Rofo 2015; 187(2): 102-108
DOI: 10.1055/s-0034-1385179
Neuroradiology
© Georg Thieme Verlag KG Stuttgart · New York

BLADE Sequences in Transverse T2-weighted MR Imaging of the Cervical Spine. Cut-off for Artefacts?

BLADE-Sequenzen zur transversalen T2-gewichteten MRT der HWS. Ende aller Artefakte?
T. Finkenzeller
1   Institute of Radiology and Neuroradiology, Hospital Nuremberg Sued, Nuremberg
,
C. M. Wendl
2   Institute of Radiology, University Hospital Regensburg
,
S. Lenhart
3   Radiology and Neuroradiology, Klinikum Weiden
,
C. Stroszczynski
2   Institute of Radiology, University Hospital Regensburg
,
G. Schuierer
4   Institute of Neuroradiology, Center of Neuroradiology, Regensburg
,
C. Fellner
2   Institute of Radiology, University Hospital Regensburg
› Author Affiliations
Further Information

Publication History

20 January 2014

12 August 2014

Publication Date:
22 September 2014 (online)

Abstract

Purpose: The BLADE (PROPELLER) technique reduces artefacts in imaging of the cervical spine in sagittal orientation, but till now failed to do so in axial orientation, because here it increased through plane CSF-flow artefacts, which spoiled the benefit of BLADE artefact reduction “in plane”. The aim of this study was to compare a BLADE sequence with optimised measurement parameters in axial orientation to T2-TSE.

Materials and Methods: Both sequences were compared in 58 patients with 31 discal, 16 bony and 11 spinal cord lesions. Image sharpness, reliability of spinal cord depiction, CSF flow artefacts and lesion detection were evaluated by 3 independent observers. Additionally the observers were asked which sequence they would prefer for diagnostic workup. Statistical evaluations were performed using sign and χ2 test.

Results: BLADE was significantly superior concerning image sharpness, spinal cord depiction and overall lesion detection. BLADE was rated better for most pathologies, for bony lesions the differences compared with TSE were statistically significant. Regarding CSF-flow artefacts both sequences showed no difference. All readers preferred BLADE in side by side reading.

Conclusion: An optimised axial T2 BLADE sequence decreases the problems of increased through plane CSF-flow artefacts in this orientation. By reducing various other artefacts it yields better image quality and has the potential to reduce the number of non-diagnostic examinations especially in uncooperative patients.

Key points:

• T2 BLADE/PROPELLER sequences proofed to reduce artefacts in sagittal spine imaging

• BLADE/PROPELLER improve image quality, but can aggravate CSF flow artefacts in axial orientation

• optimised parameter setting for axial T2 BLADE reduces “through-plane” CSF artefacts aggravation

• optimised axial T2 BLADE reduces non-diagnostic examinations especially in uncooperative patients

Citation Format:

• Finkenzeller T, Wendl CM, Lenhart S et al. BLADE Sequences in Transverse T2-weighted MR Imaging of the Cervical Spine. Cut-off for Artefacts?. Fortschr Röntgenstr 2015; 187: 102 – 108

Zusammenfassung

Ziel: BLADE (PROPELLER) Sequenzen reduzieren Artefakte in der sagittalen Bildgebung der Halswirbelsäule. Diese konnten aber nur eingeschränkt in die axiale Schichtrichtung übertragen werden, da hier bisher vermehrte through plane Artefakte des Liquors den BLADE-Benefit wieder aufgehoben haben. Ziel dieser Studie war es, eine axiale T2-BLADE-Sequenz mit optimierten Untersuchungsparametern mit einer T2-TSE zu vergleichen.

Material und Methoden: Beide Sequenzen wurden bei 58 Patienten mit 31 Bandscheibenschäden, 16 knöchernen und 11 Myelon-Läsionen verglichen. Bildschärfe, Myelonbeurteilbarkeit, Liquorflussartefakte und Läsionserkennbarkeit wurden von 3 unabhängigen Auswertern beurteilt. Zusätzlich wurden die Untersucher gefragt, welche der Sequenzen sie für eine klinisch diagnostische Auswertung bevorzugen würden. Die statistische Auswertung erfolgte mittels Vorzeichen- und χ2- Test.

Ergebnisse: BLADE zeigte signifikant bessere Bildschärfe, Myelonbeurteilbarkeit und allgemeine Läsionserkennbarkeit. BLADE wurde für fast alle Läsionen als besser gewertet, für knöcherne Läsionen war der Unterschied im Vergleich zur T2-TSE signifikant. Im Bezug auf Liquorpulsationsartefakte zeigte sich kein statistischer Unterschied der Sequenzen. Im direkten Vergleich bevorzugten alle Auswerter die BLADE-Sequenz.

Schlussfolgerung: Eine axiale T2-BLADE-Sequenz mit optimierten Untersuchungsparametern vermindert das Problem der through-plane Artefakte des Liquors in dieser Orientierung. Sie bietet durch die Reduktion der übrigen Artefakte eine bessere Bildqualität und hat somit das Potential, besonders bei unkooperativen Patienten, die Anzahl nicht auswertbarer Untersuchungen zu minimieren.

Kernaussagen:

• T2-BLADE/PROPELLER-Sequenzen reduzieren Artefakte in sagittaler Orientierung an der Wirbelsäule

• BLADE/PROPELLER verbessern die Bildqualität, können aber Liquorflussartefakte in axialer Orientierung verstärken

• Optimierte Sequenzparameter für axiale T2-BLADE reduzieren erhöhte “through-plane” Artefakte des Liquors

• Optimierte axiale T2-BLADE vermindern nicht-diagnostische Untersuchungen vor allem bei unkooperativen Patienten

 
  • References

  • 1 Meindl T, Wirth S, Weckebach S et al. Magnetic resonance imaging of the cervical spine: comparison of 2D T2-weighted turbo spin echo, 2D T2*weighted gradient-recalled echo and 3D T2-weighted variable flip-angle turbo spin echo sequences. Eur Radiol 2009; 19: 713-721
  • 2 Melhem ER. Technical challenges in MR imaging of the cervical spine and cord. Magn Reson Imaging Clin N Am 2000; 8: 435-452
  • 3 Noebauer-Huhmann IM, Glaser C, Dietrich O et al. MR imaging of the cervical spine: assessment of image quality with parallel imaging compared to non-accelerated MR measurements. Eur Radiol 2007; 17 (05) 1147-1155
  • 4 Pipe JG. Motion correction with PROPELLER MRI: application to head motion and free-breathing cardiac imaging. Magn Reson Med 1999; 42: 963-969
  • 5 Hirokawa Y, Isoda H, Maetani YS et al. MRI artifact reduction and quality improvement in the upper abdomen with PROPELLER and prospective acquisition correction (PACE) technique. Am J Roentgenol 2008; 191: 1154-1158
  • 6 Wintersperger BJ, Runge VM, Biswas J et al. Brain magnetic resonance imaging at 3 tesla using BLADE compared with standard rectilinear data sampling. Invest Radiol 2006; 41: 586-592
  • 7 Forbes KP, Pipe JG, Karis JP et al. E Brain imaging in the unsedated pediatric patient: Comparison of periodically rotated overlapping parallel lines with enhanced reconstruction with single shot fast spin-echo sequences. AJNR Am J Neuroradiol 2003; 24: 794-798
  • 8 Heyer CM, Lemburg SP, Sterl S et al. Dispensing with Sedation in Pediatric MR Imaging of the Brain: What is Feasible?. Fortschr Röntgenstr 2012; 184: 1034-1042
  • 9 Lavdas E, Mavroidis P, Kostopoulos S et al. Elimination of motion, pulsatile flow and cross-talk artifacts using blade sequences in lumbar spine MR imaging. Magn Reson Imaging 2013; 31: 882-890
  • 10 Fellner C, Menzel C, Fellner FA et al. BLADE in sagittal T2-weighted MR imaging of the cervical spine. Am J Neuroradiol 2010; 31: 674-681
  • 11 Finkenzeller T, Zorger N, Kühnel T et al. Novel application of T1-weighted BLADE sequences with fat suppression compared to TSE in contrast enhanced T1-weighted imaging of the neck: cutting-edge images?. Magn Reson Imaging 2013; 37: 660-668
  • 12 Ragoschke-Schumm A, Schmidt P, Schumm J et al. Decreased CSF-flow artifacts in T2 imaging of the cervical spine with periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER/BLADE). Neuroradiology 2011; 53: 13-18
  • 13 Lavdas E, Mavroidis P, Kostopoulos S et al. Improvement of image quality using BLADE sequences in brain MR imaging. Magn Reson Imaging 2013; 31: 189-200
  • 14 Phalke VV, Gujar S, Quint DJ. Comparison of 3.0 T versus 1.5 T MR: imaging of the spine. Neuroimaging Clin N Am 2006; 16: 241-248
  • 15 Lisanti C, Carlin C, Banks K et al. Normal MRI Appearance and Motion-Related Phenomena of CSF. Am J Roentgenol 2007; 188: 716-725
  • 16 Baledent O, Henry-Feugeas MC, Idy-Peretti I. Cerebrospinal fluid dynamics and relation with blood flow: a magnetic resonance study with semi-automated cerebrospinal fluid segmentation. Invest Radiol 2001; 36: 368-377
  • 17 Vargas MI, Delavelle J, Kohler R et al. Brain and spine MRI artifacts at 3 Tesla. J of Neuroradiology 2007; 36: 74-81