To evaluate the usefulness of T1-weighted images using the fast inversion recovery (T1FIR) technique as compared with routine T1-weighted spin echo (T1SE) images in various intracranial lesions. Routine spin echo and T1FIR images were performed in 15 consecutive patients with 18 lesions, cerebral infarction in five, astrocytoma in four, vascular lesion in three, encephalomalacia and hemorrhage in each two, arachnoid cyst and meningioma in each one. T1FIR images were performed with 1.5-T Signa [repetition time (TR)/echo time (TE)/inversion time (TI) was 2000/34/800 in 14, 4000/34/1200 in four lesions] and qualitatively compared with the T1SE images in signal intensity, lesion detectability, determination of lesion extent and conspicuity, contrast between lesion and background. Additionally, gray-to-white matter and cerebrospinal fluid (CSF)-to-white matter contrast were evaluated. The signal intensity of the lesions was similar on both T1FIR and T1SE images in all cases. The lesion detectability was similar on both sequences in 15 lesions, and the determination of the lesion extent was definitely higher in 16 lesions on the T1FIR images. Lesion conspicuity was superior in 11, similar in 5, and inferior in 2 patients on the T1FIR images. And also, contrast of lesion-to-background, gray-to-white matter, and CSF-to-white matter was superior on the T1FIR images. The T1FIR technique improved the determination of lesion extent and lesion conspicuity and was qualitatively superior for image contrast as compared with T1SE, but it takes more time than T1SE. The clinical application of T1FIR images depends on whether the superior aspect of the T1FIR images outweighs the disadvantage of the longer time required for this technique.