta-adrenergic stimulation in the SHR at 76 weeks is not due to altered availability of SR Ca2+.

The Nuclear Receptor Resource Project

We have expanded the original Glucocorticoid Receptor Resource (GRR) database to include several individual resources as part of a larger project called the Nuclear Receptor Resource (NRR). In addition to the GRR, the NRR currently features the Thyroid Hormone Receptor Resource, the Androgen Receptor Resource, the Mineralocorticoid Receptor Resource, the Vitamin D Receptor Resource, and the Steroid Receptor Associated Proteins Resource. The goal of the NRR project is to provide a comprehensive resource for information on the nuclear receptor superfamily, and to provide a forum for the dissemination and discussion of both published and unpublished material on these proteins. Although the individual resources are managed from different servers, all the files are integrated and can be accessed through the project's Home Page, housed at http://nrr. georgetown.edu/nrr.html. In the near future, we hope to expand the project to contain information on other nuclear receptors and to better our electronic publication system. To accomplish this, we encourage the involvement of nuclear receptor investigators in the NRR.

Nonclassical adrenal hyperplasia due to 21-hydroxylase-deficiency: does genotyping predict the clinical manifestation?

8 patients of 7 families with nonclassical adrenal hyperplasia (NCAH) were analysed for defects of the 21-hydroxylase-B-gene. As the defects were small or rare, complete molecular genetic diagnostic up to sequencing of this gene was necessary to detect the genotype, which then was associated with the phenotype. However, mutations in 4 alleles from 3 families are still undetectable. Thus, correct prenatal diagnosis in NCAH-families without index patient remains difficult.

Activity-dependent ultra-slow inactivation of calcium currents in rat anterior pituitary cells

1. The inactivation of high-voltage-activated (HVA) calcium currents during long depolarizations in holding potential (Vh) was studied with the use of whole cell patch-clamp recording from rat anterior pituitary cells. 2. An ultra-slow inactivation in the amplitude of HVA calcium currents, with an average slow time constant of 149.3 s for peak currents and 159.1 s for sustained currents (n = 9), was unveiled during 5-min step depolarizations in Vh. 3. The ultra-slow inactivation of HVA calcium currents was found to be generated by at least two processes: a voltage-dependent inactivation that increases with increasing depolarization in Vh and an activity-dependent inactivation that is initiated, but not increased, with increasing depolarization in Vh. The relative contribution of the activity-dependent component to the ultra-slow inactivation was 80% when Vh was stepped from -80 to -60 mV and only 40% when Vh was stepped from -80 to -40 mV. 4. The activity-dependent inactivation of the HVA currents was not altered significantly in experiments in which barium replaced calcium as charge carrier and 1,2-bis (1-aminophenoxy) ethane N,N,N' N'-tetraacetic acid (BAPTA) was used as an intracellular calcium buffer instead of the less potent ethylenglycol-bis-(beta-aminoethylether) N,N,N' N'-tetraacetic acid (EGTA). In addition, activity-dependent inactivation was observed with sodium as the charge carrier through the calcium channels. 5. The activity-dependent inactivation depends on divalent cation influx. The activity-dependent inactivation was abolished when the test potentials, during the depolarization in Vh, were increased from 0 to +70 mV (close to the reversal potential for calcium currents under our experimental conditions). This reduction in driving force for calcium currents eliminated divalent cation influx and abolished the activity-dependent inactivation. 6. The activity-dependent inactivation lacks several characteristic features for calcium-dependent inactivation, such as dependence on charge carrier (see above), dependence on the size of the calcium current, and increase in decay rate of the calcium current during the test pulse. These latter notions were also supported by our paired pulse experiments, in which the calcium current elicited by a constant test pulse was virtually unaffected (7%) by conditioning pulses that produced maximal calcium currents. We therefore conclude that the dependence of activity-dependent inactivation on divalent cation influx cannot be attributed to the known form of calcium-dependent inactivation. 7. In conclusion, this study shows that calcium influx through HVA channels in anterior pituitary cells can be regulated by subthreshold changes in membrane potential and that the extent of this regulation depends on low-frequency activation of HVA calcium channels during the depolarization in membrane potential. Thus the pituitary cell may regulate hormone secretion by changes in membrane potential and in a use-dependent manner via regulation of calcium influx.

[Intramural hematoma of the thoracic aorta: diagnostic imaging and differential diagnosis]

PURPOSE

Aortic wall thickening due to intramural hemorrhage may be the only sign of aortic dissection. The aim of this study was to evaluate the incidence, imaging features and differential diagnoses of intramural hemorrhage (IMH) of the thoracic aorta.

METHODS

98 patients with clinically suspected aortic dissection were investigated via Spiral-CT and MRT. Diagnosis of IMH based on the presence of smooth crescentic or concentric wall thickening over a longer segment of the thoracic aorta without flow visualization and without compression or distortion of the aortic lumen.

RESULTS

69 patients had classic aortic dissections and 7 patients were diagnosed to have IMH of thoracic aorta. One patient with IMH of the ascending aorta died of aortic rupture and subsequent pericardial tamponade 12 hours after onset of symptoms. In one patient with IMH of the descending aorta on initial examination, there was a progression of overt aortic dissection at follow-up after three weeks. In two patients with IMH of the descending aorta, wall thickening decreased in size at follow-up (10-15 weeks), whereas in one patient it remained unchanged.

CONCLUSION

IMH of the aorta should be considered a precursor of aortic dissection. At follow-up IMH may decrease in size, rupture or progress to overt aortic dissection.

[Standardization and acceleration of quantitative analysis of dynamic MR mammographies via parametric images and automatized ROI definition]

PURPOSE

To evaluate quantitative analysis of dynamic breast MRI studies using a dedicated PC based diagnosis system (DS) providing parametric images and automatic ROI definition as compared to the standard subtraction image, manual-ROI based procedure.

METHODS

We compared the diagnostic usefulness of parametric versus subtraction images in terms of visualisation of enhancement inhomogeneities and enhancement velocities. Quantitative analysis of enhancing lesions of 15 breast MRI studies was performed using both the DS and the system's console software (SC). We assessed the time needed for complete quantitative analysis and number of lesions evaluated. This was followed by assessment of within-reader and between-reader variability or within-case reproducibility of results of quantitative analysis.

RESULTS

Parametric images are superior to subtraction images in visualizing enhancement inhomogeneities or ring enhancement in breast cancers. Mean time needed for analysis at DS and SC was 4 (3-5) min. and 23 (8-39) min., respectively. During this time period, significantly more lesions were evaluated per case using the DS as compared to the SC (2-14 vs. 1-6). Mean within-reader variability of enhancement velocities of the same lesions was 0% and 25% (DS and SC); between-reader variability of enhancement values obtained in the same lesions was 11% (DS) versus 41% (SC).

CONCLUSION

The DS significantly cuts down the time needed for quantitative analysis. It significantly improves reproducibility of quantitative enhancement values due to standardization of ROI analysis.

[A new application of MR tomography of the lung using ultra-short turbo spin echo sequences]

PURPOSE

Development of an improved MR sequence for examining the lung.

METHOD

T2 weighted ultra-short turbo spin echo sequences were used in five individuals with variations in echo times, delayed triggering and echo intervals. To reduce movement artifacts all examinations were carried out with ECG and respiratory triggering. The sequences giving optimal image quality were then employed in 19 patients having various pulmonary abnormalities. Image resolutions, artifacts, image contrasts and diagnostic value were then judged by two observers and compared with CT.

RESULTS

In the first study, a diastole-triggered UTSE sequence with the shortest echo proved optimal (TE = 90 ms, TR = 2-4 s, echo = 9 ms, turbo factor = 19). In the patient series studied, MRT was inferior to CT with regard to resolution and number of artifacts, but better in respect of contrast and diagnostic value.

CONCLUSION

Using UTSE of the lung, MRT can produce images of good quality. Compared with CT, contrast is better with MRT, offering diagnostic advantages for MRT.

Aortic dissection: a comparative study of diagnosis with spiral CT, multiplanar transesophageal echocardiography, and MR imaging

PURPOSE

To compare the usefulness of spiral computed tomography (CT), multiplanar transesophageal echocardiography (TEE), and magnetic resonance (MR) imaging in the diagnosis of thoracic aortic dissection and arch vessel involvement.

MATERIALS AND METHODS

Forty-nine symptomatic patients with clinically suspected aortic dissection were examined with contrast material-enhanced spiral CT, multiplanar TEE, and 0.5-T MR imaging (T1-weighted, cardiac-gated, spin-echo sequences). Imaging results were confirmed at autopsy (five patients), intraoperative exploration (23 patients), angiography (nine patients), and follow-up (12 patients).

RESULTS

Sensitivity in the detection of thoracic aortic dissection was 100% for all techniques. Specificity was 100%, 94%, and 94% for spiral CT, multiplanar TEE, and MR imaging, respectively. In the assessment of aortic arch vessel involvement, sensitivity was 93%, 60%, and 67%, respectively, and specificity was 97%, 85%, and 88%, respectively.

CONCLUSION

Spinal CT and multiplanar TEE are as valuable as MR imaging in the detection of thoracic aortic dissection. In the assessment of the supraaortic branches, spiral CT is superior (P<.05).

Strong association of dermatomyositis-specific Mi-2 autoantibodies with a tryptophan at position 9 of the HLA-DR beta chain

OBJECTIVE

To characterize the clinical and immunogenetic features of patients with Mi-2 autoantibodies.

METHODS

Eighteen adult white patients with Mi-2 antibodies were clinically characterized and compared with 41 Mi-2-negative dermatomyositis (DM) patients. HLA class I and class II typing for DRB alleles was done by microcytotoxicity assay and for DQA and DQB alleles by polymerase chain reaction-based oligotyping.

RESULTS

Seventeen of the 18 Mi-2-positive patients had DM. Symptoms of scleroderma, lung involvement, and arthritis were less common in this group than in the Mi-2-negative DM patients; the V-sign rash and nailfold involvement were found more frequently. Mi-2 antibodies were strongly associated with HLA-DR7 (88% versus 24% in healthy controls), HLA-DQA1*0201 (86% versus 23%), and DR7 "homozygosity" (31% versus 0%). A tryptophan residue at position 9 of the HLA-DR beta chain was present in all Mi-2-positive patients (100% versus 62%; homozygous in 81% versus 15%).

CONCLUSION

Our results reemphasize the specificity of Mi-2 antibodies for DM, and extend previous reports that Mi-2 antibody production is associated with certain HLA class II antigens. We propose beta 9-Trp as a candidate epitope on the HLA-DR beta chain as a prerequisite for this type of autoimmune response.

Pharmacokinetic profile of cyclosporine A after conversion to Sandimmun Optoral: influence on ambulatory blood pressure in renal transplant patients

The aim of the present study was to investigate whether the pharmacokinetic profile of cyclosporin A under Sandimmun Optoral compared to Sandimmun has an effect on blood pressure in patients with stable renal allograft function. Twenty-eight patients were randomized into two groups. Two pharmacokinetic profiles (I, II; time interval 7 days) were obtained in each group. One group (n = 18) was switched from Sandimmun to an equal dose (1:1) of Sandimmun Optoral after the first kinetic and the other (n = 10) received Sandimmun for both kinetics. Eight blood samples were taken during each kinetic and cyclosporine values were measured. Ambulatory blood pressure measurement was performed during each kinetic. There were no differences in the pharmacokinetic parameters between kinetics I and II in the control group but significant differences in the switched group with increased Cmax (+64%), AUC (+44%), C0 (+17%) and decreased Tmax (-39%) in kinetic II compared to kinetic I. Correlation of C0 with AUC was stronger for Sandimmun Optoral (r = 0.792) than for Sandimmun (r = 0.718). Correlation of C0 with Cmax was similar for Sandimmun Optoral (r = 0.53) and Sandimmun (r = 0.56). Mean 12 h blood pressure of kinetic II tended to be lower than that of kinetic I in the control group, but the opposite was true for the switched group. When blood pressure levels around Tmax +/- 1 h were analyzed only, RR (syst/diast) in mmHg was 135 +/- 3.7/89 +/- 2.2 (kinetic I) and 130 +/- 2.8/85 +/- 2.8 (kinetic II) for control as compared to 134 +/- 2.4/85 +/- 2.9 and 137 +/- 3.1/86 +/- 2.8 for the switched group, respectively. Sandimmun Optoral shows an improved pharmacokinetic profile. However, higher blood concentrations of cyclosporine under Sandimmun Optoral tend to increase slightly systemic blood pressure as compared to that under Sandimmun.

[Endovascular balloon occlusion test of the internal carotid artery with increased hemodynamic monitoring for determination of circulatory reserve before planned carotid occlusion]

PURPOSE

To evaluate stroke risk assessment of balloon test occlusion of the internal carotid artery (ICA) with enlarged haemodynamic monitoring prior to permanent ICA occlusion.

MATERIAL AND METHODS

24 patients with cervical metastasis (n = 18), cavernous meningiomas (n = 3) or inoperable cavernous aneurysms (n = 3) were examined. The test occlusion was monitored by EEG, neurological examinations and transcranial Doppler sonography of the ipsilateral middle cerebral artery with evaluation of the cerebrovascular reserve capacity. Additionally 99mTc-HMPAO-SPECT imaging was added showing the perfusion during test occlusion.

RESULTS

In one (4%) patient the test occlusion had to be interrupted previously due to an acute neurological deficit. This patient and two (8%) patients with highly pathological test results in SPECT and TCD were excluded from permanent carotid occlusion. In 6 (25%) patients quantitative TCD monitoring could improve the stroke risk assessment by differentiating the patients in a low and high risk group. 6 (25%) patients were definitely occluded without haemodynamic complications, but two patients suffered from embolic infarctions which cannot be predicted by this procedure.

CONCLUSIONS

The multimodal balloon test occlusion with enlarged haemodynamic monitoring allows haemodynamic stroke risk assessment prior to permanent occlusion of the ICA.

18F-fluorodeoxyglucose-PET and 99mTc-bicisate-SPECT in Creutzfeldt-Jakob disease

In a patient with the occipitoparietal form of Creutzfeldt-Jakob disease (CJD) (Heidenhain type) positron emission tomography (PET) demonstrated decreased glucose utilization in the occipital lobes and adjacent cortical regions. Single photon emission computed tomography (SPECT) with 99mTc-bicisate showed a "coupled" decrease in blood flow in identical cortical areas in this patient. In contrast, magnetic resonance imaging (MRI) was normal. In the early stage of CJD, when still no major morphological abnormalities can be observed, functional imaging is useful for differential diagnosis, particularly to exclude other causes of dementia or pathological EEG patterns.

[Value of Turbo-FLAIR sequence in the diagnosis of brain diseases at 0.5 tesla]

PURPOSE

Aim of the study was to evaluate FLAIR combined with Turbo-Spin-Echo (Turbo-FLAIR) at 0.5 tesla in comparison to conventional T1- and T2-weighted spin-echo images (SE) in MRI of the brain.

MATERIAL AND METHODS

A Turbo-FLAIR sequence was optimised for 0.5 Tesla (Philips Gyroscan T5-II) that provided seventeen 5 mm sections in 4:21 minutes (TR = 6075 ms, T1 = 1600 ms, TE = 120 ms and a turbofactor = 17). Images were compared with T1- (TR = 500 ms, TE = 15 ms) proton density and T2-weighted spin-echo (TR = 2500 ms, TE = 20/90 ms) studies in 10 healthy volunteers and 30 patients with various brain pathologies.

RESULTS

Turbo-FLAIR could effectively eliminate the CSF signal in all studies except ventricular areas with CSF inflow. Contrast-to-noise ratios (C/N) for the contrast between lesions and CSF was superior in Turbo-FLAIR. C/N between lesions and grey matter was significantly higher in Turbo-FLAIR than in proton density (PD)-weighted SE. C/N between lesions and white matter was equal to PD-weighted SE but significantly smaller than on T2-weighted SE. Visual analysis showed greater lesions conspicuity with Turbo-FLAIR and a higher frequency of detection of cortical and subcortical lesions.

CONCLUSIONS

Turbo-FLAIR is a reliable and practical technique on 0.5 Tesla, that is more sensitive than SE sequences especially for the detection of cortical, subcortical lesions and lesions surrounded by CSF.