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  • Title: Fat-suppressed MR of the orbit and cavernous sinus: comparison of fast spin-echo and conventional spin-echo.
    Author: Mukherji SK, Tart RP, Fitzsimmons J, Belden C, McGorray S, Guy J, Mancuso AA.
    Journal: AJNR Am J Neuroradiol; 1994 Oct; 15(9):1707-14. PubMed ID: 7847218.
    Abstract:
    PURPOSE: To compare T2-weighted fat-suppressed fast spin-echo imaging with fat-suppressed conventional spin-echo imaging in the detection of normal intraorbital and pericavernous anatomy and orbital disease, and to determine the efficacy of fat saturation with T2-weighted fast spin-echo imaging of the cavernous sinus. METHODS: Contrast-to-noise ratios of normal intraorbital anatomy were calculated and compared in 10 consecutive patients using fat-suppressed fast spin-echo and conventional spin-echo T2-weighted images. Contrast-to-noise ratios of common intraorbital lesions were calculated and compared using fat-suppressed fast spin-echo and fat-suppressed conventional spin-echo. Qualitative evaluation was performed and compared for normal intraorbital anatomy using both fat-suppressed fast spin-echo and fat-suppressed conventional spin-echo in 16 patients. Qualitative evaluation for the detection of normal anatomic structures of the pericavernous region was performed and compared using fast spin-echo with and without fat suppression and fat-suppressed conventional spin-echo T2-weighted images in 16 patients. Fat saturation was performed using standard commercially available chemical saturation technique. RESULTS: Reduced imaging time allowed more acquisitions for fat-suppressed fast spin-echo images, which significantly improved visibility of intraorbital and pericavernous anatomy over fat-suppressed conventional spin-echo. Anatomic visibility was also improved because of reduced motion, phase encoding, and susceptibility artifacts. There was no significant difference between contrast-to-noise ratios for fat-suppressed fast spin-echo and fat-suppressed conventional spin-echo imaging of the lateral and medial rectus muscles. Contrast-to-noise ratios of fat suppressed fast spin-echo of orbital disease was significantly greater than contrast-to-noise ratios of fat-suppressed conventional spin-echo. Detection of several normal anatomic structures of the pericavernous region was significantly improved with non-fat-suppressed fast spin-echo over fat-suppressed fast spin-echo because of significantly reduced magnetic susceptibility artifact. CONCLUSIONS: Fat-suppressed fast spin-echo is superior to fat-suppressed conventional spin-echo for T2-weighted orbital imaging. Non-fat-suppressed fast spin-echo is the preferred pulse sequence for T2-weighted imaging of the cavernous sinus because of the minimal susceptibility artifact.
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