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OBJECTIVE To test the accuracy of fast spin-echo (FSE) imaging versus that of double-echo conventional spin-echo (CSE) imaging in identification of the increased hippocampal signal intensity associated with mesial temporal sclerosis (MTS). METHODS Thirty-four subjects who subsequently underwent anterior temporal lobectomy for intractable seizures and in whom the presence or absence of MTS was ascertained with certainty were imaged with CSE and FSE. Three blinded reviewers evaluated the first and second CSE images (CSE1 and CSE2) and the FSE images. RESULTS CSE1 imaging had lower accuracy than FSE (P = .038) and CSE2 (P = .006) imaging. CSE2 imaging was slightly more accurate than FSE imaging (P = .048). Contrast-to-noise ratios were lower for CSE1 imaging than for CSE2 or FSE imaging (P < .001). CONCLUSIONS The FSE sequence evaluated was more time efficient than CSE imaging but slightly less accurate. Therefore, substitution of this sequence for a CSE sequence seems unwarranted.
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