Suspected multiple sclerosis: MR imaging with a thin-section fast FLAIR pulse sequence.

PURPOSE: To compare thin-section, sagittal, fast fluid-attenuated inversion-recovery (FLAIR) magnetic resonance (MR) imaging with conventional axial spin-echo (SE) imaging for early detection of multiple sclerosis (MS) in the brain.

MATERIALS AND METHODS: Conventional 5-mm axial proton-density- and T2-weighted SE images and sagittal 2-mm fast FLAIR images of the brain in five healthy volunteers and 25 patients with clinically suspected MS were evaluated and graded as normal or as showing possible or probable MS in a double-blind study.

RESULTS: Fast FLAIR was judged better than SE in 37% of cases, equal to SE in 63%, and never worse than SE. In 43% of patients considered to have normal SE images, fast FLAIR images showed abnormalities consistent with MS. A subependymal striated appearance observed in several cases is believed to represent early inflammation and/or demyelination around subependymal veins in MS.

CONCLUSION: Sagittal thin-section fast FLAIR is superior to conventional axial proton-density- and T2-weighted SE pulse sequences for detection of MS plaques in the brain.