Improved Lesion Conspicuity with Contrast-Enhanced 3D T1 TSE Black-Blood Imaging in Cranial Neuritis: A Comparative Study of Contrast-Enhanced 3D T1 TSE, 3D T1 Fast-Spoiled Gradient Echo, and 3D T2 FLAIR
Tae Wook Baek, Yeonah Kang, Ho‐Joon Lee
Abstract
<h3>BACKGROUND AND PURPOSE:</h3> Contrast-enhanced 3D-turbo spin-echo (TSE) black-blood sequence has gained attention, as it suppresses signals from vessels and provides an increased contrast-noise ratio. The purpose was to investigate which among the contrast-enhanced 3D T1 TSE, 3D T1 fast-spoiled gradient echo (FSPGR), and 3D T2 FLAIR sequences can better detect cranial nerve contrast enhancement. <h3>MATERIALS AND METHODS:</h3> Patients with cranial neuritis based on clinical findings (<i>n</i> = 20) and control participants (<i>n</i> = 20) were retrospectively included in this study. All patients underwent 3T MR imaging with contrast-enhanced 3D T1 TSE, 3D T1 FSPGR, and 3D T2 FLAIR. Experienced and inexperienced reviewers independently evaluated the 3 sequences to compare their diagnostic performance and time required to reach the diagnosis. Additionally, tube phantoms containing varying concentrations of gadobutrol solution were scanned using the 3 sequences. <h3>RESULTS:</h3> For the inexperienced reader, the 3D T1 TSE sequence showed significantly higher sensitivity (80% versus 50%, <i>P</i> = .049; 80% versus 55%; <i>P</i> = .040), specificity (100% versus 65%, <i>P</i> = .004; 100% versus 60%; <i>P</i> = .001), and accuracy (90% versus 57.5%, <i>P</i> = .001; 90% versus 57.5%, <i>P</i> = .001) than the 3D T1 FSPGR and 3D T2 FLAIR sequences in patients with cranial neuritis. For the experienced reader, the 3D T1-based sequences showed significantly higher sensitivity than the 3D T2 FLAIR sequence (85% versus 30%, <i>P</i> < .001; 3D T1 TSE versus 3D T2 FLAIR, 85% versus 30%, <i>P</i> < .001; 3D T1 FSPGR versus 3D T2 FLAIR). For both readers, the 3D T1 TSE sequence showed the highest area under the curve (inexperienced reader; 0.91, experienced reader; 0.87), and time to diagnosis was significantly shorter with 3D T1 TSE than with 3D T1 FSPGR. <h3>CONCLUSIONS:</h3> The 3D T1 TSE sequence may be clinically useful in evaluating abnormal cranial nerve enhancement, especially for inexperienced readers.