The major attraction of fast-spin-echo (FSE) imaging is reduced acquisition time; however, careful review of the literature reveals many weaknesses: phase-encoded blurring, truncation artefact, bright fat signal, reduced magnetic susceptibility and increased motion artefact. Our aim was a prospective, blinded comparison of FSE and conventional spin echo (CSE) in the cervical spine. Both sequences were performed in 43 patients (19 males and 24 females; mean age 45 years, range 15-66 years). Twenty-eight patients were studied at 1.5 T and 15 at 0.5 T. Typical sequence parameters were: at 1.5 T, TR/TE 2000/90 CSE and 3000/120 FSE, and at 0.5 T, 2200/80 CSE and 2800/120 FSE. Time saved on the FSE was used to increase the matrix and the number of acquisitions. Two neuroradiologists evaluated the images for pathology, artefacts, disc signal intensity, thecal sac compression and image quality. Ten patients had cord lesions; 2 (20 %) were missed on CSE. In 4 of 10 patients with moderate/severe thecal sac compression, the degree of stenosis was apparently exaggerated on CSE. The mean degree of confidence for the CSE sequences was 1.8 and for the FSE 1.1, where 1 is optimal. For cervical spine imaging, FSE should be preferred to CSE.

Our purpose was to investigate some of the newer MR angiography (MRA) techniques for studying the carotid arteries. Forty-two arteries in seven asymptomatic, healthy volunteers were studied using five MRA sequences: two conventional time-of-flight sequences, 2D time-of-flight (2DTOF) and 3D time-of-flight (3DTOF); 2D and 3D magnetisation-prepared, segmented time-of-flight sequences (2DTFE and 3DTFE); and a 3D phase contrast angiography (3DPCA) sequence. A protocol that could be realistically employed in a routine clinical situation was chosen. 2DTOF had significantly (P < 0.05) better signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) than 2DTFE. 3DTOF demonstrated better SNR than 3DTFE but 3DTFE demonstrated better CNR than 3DTOF. 3DPCA provided maximal anatomical coverage. No one sequence provided optimal anatomical coverage, accurate demonstration of the carotid bulb and maximal SNR and CNR. The combination of 3DPCA and a 3D inflow sequence was best. 2DTOF sequences are useful when only one brief sequence is practicably feasible.