Cardiac MRI: comparison between single-shot fast spin echo and conventional spin echo sequences in the morphological evaluation of the ventricles

PURPOSE: Black blood single shot FSE sequences (Nffse) employ 180 degrees RF refocalisation pulses preceded by an inversion RF double pulse associated to presaturation pulses. The latter produce signal void of the external volume, and possible reduction of the field of view without wrap-around artifacts along the phase coding direction. The aim of our study was to compare the diagnostic possibilities of the Nffse sequences with those of conventional SE study of cardiac morphology. MATERIAL AND METHODS: Twenty-five patients (19 males and 9 females with age ranging from 20 to 54 years) presented findings suggesting right ventricular arrhythmogenic dysplasia. MR examinations were performed with a 1,5 T unit (GE Signa Horizon Echospeed 8.3, Milwaukee, USA) and Torso Phased Array coil positioned at thoracic level. The morphologic study was performed with SE multiphase-multislice ECG-gated sequences (TR: R-R, TE: 30 ms, FOV 320X250, matrix 160X256, slice thickness 10 mm, acquisition time about 5 minutes) and Single-Shot FSE Half Fourier sequences (TR: R-R, TE: 30 ms, flip angle 120 degrees, ETL 30-40, FOV 360X180, Phase FOV 0,5, VBW 64 MHz, slice tickness 10 mm, acquisition time about 10-12 seconds), by imaging along the long and short axis. The study was completed with Fast Gradient Echo sequences (TR: 9ms, TE: 8,2ms, flip angle 25 degrees, VBW 15,63 MHz, FOV 320X250, 10 mm slice thickness, matrix 128X256), subsequently assessed by cine-MR. In order to compare both sequences, two experienced radiologists performed an analysis of quantitative parameters (signal intensity ratio between fat and muscular interventricular septum) and qualitative parameters (double blind evaluation for the presence of cardiac and respiratory artifacts). RESULTS: The signal intensity ratio for the Nffse sequence images was 4.63 +/- 1.56 on the long axis and 7.69 +/- 2.46 on the short axis, whereas it was 3.17 +/- 0.64 on the long axis and 3,50 +/- 0,75 on the axis one for SE images, with a statistically significant difference (p<0,001 and p<0.002 for the long and short axis, respectively). The two radiologists evaluation of the magnitude of artifacts on the SE and Nffse images was similar only as regards the images with significant artefacts alone. Nffse images consistently afforded a detailed evaluation of the right ventricular wall, although blurring artifacts were more common than with good quality SE images. Presence of fatty infiltration of the right ventricle wall was observed in 5 out of 25 patients. In the remaining 20 patients no fatty substitution of the muscular wall of the right ventricle was observed. DISCUSSION AND CONCLUSIONS: The Nffse sequences provide a number of gated multiphase-multislice images, similar to that obtained by conventional SE sequences, in one breath-hold time interval. Due to high intrinsic contrast and reduction of motion artifacts, the Nffse sequences allow a good evaluation of the ventricular morphology and subepicardial and paracardiac adipose tissue. Image quality can be suboptimal due to blurring artifacts. Therefore Nffse sequences can be advantageously employed to image patients with suspected right ventricular arrhythmogenic dysplasia, whenever conventional SE images exhibit substandard quality.     

Optimization of a dual echo in the steady state (DESS) free-precession sequence for imaging cartilage

Three-dimensional (3D) MR imaging of the knee is useful to detect cartilage abnormalities, although the tissue contrast in 3D gradient-recalled echo (GRE) sequences such as gradient-recalled acquisition in the steady state (GRASS) or fast low-angle shot (FLASH) is poor. T2 contrast can be added to a GRASS sequence by combining the signals from the first and second gradient echoes, which form immediately after and immediately before each radiofrequency (RF) pulse in a 3D GRE sequence. We have optimized a 3D dual echo in the steady state (DESS) sequence, which produces one averaged image from the two echoes, for use in the detection of articular cartilage abnormalities. In the optimization process, we examined the imaging parameters of flip angle (α), repetition time (TR), echo time (TE), and bandwidth to maximize the contrast between cartilage and joint fluid. A theoretical simulation of the sequence was confirmed with experiments conducted on phantoms with known T1 and T2. On the basis of theoretical predictions and experiments using healthy volunteers, we determined that an optimized sequence with a bandwidth of 98 Hz per pixel, a TR of 30 msec, a TE of 7.1 msec, and an α of 60° produced the highest contrast between cartilage and fluid within a defined acquisition time of 6 minutes. Additional contrast was obtained by filtering the second-echo image to eliminate noise before adding it to the first-echo image.     

Optimizing fast spin echo acquisitions for hepatic imaging in normal subjects

The purpose of this study was to determine which implementations of a T2-weighted fast spin-echo sequence of the liver resulted in observer preference in normal subjects. Five volunteers were scanned with a series of fast spin-echo sequences modified to allow for flow compensation, respiratory triggering (RT), ECG triggering, randomized phase encoding (RPE), breathholding, and echo train length (ETL). Images were compared with conventional 2500/40/80 msec spin-echo images using flow compensation and spatial presaturation by two observers blinded to the specific sequence parameters. All FSE sequences were completed in less than the 12 minutes necessary to perform a conventional spin-echo sequence. The most preferred fast spin-echo sequence employed flow compensation, RT, and used an 8 ETL. Analysis of image preference, signal to noise, and contrast to noise showed that RT was the single most important variable in determining each image response (P < .01, P < .02, P < .01, respectively). There was some evidence that images obtained with an 8 ETL were preferred over those using a 16 ETL (P=.07). No other variables approached statistical significance although one reader preferred images with flow compensation in the frequency direction to those either not flow compensated or flow compensated in the slice direction. Respiratory triggered fast spin-echo images combined with flow compensation in the frequency direction and using ETL=8 can provide image quality equal to conventional spin-echo sequences with significant time savings.     

Pulse sequence optimization for MR imaging using a paramagnetic hepatobiliary contrast agent

Paramagnetic agents enhance contrast between tissues in magnetic resonance (MR) imaging by altering tissue relaxation times. The effect of these changes on MR image intensity depends in part on the choice of operator-controlled pulse sequence parameters. With the newly described paramagnetic hepatobiliary contrast agent, iron(III) ethylenebis-(2-hydroxyphenylglycine), Fe(EHPG)-, an in vivo experimental analysis of pulse sequence optimization was performed on the rat. We compared the enhancement of the liver divided by background noise, EL/N, of standard inversion-recovery (IR) and spin-echo (SE) T1-weighted pulse sequences and several pulse sequences theoretically predicted to have improved EL/N. Optimization of the echo time (TE = TEmin) gave a substantial (greater than 60%) increase in EL/N over the standard IR and SE pulse sequences. Images obtained with optimized repetition rate and inversion time gave only a slight additional improvement. Within the uncertainties of our relaxation measurements, the measured changes in EL/N with pulse sequence optimization corresponded well with theoretical predictions. With the experimental and theoretical data, the importance of using a short echo time to obtain maximal T1 contrast in contrast-enhanced MR imaging and the relative merits of optimized SE versus IR pulse sequences for contrast-enhanced MR imaging are discussed.     

Influence of pulse sequence parameters at 1.5?T and 3.0?T on MRI artefacts produced by metal–ceramic restorations

Objectives:

Susceptibility artefacts from dental materials may compromise MRI diagnosis. However, little is known regarding MRI artefacts of dental material samples with the clinical shapes used in dentistry. The present phantom study aims to clarify how pulse sequences and sequence parameters affect MRI artefacts caused by metal–ceramic restorations.

Methods:

A phantom consisting of nickel–chromium metal–ceramic restorations (i.e. dental crowns and fixed bridges) and cylindrical reference specimens immersed in agar gel was imaged in 1.5 and 3.0 T MRI scanners. Gradient echo (GRE), spin echo (SE) and ultrashort echo time (UTE) pulse sequences were used. The artefact area in each image was automatically calculated from the pixel values within a region of interest. Mean values for similar pulse sequences differing in one parameter at a time were compared. A comparison between mean artefact area at 1.5 and 3.0 T, and from GRE and SE was also carried out. In addition, a parametric correlation between echo time (TE) and artefact area was performed.

Results:

A significant correlation was found between TE and artefact area in GRE images. Higher receiver bandwidth significantly reduced artefact area in SE images. UTE images yielded the smallest artefact area at 1.5 T. In addition, a significant difference in mean artefact area was found between images at 1.5 and 3.0 T field strengths (p = 0.028) and between images from GRE and SE pulse sequences (p = 0.005).

Conclusions:

It is possible to compensate the effect of higher field strength on MRI artefacts by setting optimized pulse sequences for scanning patients with metal–ceramic restorations.     

Reduced-bandwidth method for F-19 imaging of perflubron.

A reduced-bandwidth imaging method has been developed to eliminate the chemical shift artifacts in magnetic resonance (MR) imaging of the blood substitute perflubron (PFB) and simultaneously enhance the signal-to-noise ratio (SNR). The two strongest spectral peaks, which have relatively long T2 values (247 and 471 msec), were used. When the receiver bandwidth is reduced substantially by increasing the data acquisition time Ts, the bandwidth across the object becomes less than the chemical shift frequency. The reduced bandwidth eliminates misregistration by displaying the images corresponding to multiple spectral peaks on the same image plane simultaneously. An additional gain due to the reduced bandwidth is the reduced thermal Gaussian noise. Unfortunately, the increased Ts results in an increased TE, which causes the signal to be attenuated by T2 relaxation. The optimum measured Ts (and TE) values for successful image separation and maximum SNR were 120 and 144 msec for the two spectral peaks, respectively. The long TE also suppresses the rest of the downfield spectral peak cluster of PFB. The degree of magnetic field inhomogeneity and tissue susceptibility across the object may cause some limitations in the application of this technique; however, a composite radio-frequency pulse that will allow use of additional spectral lines and/or localized volume imaging techniques may be incorporated to overcome these limitations.     

Assessment of myocardial viability using delayed enhancement magnetic resonance imaging at 3.0 Tesla

OBJECTIVE: Cardiac magnetic resonance imaging (MRI) at 3.0 T has recently become available and potentially provides a significant improvement of tissue contrast in T1-weighted imaging techniques relying on Gd-based contrast enhancement. Imaging at high-field strength may be especially advantageous for methods relying on strong T1-weighting and imaging after contrast material administration. The aim of this study was to compare cardiac delayed enhancement (DE) MRI at 3.0 T and 1.5 T with respect to image quality, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) between infarcted and normal myocardium. MATERIALS AND METHODS: Forty consecutive patients with history of myocardial infarction were examined at 3.0 T (n = 20) or at 1.5 T (n = 20). Myocardial function was assessed using cine steady-state-free-precession (SSFP) sequences (TR 3.1 milliseconds, TE 1.6 milliseconds, flip angle 70 degrees , and a matrix of 168 x 256 at 1.5 T and TR 3.4 milliseconds, TE 1.7 milliseconds, flip angle 50 degrees and a matrix of 168 x 256 at 3.0 T), acquired in long- and short-axes views. DE images were obtained 15 minutes after the administration of 0.15 mmol of Gd-DTPA/kg body weight using a segmented inversion recovery prepared gradient echo sequence at 1.5 T (TR 9.6 milliseconds, TE 4.4 milliseconds, flip angle 25 degrees , matrix 160 x 256, bandwidth 140 Hertz/pixel) and at 3.0 T (TR 9.8 milliseconds, TE 4.3 milliseconds, flip angle 30 degrees , matrix 150 x 256, bandwidth 140 Hertz/pixel). For image analysis, standardized SNR and CNR measurements were performed in infarcted and remote myocardial regions. Two independent observers rated image quality on a 4-point scale (0 = poor image quality, 1 = sufficient image quality, 2 = good image quality, 3 = excellent image quality). RESULTS: High diagnostic image quality was obtained in all patients. Rating of mean image quality was 2.2 +/- 0.8 at 1.5 T and 2.5 +/- 0.6 at 3.0 T (P = 0.012) for observer 1 and 2.2 +/- 0.7 at 1.5 T and 2.6 +/- 0.6 at 3.0 T (P = 0.003) for observer 2, respectively. Interobserver agreement was good (kappa = 0.68 at 1.5 T and 0.78 at 3.0 T). SNR measurements yielded a mean SNR of 37.8 +/- 13.9/22.9 +/- 6.0 in infarcted myocardium (P < 0.001) and 5.6 +/- 2.2/5.9 +/- 2.4 in normal myocardium (P = 0.45) at 3.0 T/1.5 T, respectively. CNR measurements revealed mean values of 32.4 +/- 13.0/16.7 +/- 5.4 (P< 0.001) at 3.0 T/1.5 T, respectively. CONCLUSIONS: Delayed enhancement MRI at 3.0 T is feasible and provides superior image quality compared with 1.5 T. Furthermore, using identical contrast doses, increased SNR and CNR values were recorded at 3.0 T.     

Comparison of inversion recovery fast spin-echo (FSE) with T2-weighted fat-saturated FSE and T1-weighted MR imaging in bone marrow lesion detection

 Objective To prospectively compare inversion recovery (IR) fast spin-echo (FSE) with T1-weighted spin-echo (SE) and T2-weighted chemical-shift fat-saturated (FS) FSE magnetic resonance sequences in the detection of bone marrow abnormality. Design. Twenty-nine sets of T1-weighted SE [400–640/10–20 (TR/TE)], T2-weighted FS-FSE [2400–3800/91–112/8 (TR/TE/ETL)], and IR-FSE [3700–6000/12–14/170/8 (TR/TE/T1/ETL)] images were acquired with a 1.5-T magnet in 27 patients with bone marrow lesions. The visibility, margination, and extent of 41 lesions, image quality, contrast, and artifacts were qualitatively and quantitatively compared. Results. The lesions were more conspicuous on the IR-FSE than on the T1-weighted SE and T2-weighed FS-FSE images. The extent of lesions was similar for all three sequences. Image quality was better and there were fewer motion artifacts on the T1-weighted images. The mean lesion contrast-to-noise ratio was significantly higher on the T1-weighted images (p<0.05). Conclusion. The IR-FSE sequence is highly sensitive for detecting bone marrow pathology, with scan time comparable to the T1-weighted SE and T2-weighted FS-FSE sequences.     

Fast spin-echo MR imaging of the abdomen: Contrast optimization and artifact reduction

The effects of various fast spin-echo (FSE) magnetic resonance (MR) imaging parameters and artifact reduction techniques on FSE image contrast and quality were studied. The authors performed 139 abdominal MR examinations, comparing standard FSE images (echo train length [ETL] = 8, echo space [E-space] = 17 msec, bandwidth = ±16-kHz) with FSE images with an ETL of 16 (n = 22) or FSE images with a ±32-kHz bandwidth and an E-space of 11-14 msec (n = 22). FSE artifact reduction techniques were evaluated with spectral fat saturation (n = 40) or with a new flow compensation FSE sequence (n = 55). Images of liver lesions were reviewed qualitatively and with contrast-to-noise ratio (C/N) measurements. Decreasing the time of echo train sampling produced superior image quality, with increased anatomic sharpness, less image artifact, and improved liver-lesion C/N. Images obtained with an ETL of 16 showed more image blurring and a 23% decrease in relative contrast and 28% decrease in relative C/N for liver tumors. Increasing the bandwidth reduced E-space, producing a 12% decrease in background noise. Artifact reduction with fat saturation or flow compensation produced images with less ghosting artifact and superior overall image quality, with 39% and 20% increases in liver-tumor C/N, respectively. FSE image quality and contrast in the depiction of hepatic disease can be optimized with careful selection of imaging parameters and the use of artifact reduction techniques.     

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

PURPOSE: To evaluate motion correction effect and image quality in the upper abdomen with the periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) (BLADE) and parallel imaging acquisition technique. MATERIALS AND METHODS: A total of 50 consecutive patients underwent abdominal MR imaging. Fat-saturated T2-weighted turbo spin-echo sequences were obtained by respiratory triggering. The subjects were examined with three different conditions of echo train length (ETL), blade width, and percent k-space coverage in the same scanning time: 19/30/100%, 30/30/100%, and 30/52/175%, which were designated as L/C(1), L/C(2), and L/C(3), respectively. The parallel imaging acquisition technique was used to either reduce ETL from 30 to 19 in L/C(1) or increase k-space coverage from 100% to 175% in L/C(3) compared with L/C(2). Motion and streak artifacts, and overall image quality were evaluated visually by two radiologists, independently. RESULTS: Motion and streak artifacts were mostly reduced in L/C(3) condition. The L/C(3) image also gave the best overall image quality compared with other conditions (P < 0.001). The inter-rater reliability for each evaluation agreed well. CONCLUSION: In upper abdominal BLADE MRI, it was possible to reduce image artifacts and obtain better image quality by increasing the k-space coverage with parallel imaging in the same scanning time.     

Optimal Pulse Sequence for Ferumoxides-Enhanced MR Imaging Used in the Detection of Hepatocellular Carcinoma: A Comparative Study Using Seven Pulse Sequences

Objective

To identify the optimal pulse sequence for ferumoxides-enhanced magnetic resonance (MR) imaging in the detection of hepatocelluar carcinomas (HCCs).

Materials and Methods

Sixteen patients with 25 HCCs underwent MR imaging following intravenous infusion of ferumoxides. All MR studies were performed on a 1.5-T MR system, using a phased-array coil. Ferumoxides (Feridex IV) at a dose of 15 µmol/Kg was slowly infused intravenously, and axial images of seven sequences were obtained 30 minutes after the end of infusion. The MR protocol included fast spin-echo (FSE) with two echo times (TR3333 8571/TE18 and 90-117), singleshot FSE (SSFSE) with two echo times (TR∞/TE39 and 98), T2*-weighted gradient-recalled acquisition in the steady state (GRASS) (TR216/TE20), T2*-weighted fast multiplanar GRASS (FMPGR) (TR130/TE8.4-9.5), and T2*-weighted fast multiplanar spoiled GRASS (FMPSPGR) (TR130/TE8.4-9.5). Contrast-to-noise ratios (CNRs) of HCCs determined during the imaging sequences formed the basis of quantitative analysis, and images were qualitatively assessed in terms of lesion conspicuity and image artifacts. The diagnostic accuracy of all sequences was assessed using receiver operating characteristic (ROC) analysis.

Results

Quantitative analysis revealed that the CNRs of T2*-weighted FMPGR and T2*-weighted FMPSPGR were significantly higher than those of the other sequences, while qualitative analysis showed that image artifacts were prominent at T2*-weighted GRASS imaging. Lesion conspicuity was statistically significantly less clear at SSFSE imaging. In term of lesion detection, T2*-weighted FMPGR, T2*-weighted FMPSPGR, and proton density FSE imaging were statistically superior to the others.

Conclusion

T2*-weighted FMPGR, T2*-weighted FMPSPGR, and proton density FSE appear to be the optimal pulse sequences for ferumoxides-enhanced MR imaging in the detection of HCCs.     

Intracranial black-blood MR angiography with high-resolution 3D fast spin echo

Three-dimensional fast spin-echo (3DFSE) techniques are promising for black-blood imaging of cerebral vessels. In this study, flow-related signal dephasing was demonstrated as the primary mechanism for blood signal attenuation. Parameter optimization of TR (1500 to 3000 ms), receiver bandwidth (25 to 31.25 kHz), effective TE (25.7 to 30.1 ms), and ETL (7 to 8) was accomplished by making measurements of vessel-totissue contrast-to-noise ratios on vessels. A comparison of high-resolution 3DFSE and 3DTOF magnetic resonance angiography demonstrated that 3DFSE can generate images with equivalent or better small vessel detail than conventional techniques. 3DFSE black-blood techniques may provide improved sensitivity of small arteries and veins with slow or in-plane flow and immunity to flow-related distortions. Future studies with optimized parameters will determine the clinical efficacy of this technique.     

Gd-DTPA-enhanced short repetition time and short inversion time inversion recovery magnetic resonance imaging. Experimental and clinical assessment

To suppress both water and fat signal while retaining the high signal of Gd-DTPA enhancement, magnetic resonance imaging (MRI) of phantoms and 28 patients with mass lesions was done using short repetition time (TR) and short inversion time inversion recovery (STIR) sequences. Optimal STIR pulse sequences of 500 to 1000/80-100/20-30 (TR/TI/TE) were determined by an experimental study. In most instances, a signal bandwidth of +/- 8 kHz was used to increase the signal-to-noise ratio. The authors measured image contrast between lesions and adjacent fatty tissue and compared postcontrast STIR and T1-weighted spin-echo (T1-W SE) images. When the signal intensity of a lesion is 80% of adjacent fatty tissue on postcontrast T1-W SE, short TR STIR images provide better tumor delineation.     

Comparison of echo-planar sequences for perfusion-weighted MRI: which is best?

We compared gradient-echo (GRE), spin-echo (SE) and stimulated-echo (STE) echo-planar imaging sequences for perfusion-weighted imaging at different field strengths. Focal cerebral ischaemia was induced by endovascular occlusion of the middle cerebral artery in eight rats. MR was performed at 4.7 T or 2.35 T. With each sequence, we acquired data sets before, during and after bolus injection of Gd-DTPA with a time resolution of 1.2 s per image. The perfusion-weighted images were assessed with regard to image quality, artefacts, signal-to-noise ratio (SNR), and signal-attenuation-to-noise ratio (ΔSNR) of the non-ischaemic tissue. Visual assessment showed GRE-EPI images acquired at 4.7 T to suffer from distortion due to susceptibility artefacts. Artefacts were less marked with the SE and STE series. The GRE-EPI sequence gave the highest SNR and ΔSNR. At 2.35 T, the SNR of the STE sequences was less than 3 and therefore did not allow construction of reliable signal-time curves. SE-EPI was best suited for perfusion-weighted imaging at high field strength thanks to its minimal distortion artefacts and high SNR. Using lower field strengths (2.35 T and less), susceptibility artefacts are reduced; GRE-EPI sequences are then best suited, because they have the highest SNR and T2^* sensitivity. Received: 19 September 1997 Accepted: 16 October 1997     

Optimized T1-weighted contrast for single-slab 3D turbo spin-echo imaging with long echo trains: application to whole-brain imaging.

T(1)-weighted contrast is conventionally obtained using multislice two-dimensional (2D) spin-echo (SE) imaging. Achieving isotropic, high spatial resolution is problematic with conventional methods due to a long acquisition time, imperfect slice profiles, or high-energy deposition. Single-slab 3D SE imaging was recently developed employing long echo trains with variable low flip angles to address these problems. However, long echo trains may yield suboptimal T(1)-weighted contrast, since T(2) weighting of the signals tends to develop along the echo train. Image blurring may also occur if high spatial frequency signals are acquired with low signal intensity. The purpose of this work was to develop an optimized T(1)-weighted version of single-slab 3D SE imaging with long echo trains. Refocusing flip angles were calculated based on a tissue-specific prescribed signal evolution. Spatially nonselective excitation was used, followed by half-Fourier acquisition in the in-plane phase encoding (PE) direction. Restore radio frequency (RF) pulses were applied at the end of the echo train to optimize T(1)-weighted contrast. Imaging parameters were optimized by using Bloch equation simulation, and imaging studies of healthy subjects were performed to investigate the feasibility of whole-brain imaging with isotropic, high spatial resolution. The proposed technique permitted highly-efficient T(1)-weighted 3D SE imaging of the brain.     

Fast MR imaging of liver metastasis using FLASH and FISP--optimal sequences for T1- and T2*-weighted images

This paper deals with a study to obtain the optimal sequence of gradient echo (GE) for T1- and T2*-weighted images similar to T1- and T2-weighted images of spin echo (SE). Two GE sequences, fast low angle shot (FLASH) and fast imaging with steady-state precession (FISP), were performed in 15 cases of liver metastasis in various combination of flip angle (FA), repetition time (TR), and echo time (TE). The optimal combinations were summarized as follows: 1) T1-weighted FLASH image with FA of 40 degrees, TR of 22 msec and TE of 10 msec, 2) T1-weighted FISP image with FA of 70 degrees, TR of 100 msec, TE of 10 msec, 3) both T2*-weighted FLASH and FISP images with FA of 10 degrees, TR of 100 msec and TE of 30 msec. Not only to provide the adequate T1- and T2*-weighted images but also to enable breath-holding MR imaging, GE sequences can optionally take place SE in cases of deteriorated images caused by moving artifacts. Other applications support the re-examination and further detailing when required, conveniently rather in short time.     

T1-Weighted MR imaging of the brain using a fast inversion recovery pulse sequence

The purpose of this paper was to develop and evaluate a fast inversion recovery (FIR) technique for T1-weighted MR imaging of contrast-enhancing brain pathology. The FIR technique was developed, capable of imaging 24 sections in approximately 7 minutes using two echoes per repetition and an alternating echo phase encoding assignment. Resulting images were compared with conventional T1-weighted spin echo (T1SE) images in 18 consecutive patients. Compared with corresponding T1SE images, FIR images were quantitatively comparable or superior for lesion-to-background contrast and contrast-to-noise ratio (CNR). Gray-to-white matter and cerebrospinal fluid (CSF)-to-white matter contrast and CNR were statistically superior in FIR images. Qualitatively, the FIR technique provided comparable lesion detection, improved lesion conspicuity, and superior image contrast compared with T1SE images. Although FIR images had greater amounts of image artifacts, there was not a statistically increased amount of interpretation-interfering image artifact. FIR provides T1-weighted images that are superior to T1SE images for a number of image quality criteria.     

Optimal pulse sequence for imaging hepatic metastases

For magnetic resonance (MR) imaging studies in which the diagnosis is dependent on image contrast, it is essential that an optimized imaging technique be used. Using detection of hepatic metastases as an example, the authors describe a rational strategy for optimizing MR imaging technique. First, for a single patient with proved hepatic metastases, a variety of imaging sequences is discussed and evaluated, leading to characterization of the patient's hepatic tissues. Then the characteristics of the tissues of a representative patient population are presented. These are used to determine two optimal pulse sequences that maximize the achievable signal difference-to-noise ratio achievable in a fixed imaging time. The recommended imaging sequence for detection of hepatic metastases at 0.15 T is either a three-dimensional volume spin-echo (SE) sequence with echo time (TE) = 12 msec and repetition time (TR) = 184 msec or a multisection inversion recovery sequence with TE = 22 msec, inversion time = 250 msec, and TR = 1,375 msec. The variation of this optimum pulse sequence with field strength is also presented.     

Combined gadolinium-enhanced and fat-saturation MR imaging of renal masses

Combined gadopentetate dimeglumine enhancement and fat-saturation (FS) spin-echo (SE) magnetic resonance (MR) imaging for the detection and characterization of renal masses was evaluated in 43 patients with a total of 71 lesions (28 solid masses and 43 cysts). SE MR sequences compared were the following: short repetition time (TR)/echo time (TE), conventional SE, short TR/TE FS SE, long TR/TE conventional SE, gadolinium-enhanced short TR/TE conventional SE, and gadolinium-enhanced short TR/TE FS SE techniques. MR findings were compared with findings of contrast-enhanced computed tomography (CT) and with pathologic findings in all patients. The sensitivities for detection of renal masses with gadolinium-enhanced FS (71 of 71 lesions) and with gadolinium-enhanced short TR/TE conventional (65 of 71 lesions) SE sequences were significantly (P less than .01) greater than with any unenhanced (short TR/TE conventional [40 of 71 lesions], or long TR/TE [39 of 71 lesions]) SE sequence. Lesion characterization was also best with the gadolinium-enhanced FS SE sequence (65 of 71 lesions correctly classified). When combined pre- and postcontrast short TR/TE FS SE images were analyzed with both qualitative (visual) and quantitative (region-of-interest measurements) assessment, lesion characterization improved even further (70 of 71 lesions were correctly characterized). All lesions detected with CT were visualized with the gadolinium-enhanced FS SE MR sequence, which in addition depicted seven cysts and two small renal cell carcinomas. In summary, the use of gadopentetate dimeglumine, especially when combined with the FS technique, was superior to unenhanced MR imaging for detection and characterization of renal lesions.     

Short TI inversion-recovery imaging of the liver: pulse-sequence optimization and comparison with spin-echo imaging

Magnitude-reconstructed short inversion-time (TI) inversion-recovery (IR) sequences have the advantage of reducing the signal of fat while providing additive T1 and T2 contrast. A double-echo short TI IR sequence was implemented to offer different degrees of T1- and T2-dependent image contrast. In 50 consecutive patients with proved liver tumors (30 metastases, 13 hemangiomas, seven other primary liver tumors), images obtained with a double-echo IR sequence at a repetition time (TR) of 1,500 msec, echo time (TE) of 30 and 60 msec, and TI of 80 msec (TR/TE/TI = 1,500/30, 60/80) were compared with those obtained with spin-echo (SE) sequences at a TR of 275 msec and a TE of 14 msec (TR/TE = 275/14) and 2,350/60, 120, 180. Metastases-liver contrast-to-noise ratios were highest at SE 275/14, followed by IR 1,500/30/80 and SE 2,350/180. IR 1,500/30/80 and SE 275/14 sequences consistently showed higher sensitivity for the detection of metastases than T2-weighted SE sequences. Differential diagnosis of benign and malignant lesions was more reliable with T2-weighted SE sequences than T2-weighted short TI IR sequences.