T2 relaxation measurements in X-linked adrenoleukodystrophy performed using dual-echo fast fluid-attenuated inversion recovery MR imaging

Abstract

The purpose of this study was to determine whether dual-echo fast fluid-attenuated inversion recovery MR imaging and corresponding T2 brain maps can show different zones in the affected white matter of patients with cerebral X-linked adrenoleukodystrophy. Ten male patients with cerebral X-linked adrenoleukodystrophy underwent imaging performed using dual-echo fast fluid-attenuated inversion recovery and dual-echo conventional spin-echo MR sequences. Corresponding T2 relaxation maps of the brain were generated. On the basis of dual-echo fast fluid-attenuated inversion recovery images and T2 maps, the affected white matter could be divided into two distinct zones in four patients with cerebral X-linked adrenoleukodystrophy.

fig 1.

Images of a 13-year-old male patient with X-linked adrenoleukodystrophy. A, Axial first echo fast FLAIR image (6000/58 [TR/first TE_eff]; inversion time, 2000 ms). B, Axial second echo fast FLAIR image (6000/160 [TR/second TE_eff] inversion time, 2000 ms). C, Axial first echo conventional spin-echo MR image (3000/30 [TR/first TE]). D, Axial second echo conventional spin-echo MR images (3000/100 [TR/second TE]) of the brain, obtained at the level of the lateral ventricles, show symmetrical and confluent abnormal signal intensity in the deep white matter of the both parietooccipital lobes and splenium of the corpus callosum. The peripheral (arrowheads) and central (asterisks) zones are most distinct on the first echo fast-FLAIR image.

fig 2.

Images of an 8-year-old male patient with X-linked adrenoleukodystrophy. A, Axial view first echo fast-FLAIR image (6000/58 [TR/first TE_eff]; inversion time, 2000 ms). B, Axial view second echo fast-FLAIR image (6000/160 [TR/second TE_eff]; inversion time, 2000 ms). C, Corresponding T2 maps of the brain, obtained at the level of the lateral ventricles, show symmetrical and confluent abnormal signal intensity in the deep white matter of the both parietooccipital lobes. Note that regions of highest signal intensity on the T2 map (ie, highest T2 values) correspond to the central zone of low signal intensity on the first echo FLAIR image.