Comparison of spin echo T 1-weighted and FLASH 90° gadolinium-enhanced magnetic resonance imaging in the detection of cerebral metastases

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Abstract
A direct comparison of post-gadolinum FLASH 90.degree. magnetic resonance (MR) images against conventional post-gadolinium T1-weighed spin echo MR images obtained in patients with suspected cerebral metastatic disease shows the FLASH sequence to be inferior. False negative FLASH 90.degree. gadolinium-enhanced mR images are a result of either difficulty in intepreting the high signal seen in small vessels or, again, magnetic susceptibility effects. In addition, our study shows small abnormalities suggestive of cerebral metases on the FLASH 90.degree. gadolinium-enhanced sequences which were not seen on the spin echo T1-weighed gadolinium-enhanced sequences. We believe that spin echo T1-weighted godolinium-enhanced MR sequences demonstrated 131 out of 139 (94.2%) and FLASH 90.degree. gadolinium-enhanced MR sequences detected 122 out of 139 (87.8%) possible metastases. From this we conclude that spin echo T1-weighted gadolinium-enhanced MR sequences is a better test than FLASH 90.degree. gadolinium-enhanced MR in the diagnosis of brain metastases and that either sequence alone is limited as a screening test.