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



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.


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.


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).


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.


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


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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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