SU-E-I-67: Arachnoid Cysts: The Role of the BLADE Technique

Abstract

Purpose: The purpose of this study is first to show the extent by which BLADE sequences can reduce all the image artifacts and second to verify that the usefulness of this technique in certain pathological conditions is significant. Methods: In this study, fourteen consecutive patients (5 females, 9 males), who routinely underwent MRI brain examination, between 2010–2014, were selected. The applied routine protocols for brain MR examination included the following sequences: 1) T2‐W FLAIR axial; 2) T2‐W TSE axial; 3) T2*‐W axial, 4) T1‐W TSE sagittal; 5) DWI‐W axial; 6) T1‐W TSE axial; 7) T1‐W TSE axial+contrast. In cases of cystic tumors, the T2‐W FLAIR BLADE sequence was added to the protocol. All the images were evaluated independently at two separate settings with 3 weeks interval by two radiologists. The radiologists also evaluated the presence of image artifacts (motion, flow, chemical shift, Gibbs ringing). To evaluate the size of the cyst, the two radiologists compared the two techniques (conventional and BLADE) by assessing the extent of the divergence in the measurements of the cysts. Results: Regarding the extent of the cyst size, BLADE measurements were found to be more reliable than the conventional ones with the differences being statistically significant (p<0.01). The qualitative measurements indicated that the T2 FLAIR BLADE sequences were superior to the conventional T2 FLAIR with statistically significant differences (p<0.001) in the following characteristics: 1) overall image quality, 2) CSF nulling; 3) contrast at the pathology and its surrounding; 4) limits of the pathology; 5) motion artifacts; 6) flow artifacts; 7) chemical shift artifacts and 8) Gibbs ringing artifacts. Conclusion: BLADE sequence was found to decrease both flow artifacts in the temporal lobes and motion artifacts from the orbits and it is proposed for clinical use.

Predictors for complete surgical resection of posterior fossa neurenteric cysts: A case report and meta-analysis

“…[ 13 ] Epidermoid and dermoid cysts are most difficult to differentiate from NCs as they also are commonly situated at the midline, rarely show enhancement from gadolinium, and are usually hypodense on CT. However, epidermoid and dermoid cysts commonly encase neurovascular structures[ 15 , 16 ] whereas NCs are more likely to compress the adjacent structures. Greater restriction on DWI is also observed when compared to NCs.…”