Comparison of multi echo and contrast-enhanced MR scans: Image contrast and delineation of intracranial tumors

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Abstract
In 56 patients with intracranial tumor T2-weighted multi echo (ME) [TR: 1600 ms, TE: 30 to 240 ms (8 echoes)] and T1-weighted Gd-DTPA-enhanced images (TR: 400 ms, TE: 30 ms or 35 ms) were compared with respect to tumor contrast and tumor delineation. In subgroups of 20 and 14 patients, respectively, tumor/brain-and tumor/edemacontrast were assessed on both a subjective and a quantitative basis (contrast-to-noise ratio, CNR). CNR's for tumor/brain-contrast were significantly higher on Gd-DTPA enhanced images than on ME scans. No significant differences between techniques were found for CNR's of tumor/edema-contrast. ME images yielded pathological findings in 54 of the 56 patients but visually assessed tumor delineation was achieved in only 36 cases. Fifteen out of 25 intraaxial tumors and 5 out of 31 extraaxial tumors could not be sufficiently delineated on ME images. In contrast, Gd-DTPA-enhanced images provided differentiation of tumor and surrounding tissues in 55 of 56 studies. In conclusion, ME images have proved highly sensitive in detecting intracranial lesions. However, brain tumors, especially intraaxial tumors could often not be differentiated from adjacent tissues on ME images. After Gd-DTPA, T1-weighted images provided more reliable tumor detection and delineation.