A prospective comparison of brain contrast characteristics and lesion detection using single-shot fast spin-echo and fast spin-echo.

MRI is limited by movement artefact, even with current imagers, when examining a restless or claustrophobic patient. We prospectively analysed the images of 92 patients produced by a single-shot fast spin-echo (SSFSE) pulse sequence and compared them with conventional (FSE) and reduced-time fast spin-echo (RT-FSE) techniques, with regard to lesion detection and movement artefact in brain imaging. Images obtained in each case were independently reviewed and scored for overall diagnosis, number of lesions detected, and movement artefact. FSE showed 1217 lesions, RT-FSE 1137, and SSFSE 1044. This discrepancy arose mainly in patients with multiple sclerosis or small-vessel disease, since with SSFSE we were less able to separate small, adjacent low-contrast lesions than with FSE. Arbitrary movement scores were 36, 25 and zero respectively. There were, however, no clinically significant differences in overall diagnosis between the three techniques. SSFSE thus proved a reliable, fast, accurate method for obtaining T2-weighted images, and may be of particular use in the restless, claustrophobic or obtunded patient.