European Radiology

, Volume 23, Issue 11, pp 3087–3093 | Cite as

Contrast-enhanced free-breathing 3D T1-weighted gradient-echo sequence for hepatobiliary MRI in patients with breath-holding difficulties

  • C. S. Reiner
  • A. M. Neville
  • H. K. Nazeer
  • S. Breault
  • B. M. Dale
  • E. M. Merkle
  • M. R. Bashir
Magnetic Resonance

Abstract

Objective

Evaluate the image quality and diagnostic performance of a free-breathing 3D-gradient-echo sequence with radial acquisition (rGRE) compared with a Cartesian breath-hold 3D-GRE (cGRE) sequence on hepatobiliary phase MRI in patients with breath-holding difficulties.

Methods

Twenty-eight consecutive patients (15 males; mean age 61 ± 11.9 years) were analysed in this retrospective IRB-approved study. Breath-holding difficulties during gadoxetate-disodium-enhanced liver MRI manifested as breathing artefacts during dynamic-phase imaging. MRI included axial and coronal cGRE and a radially sampled rGRE sequence during the hepatobiliary phase. Two radiologists independently evaluated cGRE and rGRE images for image quality, liver lesion detection and conspicuity, and bile duct conspicuity on a four-point scale.

Results

Liver edge sharpness was significantly higher on rGRE images (P < 0.001). Overall image quality was slightly but significantly higher for rGRE than for cGRE (P < 0.001 and P = 0.039). Bile duct conspicuity scores of rGRE and cGRE were not significantly different. Sensitivity for detection of the 26 liver lesions was similar for rGRE and cGRE (81-77 % and 73-77 %, P = 0.5 and 1.0). Lesion conspicuity scores were significantly higher for rGRE for one reader (P = 0.012).

Conclusion

In patients with breath-holding difficulties, overall image quality and liver lesion conspicuity on hepatobiliary phase MRI can be improved using the rGRE sequence.

Key Points

Patients with diminished breath-holding capacities present a major challenge in abdominal MRI.

A free-breathing sequence for hepatobiliary-phase MRI can improve image quality.

Further advances are needed to reduce acquisition time of the free-breathing gradient-echo sequence.

Keywords

Image quality Liver Magnetic resonance imaging T1-weighted free-breathing GRE sequence Radial acquisition 

References

  1. 1.
    Schultz CL, Alfidi RJ, Nelson AD, Kopiwoda SY, Clampitt ME (1984) The effect of motion on two-dimensional fourier transformation magnetic resonance images. Radiology 152:117–121PubMedGoogle Scholar
  2. 2.
    McKenzie CA, Lim D, Ransil BJ et al (2004) Shortening MR image acquisition time for volumetric interpolated breath-hold examination with a recently developed parallel imaging reconstruction technique: Clinical feasibility. Radiology 230:589–594PubMedCrossRefGoogle Scholar
  3. 3.
    Vogt FM, Antoch G, Hunold P et al (2005) Parallel acquisition techniques for accelerated volumetric interpolated breath-hold examination magnetic resonance imaging of the upper abdomen: Assessment of image quality and lesion conspicuity. J Magn Reson Imaging 21:376–382PubMedCrossRefGoogle Scholar
  4. 4.
    Klessen C, Asbach P, Kroencke TJ et al (2005) Magnetic resonance imaging of the upper abdomen using a free-breathing T2-weighted turbo spin echo sequence with navigator triggered prospective acquisition correction. J Magn Reson Imaging 21:576–582PubMedCrossRefGoogle Scholar
  5. 5.
    Lee SS, Byun JH, Hong HS et al (2007) Image quality and focal lesion detection on T2-weighted MR imaging of the liver: Comparison of two high-resolution free-breathing imaging techniques with two breath-hold imaging techniques. J Magn Reson Imaging 26:323–330PubMedCrossRefGoogle Scholar
  6. 6.
    Young PM, Brau AC, Iwadate Y et al (2010) Respiratory navigated free breathing 3D spoiled gradient-recalled echo sequence for contrast-enhanced examination of the liver: Diagnostic utility and comparison with free breathing and breath-hold conventional examinations. AJR Am J Roentgenol 195:687–691PubMedCrossRefGoogle Scholar
  7. 7.
    Pipe JG (1999) Motion correction with PROPELLER MRI: Application to head motion and free-breathing cardiac imaging. Magn Reson Med 42:963–969PubMedCrossRefGoogle Scholar
  8. 8.
    Chandarana H, Block TK, Rosenkrantz AB et al (2011) Free-breathing radial 3D fat-suppressed T1-weighted gradient echo sequence: A viable alternative for contrast-enhanced liver imaging in patients unable to suspend respiration. Invest Radiol 46:648–653PubMedCrossRefGoogle Scholar
  9. 9.
    Azevedo RM, de Campos RO, Ramalho M, Heredia V, Dale BM, Semelka RC (2011) Free-breathing 3D T1-weighted gradient-echo sequence with radial data sampling in abdominal MRI: Preliminary observations. AJR Am J Roentgenol 197:650–657PubMedCrossRefGoogle Scholar
  10. 10.
    Song HK, Dougherty L (2000) k-space weighted image contrast (KWIC) for contrast manipulation in projection reconstruction MRI. Magn Reson Med 44:825–832PubMedCrossRefGoogle Scholar
  11. 11.
    Cruite I, Schroeder M, Merkle EM, Sirlin CB (2010) Gadoxetate disodium-enhanced MRI of the liver: Part 2, protocol pptimization and lesion appearance in the cirrhotic liver. AJR Am J Roentgenol 195:29–41PubMedCrossRefGoogle Scholar
  12. 12.
    Feuerlein S, Boll DT, Gupta RT, Ringe KI, Marin D, Merkle EM (2011) Gadoxetate disodium-enhanced hepatic MRI: Dose-dependent contrast dynamics of hepatic parenchyma and portal vein. AJR Am J Roentgenol 196:W18–24PubMedCrossRefGoogle Scholar
  13. 13.
    Ringe KI, Husarik DB, Sirlin CB, Merkle EM (2010) Gadoxetate disodium-enhanced MRI of the liver: Part 1, protocol optimization and lesion appearance in the noncirrhotic liver. AJR Am J Roentgenol 195:13–28PubMedCrossRefGoogle Scholar
  14. 14.
    Bashir MR, Husarik DB, Ziemlewicz TJ, Gupta RT, Boll DT, Merkle EM (2012) Liver MRI in the hepatocyte phase with gadolinium-EOB-DTPA: Does increasing the flip angle improve conspicuity and detection rate of hypointense lesions? J Magn Reson Imaging 35:611–616PubMedCrossRefGoogle Scholar
  15. 15.
    Frydrychowicz A, Nagle SK, D'Souza SL, Vigen KK, Reeder SB (2011) Optimized high-resolution contrast-enhanced hepatobiliary imaging at 3 tesla: A cross-over comparison of gadobenate dimeglumine and gadoxetic acid. J Magn Reson Imaging 34:585–594PubMedCrossRefGoogle Scholar
  16. 16.
    Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174PubMedCrossRefGoogle Scholar
  17. 17.
    Altun E, Semelka RC, Dale BM, Elias J Jr (2008) Water excitation MPRAGE: An alternative sequence for postcontrast imaging of the abdomen in noncooperative patients at 1.5 Tesla and 3.0 Tesla MRI. J Magn Reson Imaging 27:1146–1154PubMedCrossRefGoogle Scholar
  18. 18.
    Kim JH, Hong SS, Eun HW, Han JK, Choi BI (2012) Clinical usefulness of free-breathing navigator-triggered 3D MRCP in non-cooperative patients: Comparison with conventional breath-hold 2D MRCP. Eur J Radiol 81:e513–518PubMedCrossRefGoogle Scholar
  19. 19.
    Hirokawa Y, Isoda H, Maetani YS, Arizono S, Shimada K, Togashi K (2008) MRI artifact reduction and quality improvement in the upper abdomen with PROPELLER and prospective acquisition correction (PACE) technique. AJR Am J Roentgenol 191:1154–1158PubMedCrossRefGoogle Scholar
  20. 20.
    Rosenkrantz AB, Mannelli L, Mossa D, Babb JS (2011) Breath-hold T2-weighted MRI of the liver at 3T using the BLADE technique: Impact upon image quality and lesion detection. Clin Radiol 66:426–433PubMedCrossRefGoogle Scholar
  21. 21.
    Hirokawa Y, Isoda H, Maetani YS et al (2009) Hepatic lesions: Improved image quality and detection with the periodically rotated overlapping parallel lines with enhanced reconstruction technique—evaluation of SPIO-enhanced T2-weighted MR images. Radiology 251:388–397PubMedCrossRefGoogle Scholar
  22. 22.
    Hirokawa Y, Isoda H, Maetani YS, Arizono S, Shimada K, Togashi K (2008) Evaluation of motion correction effect and image quality with the periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) (BLADE) and parallel imaging acquisition technique in the upper abdomen. J Magn Reson Imaging 28:957–962PubMedCrossRefGoogle Scholar
  23. 23.
    Catalano OA, Singh AH, Uppot RN, Hahn PF, Ferrone CR, Sahani DV (2008) Vascular and biliary variants in the liver: Implications for liver surgery. Radiographics 28:359–378PubMedCrossRefGoogle Scholar
  24. 24.
    Lamade W, Glombitza G, Fischer L et al (2000) The impact of 3-dimensional reconstructions on operation planning in liver surgery. Arch Surg 135:1256–1261PubMedCrossRefGoogle Scholar
  25. 25.
    Nagle SK, Busse RF, Brau AC et al (2012) High resolution navigated three-dimensional T(1)-weighted hepatobiliary MRI using gadoxetic acid optimized for 1.5 Tesla. J Magn Reson Imaging 36:890–899PubMedCrossRefGoogle Scholar

Copyright information

© European Society of Radiology 2013

Authors and Affiliations

  • C. S. Reiner
    • 1
  • A. M. Neville
    • 1
  • H. K. Nazeer
    • 1
  • S. Breault
    • 1
  • B. M. Dale
    • 2
  • E. M. Merkle
    • 1
    • 3
  • M. R. Bashir
    • 1
  1. 1.Department of RadiologyDuke University Medical CenterDurhamUSA
  2. 2.Siemens HealthcareCaryUSA
  3. 3.Department of Medical RadiologyUniversity Hospital BaselBaselSwitzerland

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