Which MRI sequence is most commonly recommended for evaluating white matter disease?

FLAIR (Fluid-Attenuated Inversion Recovery) sequences are particularly effective for evaluating white matter disease because they allow for better visualization of lesions within the brain's white matter. This is achieved by suppressing the signal from cerebrospinal fluid (CSF), which enhances the contrast of the white matter compared to the lesions. As a result, subtle abnormalities in the white matter, such as those seen in conditions like multiple sclerosis or small vessel disease, can be identified more easily.

While T1 and T2 weighted sequences also provide valuable information and can show structural details of the brain, they do not specifically enhance the clarity of white matter lesions as effectively as FLAIR sequences. T1 sequences are more suitable for assessing anatomy and other solid structures, while T2 weighted sequences give useful information about changes in water content but do not suppress CSF signals. STIR (Short Tau Inversion Recovery) sequences are primarily used for fat suppression and are less commonly indicated for white matter evaluation compared to FLAIR.