ABSTRACT Background 3D fluid attenuated inversion recovery (FLAIR) imaging has theoretical benefits in evaluating leukoariosis relative to 2D FLAIR imaging but is historically less available in routine clinical imaging. We sought to compare the performance of 2D versus 3D FLAIR imaging for quantifying leukoariosis. Methods Whole‐brain 2D and 3D FLAIR images were acquired during the same imaging session in 38 consecutive patients. All sequences were anonymized and randomized and presented to two expert readers, blinded to patient demographics. Readers independently evaluated images using the Fazekas, age‐related white matter changes (ARWMC), and Modified Scheltens (MS) scales for quantitation of leukoariosis. Correlation between leukoariosis metrics obtained from the two sequences and interrater reliability between the two readers was assessed with the interclass correlation coefficient. Results The interclass correlation coefficient of leukoariosis assessment was greater than 0.8 for overall scores on the Fazekas Scale, MS, and ARWMC when comparing 2D FLAIR to 3D FLAIR for each reviewer. A small, not statistically significant, increase in interrater reliability was observed with 3D FLAIR imaging (p = 0.18). Conclusion There is good correlation between intrasubject leukoariosis quantitation assessed on 2D and 3D FLAIR images in images acquired during the same imaging session. These results suggest that serial intrasubject leukoariosis quantitation can be adequately assessed when imaging protocols include either 2D or 3D FLAIR sequences, and that the two sequences may be interchanged.
Curl et al. (Thu,) studied this question.