Comparison of T2-weighted fast spin-echo and spin-echo MR sequences in the detection of brain lesions of multiple sclerosis

We compared T2-weighted fast spin-echo (FSE) magnetic resonance (MR) imaging and conventional spin-echo (CSE) T2-weighted imaging in the detection of brain lesions of multiple sclerosis (MS). 20 patients with clinically definite MS underwent brain imaging with both FSE and CSE T2-weighted imaging. There was no significant difference in total number of lesions detected on FSE vs CSE (1354 vs 1378). Slightly more periventricular and subcortical lesions were detected using CSE than FSE, whereas more posterior cranial fossa lesions were detected by FSE. There was no statistically significant difference in the signal intensity (SI) ratio of MS lesions to that of surrounding normal white matter on FSE vs CSE, however the SI ratio of MS lesions was lower on FSE T2-weighted images (FSE = 1.87 +/- 0.39 vs CSE = 2.09 +/- 0.36). Considerable time savings can accrue when substituting FSE for CSE sequences in T2-weighted imaging, and this Is a compelling reason to employ such sequence in clinical practice. Our results suggest that although CSE sequences are required to confirm the diagnosis of brain involvement of MS lesions, T2-weighted FSE sequences can replace CSE sequences in long term monitoring especially when patient's movements preclude useful investigation and when optional scanning planes are required.