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INTRODUCTION AND OBJECTIVE:We previously reported on the single slice T1 mapping of human bladder using a pair of spoiled gradient recalled echo (SPGR) images acquired at different flip angles. Her...

Background/Aims:In the present study, dural venous sinuses and cerebral veins were examined using 3D SPGR MRV and 2D TOF MRV. These methods were compared in terms of detectability of venous structures and their diameters. Methods:A total of 110 patients(66 female and 44 male) who had contrast-enhanced 3D SPGR MRV and 2D TOF MRV examinations using a 1.5 T MRI machine in May 2008-June 2011 period were included in the present study. Diameters of dural venous sinuses and veins were measured at three different planes at a position 1cm distal to the site they drained into, and average values were used. Both MRV methods were compared to reveal whether the diameters calculated were different in age groups and between genders.Results:SSS, bilateral TS’s, right sigmoid sinus, Galen vein and bilateral ICV’s all could be determined using 3D SPGR MRV. Not all dural venous sinuses and veins other than right sigmoid sinus could be visualized in all patients using 2D TOF MRV.There were significant differences between the two examinations for SSS and ISS, bilateral TS and sigmoid sinuses, SS, bilateral Labbe and ICV and Galen vein diameters(p

Background Previous quantitative synthetic MRI of the brain has been solely performed in 2D. Purpose To evaluate the feasibility of the recently developed sequence 3D-QALAS for brain cortical thickness and volumetric analysis. Study type Reproducibility/repeatability study. Subjects Twenty-one healthy volunteers (35.6 ± 13.8 years). Field strength/sequence 3D T1 -weighted fast spoiled gradient recalled echo (FSPGR) sequence was performed once, and 3D-QALAS sequence was performed twice with a 3T scanner. Assessment FreeSurfer and FIRST were used to measure cortical thickness and volume of subcortical structures, respectively. Agreement with FSPGR and scan-rescan repeatability were evaluated for 3D-QALAS. Statistical tests Percent relative difference and intraclass correlation coefficient (ICC) were used to assess reproducibility and scan-rescan repeatability of the 3D-QALAS sequence-derived measurements. Results Percent relative difference compared with FSPGR in cortical thickness of the whole cortex was 3.1%, and 89% of the regional areas showed less than 10% relative difference in cortical thickness. The mean ICC across all regions was 0.65, and 74% of the structures showed substantial to almost perfect agreement. For volumes of subcortical structures, the median percent relative differences were lower than 10% across all subcortical structures, except for the accumbens area, and all structures showed ICCs of substantial to almost perfect agreement. For the scan-rescan test, percent relative difference in cortical thickness of the whole cortex was 2.3%, and 97% of the regional areas showed less than 10% relative difference in cortical thickness. The mean ICC across all regions was 0.73, and 80% showed substantial to almost perfect agreement. For volumes of subcortical structures, relative differences were less than 10% across all subcortical structures except for the accumbens area, and all structures showed ICCs of substantial to almost perfect agreement. Data conclusion 3D-QALAS could be reliably used for measuring cortical thickness and subcortical volumes in most brain regions. Level of evidence 3 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;50:1834-1842.

PURPOSE: To compare 2D gradient-recalled echo (GRE) and 2D spin-echo (SE) echo-planar imaging (EPI) MR elastography (MRE) for measurement of hepatic stiffness in adult patients with known or suspected liver disease at 3 Tesla. MATERIALS AND METHODS: Three hundred and eighty-seven consecutive patients underwent MRE of the liver at 3 Tesla with 2D-GRE and 2D-SE-EPI sequences. ‘Mean liver stiffness (LS)’ calculated by averaging 3 ROIs in the right lobe, ‘Maximum LS’ calculated by an ROI in the right lobe; and ‘Freehand LS’ calculated by an ROI in the entire liver were measured by two independent readers. Inter-observer and inter-class variability in stiffness measurements were assessed. Stiffness values were correlated with degree of liver fibrosis (METAVIR scores) in 97 patients who underwent biopsy. The diagnostic performance was compared by a receiver-operating characteristic analysis. RESULTS: The technical failure rate was 2.8% for 2D-SE-EPI (11/387) and 4.1% for 2D-GRE (16/387, 9 had R(2)* > 80 s(−1) indicating iron overload). There is high reproducibility for both GRE and SE-EPI variants (ICC = 0.84–0.94 for both GRE and SE-EPI MRE). The highest sensitivity, specificity, and accuracy of differentiating mild fibrosis (F0–F2) from advanced fibrosis (F3–F4) are 0.84 (GRE Freehand measurement), 0.92 (GRE Maximum stiffness measurement), and 0.88 (GRE Freehand measurement), respectively. CONCLUSIONS: High intra-class correlation and intra-reader correlation are seen on measured hepatic stiffness for both 2D-GRE and 2D-SE-EPI MRE. 2D-SE-EPI has lower failure rate. Diagnostic performance of both sequences is equivalent, with highest sensitivity for 2D-GRE Freehand stiffness measurement, and highest specificity 2D-GRE Maximum stiffness measurement.

BACKGROUND AND PURPOSE: SWI is valuable for characterization of intracranial hemorrhage and mineralization but has long acquisition times. We compared a highly accelerated wave–controlled aliasing in parallel imaging (CAIPI) SWI sequence with 2 commonly used alternatives, standard SWI and T2*-weighted gradient recalled-echo (T2*W GRE), for routine clinical brain imaging at 3T. MATERIALS AND METHODS: A total of 246 consecutive adult patients were prospectively evaluated using a conventional SWI or T2*W GRE sequence and an optimized wave–CAIPI SWI sequence, which was 3–5 times faster than the standard sequence. Two blinded radiologists scored each sequence for the presence of hemorrhage, the number of microhemorrhages, and severity of motion artifacts. Wave–CAIPI SWI was then evaluated in head-to-head comparison with the conventional sequences for visualization of pathology, artifacts, and overall diagnostic quality. Forced-choice comparisons were used for all scores. Wave–CAIPI SWI was tested for superiority relative to T2*W GRE and for noninferiority relative to standard SWI using a 15% noninferiority margin. RESULTS: Compared with T2*W GRE, wave–CAIPI SWI detected hemorrhages in more cases (P

The centromedian (CM) nucleus is an intralaminar thalamic nucleus that is considered as a potentially effective target of deep brain stimulation (DBS) and ablative surgeries for the treatment of multiple neurological and psychiatric disorders. However, the structure of CM is invisible on the standard T1- and T2-weighted (T1w and T2w) magnetic resonance images, which hamper it as a direct DBS target for clinical applications. The purpose of the current study is to demonstrate the use of quantitative susceptibility mapping (QSM) technique to image the CM within the thalamic region. Twelve patients with Parkinson's disease, dystonia, or schizophrenia were included in this study. A 3D multi-echo gradient recalled echo (GRE) sequence was acquired together with T1w and T2w images on a 3-T MR scanner. The QSM image was reconstructed from the GRE phase data. Direct visual inspection of the CM was made on T1w, T2w, and QSM images. Furthermore, the contrast-to-noise ratios (CNRs) of the CM to the adjacent posterior part of thalamus on T1w, T2w, and QSM images were compared using the one-way analysis of variance (ANOVA) test. QSM dramatically improved the visualization of the CM nucleus. Clear delineation of CM compared to the surroundings was observed on QSM but not on T1w and T2w images. Statistical analysis showed that the CNR on QSM was significantly higher than those on T1w and T2w images. Taken together, our results indicate that QSM is a promising technique for improving the visualization of CM as a direct targeting for DBS surgery.

The purpose of this study is 1) to demonstrate reproducibility of spin echo-echo planar imaging (SE-EPI) magnetic resonance elastography (MRE) to estimate kidney stiffness; and 2) to compare SE-EPI MRE and gradient recalled echo (GRE) MRE-derived stiffness estimations in various anatomical regions of the kidney. Kidney MRE was performed on 33 healthy subjects (8 for SE-EPI MRE reproducibility and 25 for comparison with GRE MRE; age range: 22-66 years) in a 3 T MRI scanner. To demonstrate SE-EPI MRE reproducibility, subjects were scanned for the first scan and then asked to leave the scan room and repositioned again for the second (repeat) scan. Similar set-up was used for GRE MRE as well. The displacement data was then processed to obtain overall stiffness estimates of the kidney. Concordance correlation analyses were performed to determine SE-EPI MRE reproducibility and agreement between GRE MRE and SE-EPI MRE derived stiffness. A high concordance correlation (ρc = 0.95; p-value

Magnetic resonance imaging (MRI) has been considered a valuable diagnostic tool for noninvasive imaging of the vasculature in children and adults for more than two decades. While a variety of non-contrast MRI methods have been described for imaging of both arteries and veins (e.g., time-of-flight, phase contrast, and balanced steady-state free precession imaging), contrast-enhanced magnetic resonance angiography/venography are the most commonly employed vascular imaging techniques due to their high spatial and contrast resolutions and general reliability. In this technical innovation article, we describe a novel 3-D respiratory-triggered gradient recalled echo Dixon-based MR angiography/MR venography technique that provides high-resolution anatomical imaging of the vasculature of the neck, body and extremities without the need for intravenous contrast material or breath-holding.

Magnetic resonance imaging (MRI) assessment for appendicitis is limited by exam time and patient cooperation. The radially sampled 3-dimensional (3-D) T1-weighted, gradient recalled echo sequence (radial GRE) is a free-breathing, motion robust sequence that may be useful in evaluating appendicitis in children. To compare the rate of detection of the normal appendix with contrast-enhanced radial GRE versus contrast-enhanced 3-D GRE and a multi-sequence study including contrast-enhanced radial GRE. This was a retrospective study of patients ages 7–18 years undergoing abdominal-pelvic contrast-enhanced MRI between Jan. 1, 2012, and April 1, 2016. Visualization of the appendix was assessed by consensus between two pediatric radiologists. The rate of detection of the appendix for each sequence and combination of sequences was compared using a McNemar test. The rate of detection of the normal appendix on contrast-enhanced radial GRE was significantly higher than on contrast-enhanced 3-D GRE (76% vs. 57.3%, P=0.003). The rate of detection of the normal appendix with multi-sequence MRI including contrast-enhanced radial GRE was significantly higher than on contrast-enhanced 3-D GRE (81.3% vs. 57%, P

To assess the utility of the radial reformation of three-dimensional fat-suppressed multi-echo gradient-recalled-echo (3D FS me-GRE) for evaluating acetabular labral injuries and femoroacetabular impingement (FAI). A total of 25 patients with suspected acetabular labral injuries were examined using 3D FS me-GRE and radial 2D T2*-weighted imaging (T2*WI) on a 3-T magnetic resonance imaging (MRI) scanner. The range of acetabular labral injuries was evaluated by radial reformation through the center of the acetabulum perpendicular to the plane across the entire acetabular rim (type 1 radial reformation) of 3D FS me-GRE and radial 2D T2*WI. To evaluate the FAI morphology, we performed radial reformation perpendicular to the central axis of the femoral head and neck (type 2 radial reformation) of 3D FS me-GRE. Acetabular labral injuries were identified in 23 patients, and no acetabular labral injury was seen in two patients on type 1 radial reformation of 3D FS me-GRE and radial 2D T2*WI. The diagnostic concordance rate for the range of acetabular labral injuries between the two imaging methods was 76.0%, and there was excellent agreement for the injured angles (r = 0.977, p

Background Susceptibility-weighted imaging (SWI) in neuroimaging can be challenging due to long scan times of three-dimensional (3D) gradient recalled echo (GRE), while faster techniques such as 3D interleaved echo-planar imaging (iEPI) are prone to motion artifacts. Here we outline and implement a 3D short-axis propeller echo-planar imaging (SAP-EPI) trajectory as a faster, motion-correctable approach for SWI. Methods Experiments were conducted on a 3T MRI system. The 3D SAP-EPI, 3D iEPI, and 3D GRE SWI scans were acquired on two volunteers. Controlled motion experiments were conducted to test the motion-correction capability of 3D SAP-EPI. The 3D SAP-EPI SWI data were acquired on two pediatric patients as a potential alternative to 2D GRE used clinically. Results The 3D GRE images had a better target resolution (0.47 × 0.94 × 2 mm, scan time = 5 min), iEPI and SAP-EPI images (resolution = 0.94 × 0.94 × 2 mm) were acquired in a faster scan time (1:52 min) with twice the brain coverage. SAP-EPI showed motion-correction capability and some immunity to undersampling from rejected data. Conclusion While 3D SAP-EPI suffers from some geometric distortion, its short scan time and motion-correction capability suggest that SAP-EPI may be a useful alternative to GRE and iEPI for use in SWI, particularly in uncooperative patients. J. Magn. Reson. Imaging 2015;41:1447–1453. © 2014 Wiley Periodicals, Inc.

T2*-weighted magnetic resonance imaging (MRI) has been reported to help improve detection of intracranial hemorrhage and is widely used in human neuroimaging. To assess the utility of this technique in small animals, interpretations based on this sequence were compared with those based on paired T2-weighted and fluid-attenuated inversion recovery (FLAIR) sequences in 200 dogs and cats that underwent brain MRI for suspected intracranial disease. Two sets of images (T2 + FLAIR and T2*) were reviewed separately in random order unaccompanied by patient information and were interpreted as normal or abnormal based on whether intracranial abnormalities were seen. The number and location of intracranial lesions were recorded. Eighty-five studies were considered normal and 88 were considered abnormal based on both sets of images, with good agreement (κ = 0.731) between the two. Susceptibility artifact was present in 33 cases (16.5%) on T2*-weighted images. In 12 cases (6%) a total of 69 lesions were seen on T2*-weighted images that were not seen on T2/FLAIR, all of which were associated with susceptibility artifact caused by presumed intracranial hemorrhage. Pseudolesions were seen on T2*-weighted images in five cases, none of which were associated with susceptibility artifact. Abnormalities were seen on T2/FLAIR images that were not seen on T2*-weighted images in 35 cases, confirming that T2* does not replace standard spin echo sequences. These results support inclusion of T2*-weighted sequences in small animal brain MRI studies and indicate that that a large number of abnormalities (especially hemorrhagic lesions) can go undetected if it is not performed.

Purpose To implement in-phase and out-of-phase (IP/OP) techniques with Magnetization-prepared gradient recalled echo (MP-GRE) and to evaluate the feasibility and diagnostic image quality among pre and post-optimized MP-GRE sequences, including patients unable to cooperate with breath-hold requirements. Materials and methods Institutional review board approval with waiver of informed consent was obtained for this HIPAA-compliant retrospective study. Two groups of patients were included in the study, before and after optimization of MP-GRE parameters, with seventy-three (24 noncooperative/49 cooperative) and sixty-four (22 noncooperative/42 cooperative) consecutive patients, respectively. The motion-insensitive sequence used in this study was a single-shot 2D MP-GRE. Two radiologists qualitatively evaluated the sequences to identify the presence of phase cancelation artifact in OP images and to determine image quality, extent of artifacts (respiratory ghosting, bounce-point artifact, spatial misregistration and pixel graininess) and lesion conspicuity on the various sequences. The ability to visually detect liver steatosis and fatty adrenal adenomas was evaluated. Qualitative analyses were compared using the Wilcoxon and Mann–Whitney tests. Results There were statistically significant differences between all MP-GRE sequences concerning phase cancelation artifact ( p 1 ) and post-optimized (IP 2 ) MP-GRE IP sequences, respectively, in all patients. Bounce point artifacts were significantly more pronounced in MP-GRE IP 1 ( p 2 ( p = .0027). MP-GRE OP and MP-GRE IP 2 showed significantly higher overall image quality ( p MP-GRE sequences subjectively identified hepatic steatosis (n = 20) and adrenal adenomas (n = 5) based on signal loss from IP to OP sequence. Conclusion Single shot IP/OP MP-GRE is feasible and allows motion resistant imaging with adequate diagnostic image quality. This technique is able to provide IP and OP information in patients unable to suspend respiration.

Purpose To develop a breathhold three-dimensional (3D) Dixon technique for fat suppressed imaging of myocardial infarction. Materials and Methods A pulse sequence was developed that uses a radial fan-beam k-space segmentation scheme for efficient coverage of k-space, enabling 3D scans in a single breathhold. The sequence uses a dual-echo bipolar readout to enable Dixon fat–water separation for improved visualization of epicardial and pericardial delayed enhancement. The 3D Dixon method was compared with a conventional 2D fast gradient recalled echo (FGRE) -based technique in 25 patients. Results Pericardial visualization scores and confidence were higher while overall image quality and artifacts were slightly worse for 3D Dixon compared with 2D FGRE. Robust fat suppression was achieved in 21 of 25 cases using the 3D Dixon method. Conclusion A 3D breathhold method for fat–water separated imaging of myocardial delayed enhancement was developed and validated. J. Magn. Reson. Imaging 2013;38:1362–1368. © 2013 Wiley Periodicals, Inc.

Purpose To evaluate the accuracy of an equilibrium magnetization (M0) map obtained using a two-dimensional (2D) spoiled gradient-recalled echo (SPGR) pulse sequence with variable flip angle (VFA). Materials and Methods Single-slice 2D SPGR images of 4% agar gel phantoms with different gadolinium-diethylene triamine pentaacetic acid (Gd-DTPA) concentrations (0–1 mM) were obtained with a VFA (2–30°). The 2D SPGR-VFA data were acquired with different repetition times (TRs; 7.8–117.2 ms), Gaussian and sinc RF pulses, and different field strengths (4.7, 7, and 9.4 Tesla). M0 and T1 maps were calculated from the 2D SPGR-VFA data. M0 and T1 values were compared with those calculated from free-relaxed 2D gradient-recalled echo (GRE) images and inversion recovery-prepared 2D SPGR images. The M0 and T1 slice profiles were also investigated. Results Consistent M0 values were obtained, regardless of the different Gd concentrations, TRs, and pulse sequences. The M0 slice profiles calculated from the sliced SPGR-VFA data quantitatively reproduced those calculated from the free-relaxed sliced GRE. In contrast, the T1 values calculated from the 2D SPGR-VFA data were underestimated at a high Gd concentration, short TR, and Gaussian RF pulse. Conclusion M0 values calculated from 2D SPGR-VFA images are highly quantitative. J. Magn. Reson. Imaging 2013;38:1245–1250. © 2013 Wiley Periodicals, Inc.

Objective: To demonstrate the usefulness of 3-tesla (3T) magnetic resonance imaging (MRI) including T2-weighted imaging (T2WI), diffusion weighted imaging (DWI), time-of-flight (TOF) magnetic resonance angiography (MRA), T2*-weighted gradient recalled echo (GRE), and susceptibility weighted imaging (SWI) in diagnosing brain death. Materials and Methods: Magnetic resonance imaging findings for 10 patients with clinically verified brain death (group I) and seven patients with comatose or stuporous mentality who did not meet the clinical criteria of brain death (group II) were retrospectively reviewed. Results: Tonsilar herniation and loss of intraarterial flow signal voids (LIFSV) on T2WI were highly sensitive and specific findings for the diagnosis of brain death ( p < 0.001 and < 0.001, respectively). DWI, TOF-MRA, and GRE findings were statistically different between the two groups (p = 0.015, 0.029, and 0.003, respectively). However, cortical high signal intensities in T2WI and SWI findings were not statistically different between the two group (p = 0.412 and 1.0, respectively). Conclusion: T2-weighted imaging, DWI, and MRA using 3T MRI may be useful for diagnosing brain death. However, SWI findings are not specific due to high false positive findings. Index terms: CNS; MR imaging; Brain; Adult; Brain death

Purpose: To compare in-phase (IP) /out-of-phase (OP) single shot magnetization-prepared gradient-recalled-echo (MP-GRE) with a standard two-dimensional gradient-recalled-echo (2D-GRE), and to compare image quality of MP-GRE in cooperative and noncooperative subjects. Materials and Methods: Ninety-six consecutive subjects (52 males, 44 females; mean age, 53.2 ± 16.7 years), both cooperative (n = 73) and noncooperative (n = 23) subjects who had MRI examinations including precontrast T1-weighted IP/OP MP-GRE with or without IP/OP 2D-GRE were included in the study. The sequences were independently qualitatively evaluated by two radiologists. Quantitative analysis of liver fat index, signal-to-noise ratio (SNR) and liver-lesion contrast-to-noise ratio (CNR) was also performed. Data were subjected to statistical analysis. Results: The visual detection of the presence or absence of liver steatosis showed no differences between 2D-GRE and MP-GRE imaging (k = 1). Minor differences were observed on image quality between MP-GRE and 2D-GRE in cooperative subjects, and between MP-GRE sequences performed in cooperative and noncooperative subjects. Liver fat index results were strongly positively correlated (r = .98; 95% confidence interval [CI] 0.97 to 0.98; P < .0001). Intercept (.14; 95% CI .13 to .15; P < .0001) and slope (.83; 95% CI .79 to .86; P < .0001) were statistically significant. Conclusion: IP/OP MP-GRE and 2D-GRE comparably demonstrate the presence or absence of hepatic steatosis. Image quality of MP-GRE was also comparable to 2D-GRE, and was not substantially adversely affected if subjects were unable to cooperate with breathholding instructions. J. Magn. Reson. Imaging 2011;33:1482–1490. © 2011 Wiley-Liss, Inc.

OBJECTIVE. The purpose of our study was to evaluate image quality in a 3D spoiled gradient-recalled echo (SPGR) sequence that was modified to incorporate respiratory navigation to limit the deleterious effects of respiratory motion and to compare it with conventional scanning during breath-holding and free breathing.CONCLUSION. Respiratory navigation of 3D SPGR sequences is technically feasible, and image quality is modestly improved over free breathing acquisitions using conventional 3D SPGR sequences. This may represent a promising imaging alternative for patients who cannot hold their breath.

Inversion-prepared pulse sequences can be used for non-contrast magnetic resonance angiography (MRA), but suffer from long scan times when acquired using conventional non-accelerated techniques. This work proposes a subtraction-based spin-labeling, 3D fast inversion recovery magnetic resonance angiography (FIR-MRA) method for imaging the intracranial arteries. FIR-MRA uses alternating cycles of non-selective and slab-selective inversions, leading to dark-blood and bright-blood images, respectively. The signal difference between these images eliminates static background tissue and generates the angiogram. To reduce scan time, segmented fast gradient recalled echo readout and parallel imaging are applied. The inversion recovery with embedded self-calibration (IRES) method used allows for parallel acceleration at factors of two and above. An off-resonance selective inversion provides effective venous suppression with no detriment to the depiction of arteries. FIR-MRA was compared against conventional 3D time-of-flight (TOF) angiography at 3T in eight normal subjects. Results showed that FIR-MRA had superior vessel conspicuity in the distal vessels (P < 0.05), and equal or better vessel continuity and venous suppression. However, FIR-MRA had inferior vessel sharpness (P < 0.05) in four of nine vessel groups. The clinical utility of FIR-MRA was demonstrated in three MRA patients.

Background and Purpose— Gradient recalled echo MRI (GRE) has been shown to be as accurate as CT for the detection of acute intracerebral hemorrhage (ICH). However, because of the differences in the signal parameter being detected, apparent hemorrhage size is expected to vary by imaging modality, with GRE providing larger volumes attributable to susceptibility effects. Methods— Image data from patients participating in 3 ICH studies were retrospectively reviewed. Patients with acute ICH were included if (1) concurrent MRI and CT were performed within 72 hours of symptom onset, and (2) each modality was performed within 240 minutes of each other. ICH volumes were calculated using a semiautomated image analysis program. The least squares method was used to develop a conversion equation based on a linear regression of GRE volume on CT volume. Results— Thirty-six patients met inclusion criteria. MRI was performed first in 18, CT first in 18. Mean hemorrhage volume was 25.2cc (range 0.1 to 83.9cc) on CT and 32.7cc (range 0.1 to 98.7cc) measured on GRE. A linear relationship defined by CT Volume=GRE Volume*0.8 (Spearman’s correlation coefficient=0.992, P Conclusions— Acute ICH volumes as measured on GRE pulse sequences are consistently larger than CT volumes. A simple mathematical conversion model has been developed: CT volume=0.8*GRE volume. This formula can be used in studies using both imaging modalities, across different studies, or to track ICH growth over time independent of imaging modality in an individual patient.

The purpose of this study was to compare brain and tumor signal characteristics of T1-weighted turbo spin-echo (TSE) and gradient recalled echo (GRE) sequence techniques at 3 T compared to TSE at 1.5 T, focusing on the detection of contrast enhancement, in a standardized animal model of a brain glioma.Twelve rats with implanted brain gliomas were evaluated at 1.5 and 3 T using matched hardware configurations. At 1.5 T, scanning was performed using a TSE sequence optimized for field strength (480/15 milliseconds; 125 Hz/Px) with postcontrast scans acquired at multiple time points after gadoteridol injection (0.1 mmol/kg). At 3 T, scanning was performed using the 1.5 T equivalent TSE as well as with TSE and GRE techniques optimized for 3 T. Signal-to-noise ratio (SNR) of brain and tumor and tumor contrast-to-noise ratio (CNR) were evaluated for all techniques at both field strengths.Postcontrast tumor SNR (63.7 +/- 10.8 vs. 29.5 +/- 4.3; P0.0001) and brain SNR (35.8 +/- 1.5 vs. 19.1 +/- 0.7; P0.0001) showed significant increase at 3 T using matched TSE. Comparing TSE optimized to each field strength (for optimized gray-white contrast), tumor and brain SNR still showed a significant increase at 3 T of 73% and 56%, respectively (both P0.0001). Comparing TSE at 1.5 T and GRE at 3 T, tumor SNR increased by 105%, whereas brain SNR increased by 141% (both P0.0001). Tumor CNR with matched TSE increased by 168% (P0.0001), with optimized TSE by 111% (P0.0001), and with GRE at 3 T versus TSE at 1.5 T by 36% (P0.001). With additional adjustments for echo time the gain in tumor CNR for 2D GRE may again reach 60%.With TSE at 3 T, the SNR gain comes close to the theoretically expected doubling with an even higher tumor CNR increase. In a clinical like setting at 3 T, where a T1w GRE sequence is used, tumor CNR gain is limited. Contrast dose should therefore not be decreased at 3 T.

Magnetic resonance imaging (MRI) has become the clinical standard to estimate liver iron overload. The most commonly used method is to measure the transversal relaxation time, T2*, from a multi gradient recalled echo sequence (MGRE). While this technique is reliable in low to moderate liver iron concentrations (LIC), it will be inaccurate when it is severe. We report a case with severe liver hemochromatosis and show the benefit of using an easily implemented MRI offset echo sequence to more accurately estimate LIC. After adjusting treatment, both Ferritin and LIC decreased. Using standard MGRE this reduction could not have been detected.

Objective: To estimate the accuracy, sensitivity, and specificity of 3 ferucarbotran-enhanced magnetic resonance (MR) imaging sequences prospectively for the detection of nontumoral portal perfusion abnormalities. Methods: Thirty-nine noncirrhotic patients with liver metastases underwent computed tomography during arterial portography (CTAP) and MR imaging comprising T1-weighted gradient recalled echo (GRE), T2-weighted fast spin echo (FSE), and T2*-weighted GRE sequences with and without ferucarbotran. Magnetic resonance images were reviewed by 4 blinded observers for rating based on the confidence scale. The accuracy, sensitivity, and specificity for each sequence were measured by receiver operating characteristic analysis. Contrast-to-noise ratio (CNR) and relative signal-to-noise ratio changes were statistically compared. Results: Thirty-nine nontumoral perfusion defects were observed in 22 patients by CTAP. Receiver operating characteristic analysis showed the accuracy was higher for T2*-weighted GRE (0.884) than for T1-weighted GRE (0.572) and T2-weighted FSE (0.597). T2*-weighted imaging achieved the highest sensitivity (81.4%) and the lowest specificity (86.6%). Postenhanced T2*-weighted imaging achieved the highest CNR (19.3 ± 9.2). Conclusions: T2*-weighted imaging was the most accurate and sensitive method for detecting portal perfusion abnormalities compared with Tl- or T2-weighted imaging, whereas T1- or T2-weighted imaging is superior in specificity to T2*-weighted imaging during ferucarbotran-enhanced MR imaging.

Purpose: To test the feasibility of performing magnetic resonance (MR)-guided trans-septal punctures in the swine heart. Materials and Methods: All procedures were performed in a 1.5-T MR scanner. A novel, active MR intravascular needle system was utilized for needle tracking and septal punctures. Trans-septal punctures were performed in five swine using electrocardiogram (ECG)-gated high resolution and non-ECG-gated, real-time MR imaging techniques. The intravascular needle was advanced over a guidewire from the femoral vein. Once the needle was in proper position, transseptal punctures were made. Results: Active tracking of the needle traversing the septum was possible. The location of the catheter tip was confirmed using real time gradient recalled echo (GRE). After a confirmatory ventriculogram with gadoliniumDTPA, a 0.014-inch guidewire was advanced into the left atrium and left ventricle. All punctures were made with no change in cardiac rhythm or rate; postmortem analysis was performed on all animals and demonstrated that 18/19 (95%) punctures were directly through the fossa ovalis. Conclusion: : Using only MR guidance and a novel active intravascular needle system, we were able to repeatedly puncture the fossa ovalis in a swine heart from a transfemoral approach, with direct visualization of all components, including the needle, the atria, the fossa ovalis, and the surrounding vasculature.

Serial surveillance of liver iron concentration (LIC) provides guidance for chelation therapy in patients with iron overload. The diagnosis of iron overload traditionally relies on core liver biopsy, which is limited by invasiveness, sampling error, cost and general poor acceptance by pediatric patients and parents. Thus noninvasive diagnostic methods such as MRI are highly attractive for quantification of liver iron concentration. To compare two MRI-based methods for liver iron quantification in children. 64 studies on 48 children and young adults (age range 4–21 years) were examined by gradient recalled echo (GRE) R2* and spin-echo R2 MRI at 1.5T to evaluate liver iron concentration. Scatter plots and Bland–Altman difference plots were generated to display and assess the relationship between the methods. With the protocols used in this investigation, Bland–Altman agreement between the methods is best when LIC is

Traditional fat-suppressed T1-weighted spin-echo or turbo spin-echo (TSE) sequences (T1-weighted images) may be degraded by motion and pulsation artifacts in head-and-neck studies. Our purpose is to evaluate the role of a fat-suppressed T1-weighted 3D radial gradient-recalled echo sequence (radial-volumetric interpolated breath-hold examination [VIBE]) in the head and neck as compared with standard contrast-enhanced fat-suppressed T1-weighted images.We retrospectively evaluated 21 patients (age range, 9-67 years) who underwent head-and-neck MRI at 1.5 T. Both contrast-enhanced radial-VIBE and conventional fat-suppressed TSE contrast-enhanced T1-weighted imaging were performed. Two radiologists evaluated multiple parameters of image quality, graded on a 5-point scale. Mixed-model analysis of variance and interobserver variability assessment were performed.The following parameters were scored as significantly better for the contrast-enhanced radial-VIBE sequence than for conventional contrast-enhanced T1-weighted imaging: overall image quality (p0.0001), degree of fat suppression (p = 0.006), mucosal enhancement (p = 0.004), muscle edge clarity (p = 0.049), vessel clarity (p0.0001), respiratory motion artifact (p = 0.002), pulsation artifact (p0.0001), and lesion edge sharpness (p = 0.004). Interobserver agreement in qualitative evaluation of the two sequences showed fair-to-good agreement for the following variables: overall image quality (intraclass correlation coefficient [ICC], 0.779), degree of fat suppression (ICC, 0.716), mucosal enhancement (ICC, 0.693), muscle edge clarity (ICC, 0.675), respiratory motion artifact (ICC, 0.516), lesion enhancement (ICC, 0.410), and lesion edge sharpness (ICC, 0.538). Excellent agreement was shown for vessel clarity (ICC, 0.846) and pulsation artifact (ICC, 0.808).The radial-VIBE sequence is a viable motion-robust improvement on the conventional fat-suppressed T1-weighted sequence.

OBJECTIVES To assess the value of 3-Tesla (3-T) MR imaging (MRI) in the evaluation of the course of the intracranial and extra-cranial tracts of the facial nerve. PATIENTS AND METHODS 83 patients were studied by MRI in order to detect the course of facial nerve; a total of 166 facial nerves were examined. T2-weighted 3D Fast imaging employing steady-state acquisition (FIESTA) and T1-weighted Fast spoiled gradient recalled echo (fast SPRG) sequences were used. Two radiologists (reader A and B), independently, evaluated the course of the tracts of the facial nerve according to a qualitative scale (excellent, good, fair, poor). The Intraclass Correlation Coefficient (ICC) and Pearson correlation coefficient were used to assess the intra-observer and interobserver variability in the nerve course evaluation. RESULTS Reader A evaluated 35 facial nerves as excellent, 94 as good, 33 as fair and 4 as poor. Reader B rated 31 facial nerves excellent, 89 good, 43 fair and 3 poor. The intraobserver variability was ICC = 0.919 in reader A and ICC = 0.842 in reader B. The interobserver variability (Pearson correlation coefficient) was 0.713 (p ≤ 0.01). CONCLUSIONS According to the preliminary results of our study the use of 3-T MRI with FIESTA and fast SPGR sequences may allow the study of the course of the facial nerve and its branches. The knowledge of the course and of the anatomic relationships of these nerve bundles with surrounding structures, as well as of the anatomical variants, provide useful informations for a prompt neurosurgery and maxillofacial surgical planning.

Purpose In this manuscript, we present our initial experience with MRI of the abdomen at 8 T of canine subjects both alive and dead. Our hypothesis is that abdominal imaging at 8 T should be possible and should demonstrate unique information. To our knowledge, this is the first description of imaging characteristics of the abdomen at such field strengths using a human MR scanner. Method An 8 T, 80 cm magnet housed in our department since 1998 was used for our study. GRE and rapid acquisition by relaxation enhancement (RARE) pulse sequences were selected to give reasonable slice profiles with relatively low power. Three dogs were imaged alive and after being killed. Results Our initial results show excellent signal-to-noise ratio and good RF penetration. Structures in the center of the abdomen were well visualized. Homogeneous signal was noted throughout each image without dielectric resonance artifact. Magnetic susceptibility artifacts were most severe on the GRE sequences. On the GRE sequences, the images appeared relatively T2 weighted. Signal voids were seen due to gas in the lung and bowel and susceptibility artifact at subcutaneous fat-muscle boundaries. The liver and spleen showed similar signal intensity, hypointense to subcutaneous muscle at low TE values. There was little internal anatomy of the liver or spleen visible except for the vessels. The kidney, in contrast, demonstrated very good internal structure with visualization of the cortex and medulla. Linear signal voids were depicted in the expected location of normal renal vascular anatomy on the GRE sequences. On the RARE sequences, the images also appeared T2 weighted. Magnetic susceptibility artifacts at subcutaneous fat-muscle boundaries were absent. Signal voids were noted in vessels with blood flow and gas. The liver and spleen were of similar signal intensity and slightly hypointense to muscle. The kidney and pancreas were of higher signal intensity than liver and subcutaneous muscle. The gallbladder wall demonstrated a striated pattern of two layers, with an inner hypointense and an outer hyperintense layer on the RARE sequence. The gastric wall demonstrated a striated pattern of five layers on the RARE sequence. Conclusion Images of the dog abdomen with the world's first ultra high field 8 T magnet show robust image quality and excellent spatial resolution. Image contrast is greatest on the RARE sequence, and susceptibility artifact is strongest on the GRE sequence.

Fast fat-suppressed (FS) three-dimensional (3D) spoiled gradient-recalled echo (SPGR) imaging of 64 articular cartilage regions in 16 patellofemoral joints was evaluated to assess its feasibility in diagnosing patellofemoral chondromalacia. It demonstrated good correlation with arthroscopic reports and took about half of the examination time that FS 3D SPGR did. This modified, faster technique has the potential to diagnose patellofemoral chondromalacia with shorter examination time than FS 3D SPGR did.

The purpose of this study was to compare three T1-weighted sequences for hepatic magnetic resonance (MRI) imaging with the use of a body phased array coil. Three different T1-weighted MR sequences were compared: a conventional spin echo (CSE); half-Fourier spin echo (HFSE), and a gradient recalled echo (GRE). Three independent reviewers compared the sequences both quantitatively and qualitatively. The T1-weighted GRE sequence scored highest for overall image quality (p p = 0.012 , and yielded the highest contrast to noise (C/N) values. GRE T1-weighted images are the best for hepatic MRI.

Our objective was to compare the sensitivity of non-breath-hold T2-weighted fast spin-echo with and without fat suppression, breath-hold T2-weighted fast spin-echo without fat suppression, and spoiled gradient-recalled echo (GRE) MR imaging for detecting hepatic tumors using surgical findings as the standard of reference.Eighteen patients with 36 surgically proven hepatic tumors had non-breath-hold T2-weighted fast spin-echo (6000/117 [TR/effective TE; echo train length, 16) MR imaging with and without fat suppression, breath-hold T2-weighted fast spin-echo MR imaging (2700/105; echo train length, 20), and spoiled GRE images (10.1/1.9; flip angle, 30 degrees) obtained before and after injection of a gadolinium chelate. Images were analyzed separately by two independent readers, with disagreements resolved by consensus reading.Non-breath-hold T2-weighted fast spin-echo MR imaging with and without fat suppression depicted 22 (61%; 95% confidence interval [CI], 43-77%) and 20 (56%; 95% CI, 37-72%) of 36 hepatic tumors, respectively. Breath-hold T2-weighted fast spin-echo imaging allowed detection of 19 (53%; 95% CI, 35-69%) of 36 hepatic tumors. Unenhanced and gadolinium chelate-enhanced spoiled GRE images allowed depiction of 18 (50%; 95% CI, 33-67%) and 29 (81%; 95% CI, 63-91%) of 36 hepatic tumors, respectively. Gadolinium chelate-enhanced spoiled GRE images allowed depiction of significantly more hepatic tumors than any of the other pulse sequences.Gadolinium chelate-enhanced spoiled GRE imaging is more sensitive than T2-weighted MR imaging obtained with a breath-hold or a non-breath-hold technique.

To assess the diagnostic accuracy of a new reconstruction technique for gradient-recalled-echo magnetic resonance (MR) sequences that provides a full decomposition of the water and fat content inside a voxel for nonalcoholic fatty liver disease (NAFLD) in rats.Rats were randomized into two groups. A control group (n = 10) was given free access to regular dry rat chow for 4 weeks. The steatosis (n = 40) group was given free access to feed and water 4 days per week, and fasted for the remaining 3 days for 4 weeks. All rats were killed at 4 weeks and assessed for fatty infiltration and biochemical method.The average fat content using the gold standard method was 2.65 g (2.20-3.05) of fat/100g liver for the control group and 4.14 g (1.95-8.60) of fat/100g of liver for the overfed group (p0.05). The average fat-fraction obtained from the MR was 0.016 (0.01-0.02) for the control group and 0.057 (0.00-0.18) for the overfed group. The Pearson correlation coefficient between the samples was r(2) = 0.87.Multi-echo MR is a good technique to quantify liver fat in rats.

A fast gradient-recalled-echo sequence with cardiac-triggered segmented acquisition (fastcard) was compared with a standard T1-weighted spin-echo sequence with cardiac gating and respiratory compensation in the evaluation of pediatric patients with thoracic cardiovascular anomalies. Twenty patients aged 1 week to 24 years (median age, 9 months) with various abnormalities underwent magnetic resonance (MR) imaging. In 18 patients, MR imaging was performed with both gated spin-echo and fastcard. Two observers rated the clinical utility of each sequence. Fastcard images were superior to spin-echo images in 10 patients, equivalent in seven, and inferior in one. Two additional patients with suspected pulmonary vascular lesions were accurately evaluated with the fastcard technique. The fastcard technique provides superior demonstration of thoracic cardiovascular structures and turbulent flow and enables imaging in multiple phases of the cardiac cycle.

PURPOSE: To demonstrate feasibility of functional MRI of liver using glucose as a stimulus to monitor metabolic changes using blood oxygenation level dependent (BOLD) contrast. We hypothesized that during hyperglycemia, liver stores the glucose and consequently there is a reduction in oxygen consumption, which can be detected using BOLD MRI. MATERIALS AND METHODS: In four mini pigs, measurements were made before and after 54 g of glucose administered intravenously. In six healthy young human subjects, measurements were made before and after oral ingestion of 75 g of glucose. T(2)* weighted images of the liver were obtained on a Siemens 3 Tesla Verio MRI scanner using multiple gradient recalled echo (mGRE) sequence. RESULTS: A statistically significant decrease (P < 0.05) in R2* (1/T(2)*) was observed postglucose both in swine (110.41 ± 14.1 s(-1) to 72.22 ± 5.7 s(-1)) and human (55.84 ±3.8 s(-1) to 50.6 ±0.5 s(-1)), suggesting improved liver oxygenation during hyperglycemia. CONCLUSION: Our preliminary data presented here demonstrate the feasibility of obtaining functional liver images that illustrate the changes in oxygen consumption. Further studies are necessary to fully validate the technique. J. Magn. Reson. Imaging 2010;32:988-991. © 2010 Wiley-Liss, Inc.

Intraplaque hemorrhage into the carotid atherosclerotic plaque has been shown to create instability and progression. We have developed an optimized 3D Spoiled Gradient recalled echo pulse sequence for Hemorrhage assessment using INversion recovery and multiple Echoes (3D SHINE) for carotid plaque imaging. The sequence was developed by incorporating multiecho acquisition to its clinically validated optimized single-echo counterpart 3D inversion recovery prepared fast spoiled gradient recalled sequence. With similar scan time (4 min), 3D spoiled gradient recalled echo pulse sequence for hemorrhage assessment using inversion recovery and multiple echoes maintained comparable high-resolution volumetric coverage, black-blood effect, contrast, signal-to-noise and contrast-to-noise ratios, and similar sensitivity and specificity in detecting whether intraplaque hemorrhage was present on an artery. The multiple echoes acquired with 3D SHINE allowed the estimation of intraplaque hemorrhage T*2 and then the subsequent characterization of intraplaque hemorrhage (T*2 for type I 14 msec). The type I intraplaque hemorrhage size estimated by 3D SHINE was significantly and positively correlated with the size estimated manually by an expert reviewer using the histology-validated multicontrast MRI technique (r = 0.836 ± 0.080, p < 0.001). With only one fast sequence, 3D SHINE can detect and characterize intraplaque hemorrhage that has previously required a multicontrast approach using a combination of black-blood T1-weighted, black-blood T2-weighted, and time-of-flight imaging techniques. Magn Reson Med, 2010. © 2010 Wiley-Liss, Inc.

To assess the utility of a T2*-weighted, multi-echo data imaging combination sequenced on superparamagnetic iron oxide (SPIO)-enhanced liver magnetic resonance imaging (MRI) using a 3 T system.Fifty patients underwent SPIO-enhanced MRI at 3 T using T2*-weighted, single-echo, gradient-recalled echo (GRE) sequences [fast imaging with steady precession; repetition time (TR)/echo time (TE), 126 ms/9 ms; flip angle, 30°] and multi-echo GRE (multi-echo data image combination) sequences (TR/TE, 186 ms/9 ms; flip angle, 30°). Three radiologists independently reviewed the images in a random order. The sensitivity and accuracy for the detection of focal hepatic lesions (a total of 76 lesions in 33 patients; 48 solid lesions, 28 non-solid lesions) were compared by analysing the area under the receiver operating characteristic curves. Image artefacts (flow artefacts, susceptibility artefacts, dielectric artefacts, and motion artefacts), lesion conspicuity, and overall image quality were evaluated according to a four-point scale: 1, poor; 2, fair; 3, good; 4, excellent. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the lesions were compared.Image artefacts were more frequent with single-echo GRE (p0.05). The mean scale of image quality assessment for flow, susceptibility, dielectric, and motion artefacts were 2.76, 3.13, 3.42, and 2.89 with single-echo, respectively, compared with 3.47, 3.43, 3.47, and 3.39, respectively, with multi-echo GRE. There was no significant difference in lesion conspicuity between single-echo (3.15) and multi-echo (3.30) GRE sequences. The overall image quality was significantly (p0.05) better with multi-echo (3.37) than with single-echo GRE (2.89). The mean SNR and CNR of the lesions were significantly (p0.05) higher on multi-echo (79±23 and 128±59, respectively) images than on single-echo (38±11 and 102±44, respectively) images. Lesion detection accuracy and sensitivity were not significantly different between the two sequences. Mean accuracies and sensitivities were 0.864 and 0.785 for single-echo and 0.847 and 0.785 for multi-echo GRE, respectively.At 3 T, the T2*-weighted, multi-echo data image combination sequence performs comparably to the T2*-weighted, single-echo GRE sequence for SPIO-enhanced MRI with good overall image quality and a decrease in undesired artefacts.

BACKGROUND AND PURPOSE: Rapid brain MR imaging is often substituted for head CT in multiply imaged patients with shunted hydrocephalus. Fast TSE-T2 sequences are commonly used in these protocols. One limitation of TSE-T2 sequences is the decreased catheter delineation compared with CT. The aim of this study was to compare fast TSE-T2 with rapid SS-GRE sequences in the evaluation of intracranial shunt catheter delineation as part of a rapid nonsedated pediatric brain MR imaging protocol. MATERIALS AND METHODS: We evaluated the findings from 179 consecutive patients who underwent routine clinical imaging according to the rapid nonsedated pediatric brain MR imaging protocol. Comparison of the quality of intracranial shunt catheter localization on SS-GRE versus TSE-T2 was performed. RESULTS: Of the total of 179 rapid nonsedated pediatric brain MR images that were reviewed, 62 (35%) had an intracranial shunt catheter. The shunt catheter tip was better localized on the SS-GRE than on the TSE-T2 images in 49/62 (79%) of these patients. Of the remaining 13/62 (21%), the TSE-T2 was either better or equivalent in localizing the shunt catheter tip. CONCLUSIONS: Our study shows that rapid SS-GRE sequences can provide better delineation of standard intracranial shunt catheters than standard rapid MR imaging protocols containing only fast TSE-T2 sequences.

The purpose of this study was to assess the repeatability of a dual gradient-recalled echo (GRE) muscle functional MRI technique. On 2 days, subjects (n = 8) performed 10 s isometric dorsiflexion contractions under conditions of: (1) maximal voluntary contraction (MVC), (2) 50% MVC (50% MVC), or (3) 50% MVC with concurrent proximal arterial cuff occlusion (50% MVC(cuff)). Functional MRI data were acquired using single-slice dual GRE (TR/TE = 1000/6, 46 ms)-echo planar imaging for 20 s before, during, and for 180 s after each contraction. The mean signal intensity (SI) time courses at each TE (SI(6) and SI(46), reflecting variations in blood volume and %HbO(2), respectively) from the tibialis anterior (TA) and extensor digitorum longus (EDL) muscles were characterized with the post-contraction change in SI and the time-to-peak SI (DeltaSI and TTP, respectively). DeltaSI(6) following an MVC was 36% higher than that obtained after a 50% MVC (p = 0.048). For DeltaSI(6), the highest intraclass correlation coefficients (ICCs) were observed for the TA muscle in the 50% MVC and MVC conditions, with values of 0.83 (p = 0.01) and 0.88 (p = 0.005), respectively. Bland-Altman plots revealed repeatability coefficients (RCs) for the 50% MVC and MVC conditions in the TA muscle of 1.9 and 1.4, respectively. The most repeatable measures for DeltaSI(46) were obtained for the 50% MVC and MVC conditions in the EDL muscle (p = 0.01 and p = 0.04, respectively). Bland-Altman plots revealed RC's for 50% MVC and MVC conditions in the EDL muscle of 3.9 and 5.7, respectively. DeltaSI(6) and DeltaSI(46) increased as a function of the contraction intensity. The repeatability of the method depends on the muscle and contraction condition being evaluated, and in general, is higher following an MVC.

To assess the accuracy of four fat quantification methods at low-flip-angle multiecho gradient-recalled-echo (GRE) magnetic resonance (MR) imaging in nonalcoholic fatty liver disease (NAFLD) by using MR spectroscopy as the reference standard.In this institutional review board-approved, HIPAA-compliant prospective study, 110 subjects (29 with biopsy-confirmed NAFLD, 50 overweight and at risk for NAFLD, and 31 healthy volunteers) (mean age, 32.6 years +/- 15.6 [standard deviation]; range, 8-66 years) gave informed consent and underwent MR spectroscopy and GRE MR imaging of the liver. Spectroscopy involved a long repetition time (to suppress T1 effects) and multiple echo times (to estimate T2 effects); the reference fat fraction (FF) was calculated from T2-corrected fat and water spectral peak areas. Imaging involved a low flip angle (to suppress T1 effects) and multiple echo times (to estimate T2* effects); imaging FF was calculated by using four analysis methods of progressive complexity: dual echo, triple echo, multiecho, and multiinterference. All methods except dual echo corrected for T2* effects. The multiinterference method corrected for multiple spectral interference effects of fat. For each method, the accuracy for diagnosis of fatty liver, as defined with a spectroscopic threshold, was assessed by estimating sensitivity and specificity; fat-grading accuracy was assessed by comparing imaging and spectroscopic FF values by using linear regression.Dual-echo, triple-echo, multiecho, and multiinterference methods had a sensitivity of 0.817, 0.967, 0.950, and 0.983 and a specificity of 1.000, 0.880, 1.000, and 0.880, respectively. On the basis of regression slope and intercept, the multiinterference (slope, 0.98; intercept, 0.91%) method had high fat-grading accuracy without statistically significant error (P.05). Dual-echo (slope, 0.98; intercept, -2.90%), triple-echo (slope, 0.94; intercept, 1.42%), and multiecho (slope, 0.85; intercept, -0.15%) methods had statistically significant error (P.05).Relaxation- and interference-corrected fat quantification at low-flip-angle multiecho GRE MR imaging provides high diagnostic and fat-grading accuracy in NAFLD.

To implement parallel imaging algorithms in fast gradient recalled echo sequences for myocardial perfusion imaging and evaluate image quality, signal-to-noise ratio (SNR), contrast-enhancement ratio (CER), and semiquantitative perfusion parameters.In 20 volunteers, myocardial perfusion imaging with gadobutrol was performed at rest using an accelerated TurboFLASH sequence (TR 2.3 milliseconds, TE 0.93 milliseconds, flip angle [FA] 15 degrees) with GRAPPA, R=2. A nonaccelerated TurboFLASH sequence with similar scan parameters served as standard of reference. Artifacts were assessed qualitatively. SNR, CER, and CNR were calculated and semiquantitative perfusion parameters were determined from fitted SI-time curves.Phantom measurements yielded significant higher SNR for nonaccelerated images (P0.001). CER was equal; differences in CNR were statistically nonsignificant. The evaluation of semiquantitative perfusion parameters yielded significantly higher peak signal intensities in nonaccelerated images (P0.001). Differences in maximum upslope were statistically nonsignificant. A qualitative examination of all images for artifacts by 2 board-certified radiologists yielded a significant reduction in dark rim artifacts with GRAPPA, R=2 (P0.001).The application of GRAPPA with an acceleration factor of R=2 leads to a significant reduction of dark rim artifacts in fast gradient recalled echo sequences.

Blood oxygenation level dependent (BOLD) MRI is sensitive to changes in regional oxygen supply versus demand and is therefore potentially useful in evaluating susceptibility to ischemic injury. Recently, we have demonstrated the use of BOLD MRI to evaluate intrarenal oxygenation using single shot echo-planar imaging (EPI). Here, we present an alternate implementation of BOLD MRI sequence, using multiple gradient echoes, that does not require any specialized hardware.

The purpose of our study was to compare the detectability of malignant hepatic tumors on ferumoxides-enhanced MRI using five gradient-recalled echo sequences at different TEs.Ferumoxides-enhanced MRIs obtained in 31 patients with 50 malignant hepatic tumors (33 hepatocellular carcinomas, 17 metastases) were reviewed retrospectively by three independent offsite radiologists. T1-weighted gradient-recalled echo images with TEs of 1.4 and 4.2 msec; T2*-weighted gradient-recalled echo images with TEs of 6, 8, and 10 msec; and T2-weighted fast spin-echo images of livers were randomly reviewed on a segment-by-segment basis. Observer performance was tested using the McNemar test and receiver operating characteristic analysis for the clustered data. Lesion-to-liver contrast-to-noise ratio was also assessed.Mean lesion-to-liver contrast-to-noise ratios were negative and lower with gradient-recalled echo at 1.4 msec than with the other sequences. Sensitivity was higher (p0.05) with gradient-recalled echo at 6, 8, and 10 msec and fast spin-echo sequences (75-83%) than with gradient-recalled echo sequences at 1.4 and 4.2 msec (46-48%), and was higher (p0.05) with gradient-recalled echo sequence at 8 msec (83%) than with gradient-recalled echo at 6 msec and fast spin-echo sequences (75-78%). Specificity was comparably high with all sequences (95-98%). The area under the receiver operating characteristic curve (A(z)) was greater (p0.05) with gradient-recalled echo at 6, 8, and 10 msec and fast spin-echo sequences (A(z) = 0.91-0.93) than with gradient-recalled echo sequences at 1.4 and 4.2 msec (A(z) = 0.82-0.85).In the detection of malignant hepatic tumors, gradient-recalled echo sequences at 8 msec showed the highest sensitivity and had an A(z) value and lesion-to-liver contrast-to-noise ratio comparable with values from gradient-recalled echo sequences at 6 and 10 msec and fast spin-echo sequences.

Sixty-two patients underwent magnetic resonance (MR) imaging of the liver with the automated contrast material bolus-detection technique. Arterial phase MR images were assessed quantitatively and qualitatively. In 23 patients, a test bolus of contrast material was injected intravenously before dynamic MR imaging. There was good correlation and agreement between delay times estimated with both timing methods. Eighty-three percent of arterial phase images obtained with automated contrast material bolus detection were optimal. There was good correlation and agreement between delay times estimated with both timing methods. Optimal hepatic arterial phase MR images can be obtained routinely with automated detection of a contrast material bolus.

Purpose To evaluate the different signal characteristics of focal hepatic lesions on ferumoxides-enhanced MR imaging, including T1-weighted spoiled gradient recalled echo (GRE) images using different echo times (TE) and T2- and T2*-weighted images. Materials and Methods Ferumoxides-enhanced MR imaging was performed using a 1.5-T system in 46 patients who were referred for evaluation of known or suspected hepatic malignancies. One hundred and seven lesions (42 hepatocellular carcinomas [HCC], 40 metastases, 13 cysts, eight hemangiomas, three focal nodular hyperplasias [FNHs], and one cholangiocarcinoma) were evaluated. Postcontrast MR imaging included 1) T2-weighted FSE; 2) T2*-weighted GRE; 3) T1-weighted spoiled GRE using moderate (TE = 4.2–4.4 msec) TE; and 4) minimum (TE = 1.8–2.1 msec) TE. Signal intensities of the focal lesions were rated by two radiologists in conference as follows: hypointense, isointense or invisible, hyperintense, and markedly hyperintense. Lesion-to-liver contrast-to-noise ratio (C/N) was measured by one radiologist for a quantitative assessment. Results On ferumoxides-enhanced FSE images, 92% of cysts were “markedly hyperintense” and most of the other lesions were “hyperintense”, and the mean C/N of cysts was significantly higher than that of other focal lesions. T2*-weighted GRE images showed most lesions with similar hyperintensities and the mean C/N was not significantly different between any two types of lesion. T1-weighted GRE images using moderate TE showed all FNHsand hemangiomas, 29 (69%) HCCs and eight (20%) metastases as “hyperintense”. On T1-weighted GRE images using minimum TE, however, all HCCs and metastasis except one were iso- or hypointense, while all of the FNHs and hemangiomas were hyperintense. Ring enhancement was highly suggestive of malignant lesions, and was more commonly seen on the minimum TE images than on the moderate TE images. Conclusion Addition of T1-weighted GRE images using minimum and moderate TE is helpful for characterizing focal lesions in ferumoxides-enhanced MR imaging. J. Magn. Reson. Imaging 2002;15:573–583. © 2002 Wiley-Liss, Inc.

The purpose of this study was to determine the accuracy of a multiphasic gadolinium-enhanced three-dimensional (3D) fast spoiled gradient-recalled echo sequence alone in the detection and characterization of focal liver lesions compared with a comprehensive liver evaluation using multiphasic gadolinium-enhanced 3D fast spoiled gradient-recalled echo, T1-weighted, and fat-suppressed fast spin-echo T2-weighted sequences.A retrospective review of abdominal MR imaging examinations in 61 patients was performed. All MR examinations included unenhanced spin-echo T1-weighted, unenhanced fat-suppressed fast spin-echo T2-weighted, and multiphasic gadolinium-enhanced 3D fast spoiled gradient-recalled echo sequences obtained during successive breath-holds. The liver was evaluated for focal lesions first with the 3D spoiled gradient-recalled echo sequences and then, during a separate sitting, with the T1- and T2-weighted sequences. The usefulness of each sequence in the detection and characterization of lesions was recorded. The gold standard for lesion detection and characterization was all three imaging sequences reviewed together.A total of 114 focal liver lesions were identified, 54 of which were simple cysts. The 3D spoiled gradient-recalled echo sequence alone detected 92 (81%) of the 114 lesions, and the T1- and T2-weighted sequences detected 95 (83%) of the 114 lesions. Of the 60 lesions that were not simple cysts, the 3D spoiled gradient-recalled echo sequence alone detected 58 (97%), and T1- and T2-weighted sequences detected 51 (85%). In 24% of the patients with lesions, the T1- and T2-weighted sequences were found to be helpful for the characterization of lesions.A multiphasic contrast-enhanced 3D fast spoiled gradient-recalled echo sequence alone detects most of the clinically relevant focal liver lesions. Additional liver examination using both unenhanced T1- and T2-weighted sequences is helpful for lesion characterization but increases the detection rate only minimally.

The purpose of this study was to compare the performance of in-phase and out-of-phase gradient recalled echo (GRE) pulse sequences on paramagnetic contrast-enhanced magnetic resonance (MR) imaging of malignant liver lesions.Fifty patients (27 women, 23 men; mean age = 50 +/- 27 years) with known or suspected focal liver lesions, nine of whom had a fatty liver, were examined at 1.5 T before and 60 min after injection of gadobenate dimeglumine at a dose of 0.05 or 0.1 mmol/kg using two GRE techniques: echo time of 2.3 ms (out-of-phase) or 4.6 ms (in-phase). Liver signal-to-noise ratio (SNR) and lesion-liver contrast-to-noise ratio (CNR) were calculated.In patients with a nonfatty liver, liver SNR increased from 26 +/- 9 to 41 +/- 17 on in-phase images and from 28 +/- 8 to 45 +/- 14 on out-of-phase images. In patients with a fatty liver, in-phase images provided significantly higher (p0.01) liver SNR than did out-of-phase images predose (34 +/- 8 on in-phase vs. 21 +/- 8 on out-of-phase) and postdose (44 +/- 13 on in-phase vs. 33 +/- 14 on out-of-phase). In patients with a nonfatty liver, lesion-liver CNR was similar on in-phase and out-of-phase images, predose and postdose. In patients with fatty liver, lesion-liver CNR was significantly (p0.01) lower on out-of-phase images on predose and postdose images.In-phase GRE imaging is recommended for imaging focal liver lesions on paramagnetic contrast-enhanced MR imaging in patients with fatty infiltration of the liver.