Hyperparathyroidism--comparison of flash imaging with spin echo MR imaging

MR images of the neck were prospectively studied in 19 patients with hyperparathyroidism. Fast low angle shot (FLASH) sequence was performed in addition to T1- and T2-weighted spin echo (SE) sequences. FLASH images were obtained with 320/12/20 degrees (TR/TE/flip angle) using presaturation technique. TE of 12 ms was chosen to eliminate high signal of fat tissue. In the evaluation of detectability, a combination of T1-weighted SE and FLASH images (T1WI + FLASH) was compared with a combination of T1- and T2-weighted SE images (T1WI + T2WI). MR imaging correctly depicted 20 of 30 abnormal glands on both T1WI + FLASH and T1WI + T2WI. FLASH imaging effectively eliminated high signal of fat tissue. Nineteen abnormal glands demonstrated higher signal than surrounding tissues on FLASH images, whereas 12 glands were high-intense on T2-weighted SE images. We conclude that FLASH imaging provides improved tissue contrast and anatomic delineation and, thus, may replace T2-weighted SE imaging in the neck.