Comparison of inversion recovery fast spin-echo (FSE) with T2-weighted fat-saturated FSE and T1-weighted MR imaging in bone marrow lesion detection

Objective To prospectively compare inversion recovery (IR) fast spin-echo (FSE) with T1-weighted spin-echo (SE) and T2-weighted chemical-shift fat-saturated (FS) FSE magnetic resonance se quences in the detection of bone marrow abnormality. Design. Twenty-nine sets of T1-weighted SE [400-640/10-20 (TR/TE)], T2-weighted FS-FSE [2400-3800/91-112/8 (TR/TE/ETL)], and IR-FSE [3700-6000/12-14/170/8 (TWTE/T1/ETL)] images were acquired with a 1.5-T magnet in 27 patients with bone marrow lesions. The visibility, margination, and extent of 41 lesions, image quality, contrast, and artifacts were qualitatively and quantitatively compared. Results. The lesions were more conspicuous on the IR-FSE than on the T1-weighted SE and T2-weighed FS-FSE images. The extent of lesions was similar for all three sequences. Image quality was better and there were fewer motion artifacts on the T1-weighted images. The mean lesion contrast-to-noise ratio was significantly higher on the T1-weighted images (p<0.05). Conclusion. The IR-FSE sequence is highly sensitive for detecting bone marrow pathology, with scan time comparable to the T1-weighted SE and T2-weighted FS-FSE sequences.