A prospective comparison study of fast T1 weighted fluid attenuation inversion recovery and T1 weighted turbo spin echo sequence at 3 T in degenerative disease of the cervical spine.

OBJECTIVE: This study compared T1 fluid attenuation inversion recovery (FLAIR) and T1 turbo spin echo (TSE) sequences for evaluation of cervical spine degenerative disease at 3 T.
METHODS: 72 patients (44 males and 28 females; mean age of 39 years; age range, 27-75 years) with suspected cervical spine degenerative disease were prospectively evaluated. Sagittal images of the spine were obtained using T1 FLAIR and T1 TSE sequences. Two experienced neuroradiologists compared the sequences qualitatively and quantitatively.
RESULTS: On qualitative evaluation, cerebrospinal fluid (CSF) nulling and contrast at cord-CSF, disc-CSF and disc-cord interfaces were significantly higher on fast T1 FLAIR images than on T1 TSE images (p < 0.001). No significant difference was seen between the sequences in evaluation of neural foramina and bone-disc interface. On quantitative evaluation, the signal-to-noise ratios of cord and CSF on fast T1 FLAIR images were significantly higher than those on T1 TSE images (p < 0.05). Contrast-to-noise ratios (CNRs) of cord to CSF on T1 FLAIR images were significantly higher than those of T1 TSE images (p < 0.05). CNRs of bone to disc for T1 weighted TSE images were significantly higher than those of T1 FLAIR images (p < 0.05).
CONCLUSION: At 3 T, T1 FLAIR imaging is superior to T1 TSE for evaluating cervical spine degenerative disease, owing to higher cord-CSF, disc-cord and disc-CSF contrast. However, intrinsic cord contrast is low on T1 FLAIR images. ADVANCES IN KNOWLEDGE: T1 FLAIR is more promising and sensitive than T1 TSE for evaluation of degenerative spondyloarthropathy and may provide a foundation for development of MR protocols for early detection of degenerative and neoplastic diseases.