Objective: The main objective of this study was to not only determine the most appropriate sequence for the analysis of white matter hyperintensities (WMH) on MRI but also to confirm the advantage of three-dimensional (3D) acquisition, as it has been suggested in previous studies, and to test the convenience of using maximum intensity projection (MIP) algorithms on 3D-fluid-attenuated inversion-recovery (FLAIR) images for a quicker evaluation of brain MR studies. Methods: The number of WMH was compared in 40 patients and a control group of 10 volunteers using 4 different imaging modalities: two dimensional (2D)-FLAIR, 2D fast spin echo proton density (FSE PD), 3D-FLAIR and FLAIR MIP. Four experienced radiologists took part in the imaging analysis. All studies were performed on a 1.5-T whole-body MR unit.Results: A statistically significant difference between the number of lesions detected on 3D acquisitions (FLAIR CUBE® or FLAIR MIP sequences) compared with those on 2D-FLAIR or 2D FSE PD was demonstrated. There is no significant difference between 3D-FLAIR and FLAIR MIP, therefore both of them can be used with similar results. Conclusion: 3D-FLAIR sequences should replace conventional 2D-FLAIR and/or FSE PD sequences in the MR acquisition protocol when WMH are suspected. MIP reformat algorithms are less time consuming, therefore these can also be used to simplify the detection. Advances in knowledge: 3D sequences are superior for WMH depiction. Moreover, MIP algorithms allow easier analyses with similar results.White matter hyperintesities (WMH) are a common finding when sequences with long repetition time (TR) are used in brain MRI studies. Most of the time these hyperintensities do not have clinical significance or they are associated with a normal ageing brain.1,2 However, in some pathological processes, it is important to detect and quantify these lesions. Multiple sclerosis (MS) is a disease in which WMH depiction is important because many MS study groups employ diagnostic criteria for MS that take into consideration the number, location and evolution of these lesions.3-5 Brain ischaemic damage is another disease that is often expressed in MRI as hyperintensities on long TR sequences. The National Institute of Neurological Disorders and Stroke and Association Internationale pour la Recherché et l'Enseignement en Neurosciences criteria for the diagnosis of vascular dementia consider the presence of hyperintensities and lacunar infarcts 6 as a useful tool for the differential diagnosis of other types of dementias.7 In summary, it is important to detect and quantify hyperintense brain lesions, especially when certain diseases are suspected.Previous studies describe that with the three-dimensional (3D) fluid-attenuated inversion-recovery (FLAIR) sequence significantly higher contrast-to-noise ratios were achieved and significantly more lesions in patients with MS were detected compared with conventional two-dimensional (2D)-FLAIR.8 Furthermore, there is the additional advantage that multiplanar reformatting is ...

According to some clinical trials and epidemiologic studies, WDL is the most common LS (40%), followed by myxoid LS (20%), DDLS, pleomorphic LS (5%), and, last, mixed-type LS. [3,6,8] There are crucial differences among each subtype regarding presentation, treatment, and prognosis. WDL WDL is the most common subtype, representing the 40-50% of all LSs. WDL is a low-grade tumor due to their highly lipomatous content. Histologically, they are composed of variable size mature adipocytes, with scattered lipoblast and large fibrous stroma, and in some cases, they may present sclerosing and inflammatory components.