Clinical utility of partial flip angle T2-weighted spin-echo imaging of the brain

Summary To assess the clinical usefulness of partial flip angle (PFA) spin-echo (SE) brain imaging, a total of eighty patients were examined with both conventional double echo T2-weighted SE (2500/30, 80/90^o/one excitation) and PFA double echo SE (1200/30, 70/45^o/two excitations) on 2.0T system. Two comparative studies were performed: (1) in 65 patients PFA SE technique was compared with conventional SE without flow compensating gradients, and (2) in 15 patients the former was compared with the latter with flow compensating gradients. Imaging time was nearly identical in each sequence. In both studies we found that PFA T2-weighted SE images were almost identical to those obtained with the conventional SE technique in the contrast characteristics and the detection rate of the abnormalities (100%, 85/85 lesions), and more importantly, PFA SE revealed few flow artifacts in the brain stem, temporal lobes and basal ganglia which were frequently seen on conventional SE without flow compensating gradients. Additionally, PFA SE images demonstrated no suppression of CSF flow void in the aqueduct which was commonly seen on conventional SE with flow compensating gradients. In overall image quality, the PFA SE images, particularly the second echo images, were almost comparable with those of conventional SE with flow compensating gradients. A flip angle of 45^o seems to be close to Ernst angle, the angle at which maximum signal occurs, for a given TR of 1200 msec for CSF and most of the abnormalities containing higher water content. In conclusion, PFA SE sequence (i. e. 1200/30, 70/45^o/2) appears to be useful as a primary or an adjunctive technique in certain clinical circumstances, particularly in imaging of hydrocephalic patients for assessing aqueductal patency.