• S Bastianello, A Bozzao, A Paolillo, E Giugni, C Gasperini, T Koudriavtseva, E Millefiorini, M A Horsfield, C Colonnese, D Toni, M Fiorelli, C Pozzilli, and L Bozzao.
• Neuroradiological Section, University of Rome La Sapienza, Italy.
• AJNR Am J Neuroradiol. 1997 Apr 1; 18 (4): 699-704.

PurposeTo compare fast spin-echo (FSE) and fast fluid-attenuated inversion recovery (FLAIR) sequences with conventional spin-echo (CSE) MR imaging in the quantification of the number and volume of multiple sclerosis lesions.MethodsIn 30 patients with relapsing-remitting multiple sclerosis, we calculated the total number and volume of lesions detected with each of the three sequences using a semiautomated program.ResultsOn CSE sequences, we calculated a total of 2,583 lesions with a global volume of 836.3 cm3. With FSE sequences, we observed a 16% relative reduction in the number of lesions detected and a 25% relative reduction in global volume as compared with CSE. With fast FLAIR sequences, we detected a significantly lower number and volume of infratentorial lesions, whereas at the cortical/subcortical level the lesions were both more numerous and bulkier than on CSE sequences. Finally, we observed a higher lesion/white matter contrast, a significant reduction in time required for the quantification of lesion load, and a very low interobserver variability in favor of fast FLAIR sequences.ConclusionDespite its limitations in the detection of infratentorial lesions, the fast FLAIR sequence in conjunction with a semiautomated quantification program provides a reliable means to evaluate the total lesion burden in patients with MS.

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