Fluid-attenuated inversion recovery FLAIR imaging

Another method to optimize image contrast includes the addition of an inversion recovery pulse before the typical SE sequence to suppress signal from cerebrospinal fluid (CSF). This yields so-called fluid-attenuated inversion recovery (FLAIR)-or CSF-suppressed DWI images or ADC maps. With this approach, the partial-volume effect of cerebrospinal fluid can be substantially reduced, which is particularly relevant in cortical regions due to the frequent CSF contribution to individual voxels (Latour and Warach 2002). The technique may enhance lesion conspicuity in the vicinity of CSF and has been shown to be of value in research studies utilizing pixel-wise analyses to predict tissue fate. The technique is not yet implemented in many centers, although this may change in the near future. 

Fig. 9.2. Fluid-attenuated inversion recovery (FLAIR, upper row) and T2-weighted (lower row) magnetic resonance images demonstrating early small focal lesions of leukoaraiosis...

Figure 18.1. MRI signal abnormalities in the brain and spinal cord in a 55-year-old woman with multiple sclerosis. (A) FLAIR (Fluid attenuated inversion recovery) image of axial brain image at the level of the lateral ventricles. Arrows point to hyperintense periventricular lesions demonstrating a characteristics MS demyelination pattern (B) T2W image of sagittal view of the spinal cord of the same individual, demonstrating focal bright signal (arrow) representing demyelination in the cervical spinal cord.

Fig. 9.5 Magnetic resonance imaging of the brain T2-weighted images using FLAIR (fluid attenuated inversion recovery) and FSE (fast spin echo) reveal enhanced signal intensity representing white matter abnormalities...

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