| With effective nulling of the cerebrospinal fluid (CSF), Fluid-attenuated inversion-recovery (FLAIR) can eliminate disadvantageous influences of pulsation artifact and partial volume effects from CSF. In imaging lesions of surface of the spinal cord and subarachnoid space, FLAIR can avoid the influences of the high signal from CSF obtained with T2-weighted spin echo (SE) and improve conspicuity and detection of these lesions.T2-weighted FLAIR is widely applied to diagnose brain dieases, but it is rarely studied in intraspinal dieases, especially tumors. At present Turbo SE (TSE) and Turbo-FLAIR have widely been adopted, but the value of T2-weighted Turbo-FLAIR imaging of intraspinal tumors is less studied.PURPOSEUsing T2-weighted TSE as control and setting up some qualitative and quantitative criteria, we evaluate comprehensively the value of T2-weighted Turbo-FLAIR for imaging intraspinal tumors at the conspicuity, detection, diagnosis of tumors and image artifacteffects.MATERIALS AND METHODS48 patients with intraspinal tumors were examined on a LOT imager with suitable scan parameters. Besides routine examination, all patients' T2-weighted Turbo-FLAIR images were obtained in the sagittal plane and some of them in the coronal plane. T2-weighted Turbo-FLAIR images were compared with T2-weighted TSE images under three qualitative and six quantitative criteria. The three qualitative criteria were tumor conspicuity, tumor detection and image artifact. The qualitative analyses were independently performed by four experienced radiologists. The six quantitative criteria were tumor signal-noise ratio (SNR), normal spinal cord SNR, tumor-to-normal spinal cord contrast, tumor-to-normal spinal cord contrast-to-noise ratio (CNR), tumor-to-CSF contrast and tumor-to-CSF CNR.RESULTS1 Qualitative Analysis1.1 Intradural-extramedullary Tumor ConspicuityFor tumor conspicuity of 37 patients in the sagittal plane, T2-weighted Turbo-FLAIR received every and overall mean score of +0.65-+0.81. There was statistically significant difference between T2-weighted Turbo-FLAIR and T2-weighted TSE (allp<0.001). For tumor conspicuity of 13 patients that were selected from 37 patients and scaned in the coronal plane, T2-weighted Turbo-FLAIR received every and overall mean score of +0.71-+0.92. There was statistically significant difference between T2-weighted Turbo-FLAIR and T2-weighted TSE (allp<0.05).In the sagittal plane for tumor conspicuity of level of and belowmedullary cone, T2-weighted Turbo-FLAIR was superior to T2-weighted TSE in 98% overall cases (51/52), while that of above medullary cone was 70% (67/96) .There was statistically significant difference between them (p=0.000). In the coronal plane, the result of tumor conspicuity on or below the level of medullary cone was 100% (20/20) , while that of above medullary cone was 81 % (24/32) . There was statistically significant difference between them 0=0.04).In the sagittal plane, the result of tumor conspicuity of meningioma and other pathological types of tumors was 93 % (41 /44 ), while that of neurinomas was 74% (77/104). There was statistically significant difference between them (p=0.006), but there was no significant difference between them in the coronal plane. In addition, In the sagittal plane a nerve root across the tumor was clearly shown only in T2-weighted Turbo-FLAIR images of 2 cases of neurinoma and the "dural tail sign" like enhancement was well displayed in those of 1 case of meningioma.No significant difference was found among tumor conspicuity of different volume in the sagittal plane. In the coronal plane, the mean tumor volume of group in which T2-weighted Turbo-FLAIR was superior to T2-weighted TSE (46/52) was 1.932cm3, but that of group in which T2-weighted Turbo-FLAIR was not superior to T2-weighted TSE (6/52) was 6.833cm3.There was statistically significant difference between them (p=0.000).1.2 Intramedullary Tumor ConspicuityFor tumor conspicuity in the sagittal plane, T2-weighted Turbo-FLAIR...
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