Short echo time 1H MRSI of the human brain at 3T with adiabatic slice‐selective refocusing pulses; reproducibility and variance in a dual center setting

Purpose:

To assess the reproducibility of ¹H‐MR spectroscopic imaging (MRSI) of the human brain at 3T with volume selection by a double spin echo sequence for localization with adiabatic refocusing pulses (semi‐LASER).

Materials and Methods:

Twenty volunteers in two different institutions were measured twice with the same pulse sequence at an echo time of 30 msec. Magnetic resonance (MR) spectra were analyzed with LCModel with a simulated basis set including an experimentally acquired macromolecular signal profile. For specific regions in the brain mean metabolite levels, within and between subject variance, and the coefficient of variation (CoV) were calculated (for taurine, glutamate, total N‐acetylaspartate, total creatine, total choline, myo‐inositol + glycine, and glutamate + glutamine).

Results:

Repeated measurements showed no significant differences with a paired t‐test and a high reproducibility (CoV ranging from 3%–30% throughout the selected volume). Mean metabolite levels and CoV obtained in similar regions in the brain did not differ significantly between two contributing institutions. The major source of differences between different measurements was identified to be the between‐subject variations in the volunteers.

Conclusion:

We conclude that semi‐LASER ¹H‐MRSI at 3T is an adequate method to obtain quantitative and reproducible measures of metabolite levels over large parts of the brain, applicable across multiple centers. J. Magn. Reson. Imaging 2010;31:61–70. © 2009 Wiley‐Liss, Inc.     

Semi‐LASER localized dynamic 31P magnetic resonance spectroscopy in exercising muscle at ultra‐high magnetic field

Magnetic resonance spectroscopy (MRS) can benefit from increased signal‐to‐noise ratio (SNR) of high magnetic fields. In this work, the SNR gain of dynamic ³¹P MRS at 7 T was invested in temporal and spatial resolution. Using conventional slice selective excitation combined with localization by adiabatic selective refocusing (semi‐LASER) with short echo time (TE = 23 ms), phosphocreatine quantification in a 38 mL voxel inside a single exercising muscle becomes possible from single acquisitions, with SNR = 42 ± 4 in resting human medial gastrocnemius. The method was used to quantify the phosphocreatine time course during 5 min of plantar flexion exercise and recovery with a temporal resolution of 6 s (the chosen repetition time for moderate T₁ saturation). Quantification of inorganic phosphate and pH required accumulation of consecutively acquired spectra when (resting) Pi concentrations were low. The localization performance was excellent while keeping the chemical shift displacement acceptably small. The SNR and spectral line widths with and without localization were compared between 3 T and 7 T systems in phantoms and in vivo. The results demonstrate that increased sensitivity of ultra‐high field can be used to dynamically acquire metabolic information from a clearly defined region in a single exercising muscle while reaching a temporal resolution previously available with MRS in non‐localizing studies only. The method may improve the interpretation of dynamic muscle MRS data. Magn Reson Med, 2011. © 2011 Wiley‐Liss, Inc.     

SPECIAL semi‐LASER with lipid artifact compensation for 1H MRS at 7 T

The measurement of full metabolic profiles at ultrahigh fields including low concentrated or fast‐relaxing metabolites is usually achieved by applying short echo time sequences. One sequence beside stimulated echo acquisition mode that was proposed in this regard is spin echo full intensity‐acquired localized spectroscopy. Typical problems that are still persistent for spin echo full intensity‐acquired localized spectroscopy are B₁ inhomogeneities especially for signal acquisition with surface coils and chemical shift displacement artifacts due to limited B₁ amplitudes when using volume coils. In addition, strong lipid contaminations in the final spectrum can occur when only a limited number of outer volume suppression pulses is used. Therefore, an adiabatic short echo time (= 19 ms) spin echo full intensity‐acquired localized spectroscopy semilocalization by adiabatic selective refocusing sequence is presented that is less sensitive to strong B₁ variations and that offers increased excitation and refocusing pulse bandwidths than regular spin echo full intensity acquired localized spectroscopy. Furthermore, the existence of the systematic lipid artifact is identified and linked to unfavorable effects due to the preinversion localization pulse. A method to control this artifact is presented and validated in both phantom and in vivo measurements. The viability of the proposed sequence was further assessed for in vivo measurements by scanning 17 volunteers using a surface coil and moreover acquiring additional volume coil measurements. The results show well‐suppressed lipid artifacts, good signal‐to‐noise ratio, and reproducible fitting results in accordance with other published studies. Magn Reson Med, 2013. © 2012 Wiley Periodicals, Inc.     

Rapid quantification of myocardial lipid content in humans using single breath‐hold 1H MRS at 3 Tesla

A rapid, proton magnetic resonance spectroscopy method to evaluate human myocardial lipid levels in a single breath‐hold at 3 T using a commercial whole‐body system is presented. During a 10 s breath‐hold, water unsuppressed and suppressed spectra were acquired by two phased array coils using a short‐echo time spectroscopic stimulated echo (STEAM) sequence electrocardiogram‐triggered to mid‐diastole. Lipid‐to‐water ratios were obtained in the septum of 15 healthy volunteers, (0.46 ± 0.19)%. These results agreed well with ratios obtained from averaged spectra acquired in seven multiple breath‐holds, (0.45 ± 0.20)%, providing increased signal‐to‐noise ratio but requiring longer acquisition times. Excellent correlation was found between the two methods (r = 0.94, P < 0.05). Reproducibility of ¹H MRS for measuring myocardial lipid levels in a short breath‐hold was acceptable in five repeated measurements within the same subject (coefficient of variation = 19%). Thus, single breath‐hold proton spectroscopy allows reliable and quick quantification of myocardial lipids at 3 T. Magn Reson Med, 2011. © 2011 Wiley‐Liss, Inc.     

Very short echo time improves the precision of glutamate detection at 3T in 1H magnetic resonance spectroscopy

Purpose:

To examine the precision of glutamate detection using a very short echo time (TE) phase rotation STEAM (PR‐STEAM) sequence.

Materials and Methods:

Spectrosopic data were acquired from the anterior cingulate gyrus in nine healthy adults using 6.5‐msec TE PR‐STEAM, 40‐msec TE PRESS, 72‐msec TE STEAM, and TE‐Averaging with an effective TE of 105 msec on a clinical 3T magnetic resonance imaging (MRI) system. All data were quantified using LCModel and reported as ratios relative to total creatine.

Results:

Glutamate Cramer‐Rao lower bounds were less than 8% for all sequences. The 6.5‐msec TE PR‐STEAM identified glutamate with the greatest precision (coefficient of variation [CV] of 7.1%), followed by TE‐Averaging (CV of 8.9%), 40‐msec TE PRESS (CV of 11.9%), and 72‐msec TE STEAM (CV of 13.8%).

Conclusion:

In the absence of spectral editing, glutamate is best detected in the human brain at 3T using very short TEs. J. Magn. Reson. Imaging 2011;. © 2011 Wiley‐Liss, Inc.     

Efficient spectral editing at 7 T: GABA detection with MEGA-sLASER

At high field (7 T) spectral editing of γ‐aminobutyric acid with MEGA‐point‐resolved spectroscopy is inefficient due to the large chemical shift displacement error. In this article, a new pulse sequence is designed which has minimal chemical shift displacement error to perform an efficient spectral editing of the γ‐aminobutyric acid 3.0 ppm resonance at 7 T. The sequence consists of the conventional MEGA editing pulses and a semi‐localized by adiabatic selective refocusing sequence. Phantom and in vivo measurements demonstrated an efficient detection of γ‐aminobutyric acid. Using ECG triggering, excellent in vivo performance of the MEGA‐semi‐localized by adiabatic selective refocusing (MEGA‐sLASER) provided well‐resolved γ‐aminobutyric acid signals in 27 mL volumes in the human brain at an echo time of 74 ms within a relatively short acquisition time (5 min). Furthermore, the high efficiency of the MEGA‐sLASER was demonstrated by acquiring small volumes (8 mL) at an echo time of 74 ms, as well as long echo time measurements (222 ms in 27 mL volume). Magn Reson Med, 2012. © 2011 Wiley Periodicals, Inc.     

Interindividual,repositioning, and time‐of‐day effects on single voxel proton MR spectroscopy of the anterior cingulate cortex

Purpose:

To measure interindividual, repositioning, and time‐of‐day effects of single voxel PRESS (P oint RES olved S pectroscopy) proton magnetic resonance spectroscopy (¹H‐MRS) acquisition of the anterior cingulate cortex (AC) in healthy human subjects.

Materials and Methods:

AC ¹H‐MRS measurements were performed in 15 healthy adult volunteers using a short echo PRESS sequence (GE Healthcare 3 Tesla, TE/TR = 30/2500 ms, 192 acquisitions, 6 cm³ voxels). For each individual, a total of eight spectra were obtained during two identical scanning sessions separated by 3.5 h. In each, two consecutive AC spectra were acquired. After the first two scans, the subject left the scanner, then immediately returned for repositioning and acquisition of two more consecutive spectra. The subject then left the imaging centre to return 3.5 h later for a repeated procedure. Spectroscopic postprocessing was done using LCmodel. Interindividual, repositioning and time‐of‐day effects were measured using restricted maximum likelihood (REML) models of variance components analysis, where response variables were levels of creatine/phosphocreatine (Cr), N‐acetyl‐aspartate (NAA), myo‐inositol (mI), choline (Cho), and the glutamate‐glutamine complex (Glx).

Results:

Interindividual effects were markedly higher than time‐of‐day and repositioning effects for all metabolites.

Conclusion:

Our findings show that ¹H‐MRS measurements of the AC are sensitive to interindividual differences, while time of day and repositioning are markedly less important. J. Magn. Reson. Imaging 2010;32:276–282. © 2010 Wiley‐Liss, Inc.     

Restoration of motion-related signal loss and line-shape deterioration of proton MR spectra using the residual water as intrinsic reference.

A postprocessing method to restore motion-related signal loss and line-shape deterioration in single-volume proton MR spectroscopy (MRS) is presented. Each acquisition is corrected by its phase offset and frequency shift, extracted from the residual water signal prior to averaging. Requirements are good gradient selection and selective suppression of CSF in residual water. Stimulated echo acquisition mode (STEAM) spectra (TE = 30 ms) were analyzed using the LCModel program to study gains in metabolite signal and spectral quality in five brain regions. Increases of total N-acetyl-aspartate concentrations of up to 5% were observed. The method may be beneficial for clinical examinations of less compliant subjects and for dynamic spectroscopy.     

High resolution localized two‐dimensional MR spectroscopy in mouse brain in vivo

Localized two‐dimensional MR spectroscopy (2D MRS) is impacting the in vivo studies of brain metabolites due to improved spectral resolution and unambiguous assignment opportunities. Despite the large number of transgenic mouse models available for neurological disorders, localized 2D MRS has not yet been implemented in the mouse brain due to size constraints. In this study we optimized a localized 2D proton chemical shift correlated spectroscopic sequence at field strength of 9.4T to obtain highly resolved 2D spectra from localized regions in mouse brains in vivo. The combination of the optimized 2D sequence, high field strength, strong gradient system, efficient water suppression, and the use of a short echo time allowed clear detection of cross‐peaks of up to 16 brain metabolites, allowing their direct chemical shift assignments in vivo. To our knowledge this is the first in vivo 2D MRS study of the mouse brain, demonstrating its feasibility to resolve and simultaneously assign several metabolite resonances in the mouse brain in vivo. Implementation of 2D MRS will be invaluable in the identification of new biomarkers during disease progression and treatment using the various available mouse models. Magn Reson Med 60:449–456, 2008. © 2008 Wiley‐Liss, Inc.     

Comparative reliability of proton spectroscopy techniques designed to improve detection of J‐coupled metabolites

Improved detection of J‐coupled neurometabolites through the use of modified proton magnetic resonance spectroscopy (1H‐MRS) techniques has recently been reported. TE‐averaged point‐resolved spectroscopy (PRESS) uses the J modulation effects by averaging FIDs with differing echo times to improve detection of glutamate, while standard PRESS detection of glutamate can be improved by using an appropriate single echo determined from J‐modulation simulations. In the present study, the reliabilities of TE‐averaged PRESS, standard PRESS with TE = 40 ms, and standard PRESS with TE = 30 ms in detecting metabolite levels in the cingulate gyrus of the human brain at 3T were compared in six subjects. TE‐averaged PRESS measures showed a mean variability of 9% for N‐acetyl aspartate, choline, and creatine, compared with < 4% for the 30‐ and 40‐ms PRESS techniques. The coefficients of variation for glutamate were 10%, 7%, and 5% for TE‐averaged, 30‐ms, and 40‐ms PRESS, respectively. PRESS with a TE of 40 ms also demonstrated improved reliability for GABA and glutamine concentrations. These results show that with the appropriate selection of echo time standard PRESS can be a reliable ¹H‐MRS technique for the measurement of J‐coupled neurometabolites in the human brain and, moreover, compares favorably with at least one J‐edited technique. Magn Reson Med 60:964–969, 2008. © 2008 Wiley‐Liss, Inc.     

A simple low‐SAR technique for chemical‐shift selection with high‐field spin‐echo imaging

We have discovered a simple and highly robust method for removal of chemical shift artifact in spin‐echo MR images, which simultaneously decreases the radiofrequency power deposition (specific absorption rate). The method is demonstrated in spin‐echo echo‐planar imaging brain images acquired at 7 T, with complete suppression of scalp fat signal. When excitation and refocusing pulses are sufficiently different in duration, and thus also different in the amplitude of their slice‐select gradients, a spatial mismatch is produced between the fat slices excited and refocused, with no overlap. Because no additional radiofrequency pulse is used to suppress fat, the specific absorption rate is significantly reduced compared with conventional approaches. This enables greater volume coverage per unit time, well suited for functional and diffusion studies using spin‐echo echo‐planar imaging. Moreover, the method can be generally applied to any sequence involving slice‐selective excitation and at least one slice‐selective refocusing pulse at high magnetic field strengths. The method is more efficient than gradient reversal methods and more robust against inhomogeneities of the static (polarizing) field (B₀). Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.     

In vivo localized 1H MR spectroscopy of rat testes: stimulated echo acquisition mode (STEAM) combined with short TI inversion recovery (STIR) improves the detection of metabolite signals.

A noninvasive NMR technique for evaluating testicular function was explored in this study. Localized in vivo 1H NMR spectroscopy was performed on rat testes using a stimulated echo acquisition mode (STEAM) sequence with a short echo time (TE). In the 1H spectra, large lipid signals dominated the chemical shift range of 0.89-2.78 ppm, which prevented the observation of metabolite signals in this region. To suppress these lipid signals, short inversion time (TI) inversion recovery (STIR) was combined with STEAM (STIR-STEAM). The optimal TI was typically 320 ms. STIR-STEAM with a TE of 15 ms allowed successful suppression of the lipid signals and the sensitive detection of several new metabolite signals. In normal testes, choline, creatine, glutamate, and glycine signals were identified. In addition to these metabolites, a lactate signal was observed in ischemic testes. To our knowledge, the signals of glutamate, glycine, and lactate have not been previously assigned in 1H MR spectra of testes in vivo. Lipid suppression by STIR aided in the detection of these metabolites, which would otherwise have been masked by the lipid signals.     

Spin‐echo magnetic resonance spectroscopic imaging at 7 T with frequency‐modulated refocusing pulses

Two approaches to high‐resolution SENSE‐encoded magnetic resonance spectroscopic imaging (MRSI) of the human brain at 7 Tesla (T) with whole‐slice coverage are described. Both sequences use high‐bandwidth radiofrequency pulses to reduce chemical shift displacement artifacts, SENSE‐encoding to reduce scan time, and dual‐band water and lipid suppression optimized for 7 T. Simultaneous B₀ and transmit B₁ mapping was also used for both sequences to optimize field homogeneity using high‐order shimming and determine optimum radiofrequency transmit level, respectively. One sequence (“Hahn‐MRSI”) used reduced flip angle (90°) refocusing pulses for lower radiofrequency power deposition, while the other sequence used adiabatic fast passage refocusing pulses for improved sensitivity and reduced signal dependence on the transmit‐B₁ level. In four normal subjects, adiabatic fast passage‐MRSI showed a signal‐to‐noise ratio improvement of 3.2 ± 0.5 compared to Hahn‐MRSI at the same spatial resolution, pulse repetition time, echo time, and SENSE‐acceleration factor. An interleaved two‐slice Hahn‐MRSI sequence is also demonstrated to be experimentally feasible. Magn Reson Med, 2013. © 2012 Wiley Periodicals, Inc.     

Observation of coupled 1H metabolite resonances at long TE.

A PRESS localization (1)H MRS acquisition sequence with a Carr-Purcell train of refocusing pulses (CP-PRESS) has been implemented using global refocusing "sandwich" pulses. The CP pulse train minimized the effects of J-coupled dephasing in metabolites with strongly coupled, multiplet resonance groups as demonstrated in both phantom data and in vivo single-voxel spectroscopy in normal volunteers. Metabolites with multiplet resonance patterns were maintained with greater signal to noise and a simpler resonance pattern at long echo times. T(2) decay times for metabolites with singlet and multiplet resonances were similar to published values, except for the NAA multiplet at 2.5 ppm, which had a significantly shorter T(2) value (147 ms) than that typically reported for the singlet at 2.01 ppm. Metabolite-nulled spectra were acquired in normal volunteers to evaluate the effects of CP-PRESS on baseline signal contributions from residual water, lipids, and macromolecules. The T(2) decay times in four baseline regions in data acquired with the CP-PRESS sequence showed longer decays than corresponding regions in metabolite-nulled spectra from a standard PRESS sequence, but were significantly diminished long before the metabolites of interest were gone. The spectral analysis for spectra with longer TE times also showed less variability due the higher metabolite SNR, simpler spectral patterns, and the decreased baseline contributions.     

Maturation of the human fetal brain as observed by 1H MR spectroscopy.

Proton MRS was used to monitor cerebral metabolite tissue levels in 35 normal fetuses during development in the gestational age range of 30-41 weeks. First, MRI in three orthogonal orientations was performed. A volume of interest (VOI) (15-43 cc) of fetal brain tissue was then selected for (1)H MRS. For localization, two pulse sequences (stimulated echo acquisition mode (STEAM) at TE = 20 ms, and point-resolved spectroscopy (PRESS) at TE = 135 ms) were applied. The MR spectra of the brain showed signals for inositol (Ino), choline (Cho), creatine (Cr), and N-acetyl (NA) compounds. From 30 to 41 weeks the absolute tissue level of NA, and the ratios of NA/Cr and NA/Cho increased, whereas the ratio of Cho/Cr decreased. These changes reflect maturation of the brain. Considering the diagnostic value of proton MRS in pediatric neurology, this new approach may also be useful for characterizing pathological conditions in the fetal brain.     

Quantitative proton short-echo-time LASER spectroscopy of normal human white matter and hippocampus at 4 Tesla incorporating macromolecule subtraction.

Accurate quantification of in vivo short-echo-time (TE) (1)H spectra must account for contributions from both mobile metabolites and less mobile macromolecules, which can fluctuate in disease. The purpose of this study was to develop an approach for the acquisition and processing of macromolecule information to optimize metabolite quantification accuracy and precision. Human parietal white matter (8-cm(3) voxel) and posterior hippocampus (1.7-cm(3) voxel) metabolite levels were quantified, following manomolecule subtraction, from short-echo-time spectra (TE = 46 ms) acquired at 4.0 Tesla with localization by adiabatic selective refocusing (LASER). Nineteen metabolites were fit using a time domain Levenberg-Marquardt minimization that incorporated prior knowledge of metabolite lineshapes. The macromolecule contribution to the spectrum was reduced by 87% (P < 0.05) when the acquisition of single averages of the full spectrum and macromolecule spectrum were interleaved to reduce subtraction errors due to motion. Subtracting the Hankel Lanczos singular value decomposition (HLSVD) fit of the macromolecule spectrum, which contained no random noise, did not alter quantified metabolite levels but did not increase metabolite quantification precision. Several metabolites had higher concentrations in the posterior hippocampus compared to parietal white matter, which emphasizes the need to carefully control for partial volume contamination in hippocampal spectroscopy studies.     

Band-selective spin echoes for in vivo localized 1H NMR spectroscopy

This study describes a new single spin-echo spatial localization sequence, BASSALE or BAnd-Selective Spin echo Acquisition for Localized Editing, that overcomes a number of the limitations of the STEAM and PRESS volume selection pulse sequences. It achieves conformal volume localization in a single shot by spatially tailored suppression of all magnetization outside a 2D region of interest followed by selection of a single orthogonal slice. This separation of spatial localization from the echo formation process has permitted use of a spectrally selective cosine-modulated sinc refocusing pulse to acquire localized ¹H spectra with the water suppression efficiency of STEAM and the sensitivity of PRESS. Echoes formed by such spectrally selective pulses have been termed bandselective spin echoes. The BASSALE sequence attains shorter echo times than PRESS, inhibits scalar spin-spin interactions to permit localized editing and T₂ relaxometry of metabolites with J-coupled spins (e.g., lactate), is insensitive to homonuclear multiple-quantum and polarization transfer effects, and can be made sensitive or insensitive to spin displacement effects. Applications are shown both with phantoms and in situ in the rat brain.     

Time‐efficient fast spin echo imaging at 4.7 T with low refocusing angles

An implementation of fast spin echo at 4.7 T designed for versatile and time‐efficient T₂‐weighted imaging of the human brain is presented. Reduced refocusing angles (α < 180°) were employed to overcome specific absorption rate (SAR) constraints and their effects on image quality assessed. Image intensity and tissue contrast variations from heterogeneous RF transmit fields and incidental magnetization transfer effects were investigated at reduced refocusing angles. We found that intraslice signal variations are minimized with refocusing angles near 180°, but apparent gray/white matter contrast is independent of refocusing angle. Incidental magnetization transfer effects from multislice acquisitions were shown to attenuate white matter intensity by 25% and gray matter intensity by 15% at 180°; less than 5% attenuation was seen in all tissues at flip angles below 60°. We present multislice images acquired without excess delay time for SAR mitigation using a variety of protocols. Subsecond half Fourier acquisition single‐shot turbo spin echo (HASTE) images were obtained with a novel variable refocusing angle echo train (20° < α < 58°) and high‐resolution scans with a voxel volume of 0.18 mm³ were acquired in 6.5 min with refocusing angles of 100°. Magn Reson Med, 2009. © 2009 Wiley‐Liss, Inc.     

In vivo metabolite profile of adult zebrafish brain obtained by high‐resolution localized magnetic resonance spectroscopy

Purpose

To optimize high‐resolution MR spectroscopy (MRS) for obtaining neurochemical composition of adult zebrafish brain in vivo.

Materials and Methods

A flow‐through setup for supporting MRS of living zebrafish has been designed. In vivo MR microscopy (MRM) images were obtained using a rapid acquisition with relaxation enhancement (RARE) sequence to select a volume of interest. In vivo MR spectra from zebrafish brain were obtained using an optimized point‐resolved spectroscopy (PRESS) sequence preceded by a variable pulse power and optimized relaxation delays (VAPOR) sequence for global water suppression interleaved with outer volume suppression (OVS). In vitro MR spectra in the brain extract were obtained by using correlated spectroscopy (COSY) sequences.

Results

Optimized high‐resolution localized MRS at 9.4T in conjunction with a strong gradient system, efficient shimming, and the water suppression scheme resulted in a reasonable separation of resonances from various metabolites in vivo from a voxel as small as 3.3 μL placed in the zebrafish brain. In addition, more than 14 metabolites were identified in adult zebrafish brain extracts.

Conclusion

We have successfully optimized a high‐resolution localized in vivo MRS technique to get access to the zebrafish brain, and obtained for the first time the neurochemical composition of the zebrafish brain. J. Magn. Reson. Imaging 2009;29:275–281. © 2009 Wiley‐Liss, Inc.     

Effect of PRESS and STEAM sequences on magnetic resonance spectroscopic liver fat quantification

Purpose

To compare PRESS and STEAM MR spectroscopy for assessment of liver fat in human subjects.

Materials and Methods

Single‐voxel (20 × 20 × 20 mm) PRESS and STEAM spectra were obtained at 1.5T in 49 human subjects with known or suspected fatty liver disease. PRESS and STEAM sequences were obtained with fixed TR (1500 msec) and different TE (five PRESS spectra between TE 30‐70 msec, five STEAM spectra between TE 20–60 msec). Spectra were quantified and T2 and T2‐corrected peak area were calculated by different techniques. The values were compared for PRESS and STEAM.

Results

Water T2 values from PRESS and STEAM were not significantly different (P = 0.33). Fat peak T2s were 25%–50% shorter on PRESS than on STEAM (P < 0.02 for all comparisons) and there was no correlation between T2s of individual peaks. PRESS systematically overestimated the relative fat peak areas (by 7%–263%) compared to STEAM (P < 0.005 for all comparisons). The peak area given by PRESS was more dependent on the T2‐correction technique than STEAM.

Conclusion

Measured liver fat depends on the MRS sequence used. Compared to STEAM, PRESS underestimates T2 values of fat, overestimates fat fraction, and provides a less consistent fat fraction estimate, probably due to J coupling effects. J. Magn. Reson. Imaging 2009;30:145–152. © 2009 Wiley‐Liss, Inc.