Comparison of a single shot T1-weighted in- and out-of-phase magnetization prepared gradient recalled echo with a standard two-dimensional gradient recalled echo: preliminary findings

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.     

Comparison of fat quantification methods: a phantom study at 3.0T

PURPOSE: To compare different imaging methods with single-voxel MR spectroscopy (MRS) for the quantification of fat content in phantoms at 3.0T. MATERIALS AND METHODS: Imaging and spectroscopy was performed on a GE Signa system. Eleven novel homogeneous fat-water phantoms were constructed with variation in fat content from 0% to 100%. These were imaged using three techniques and compared with single-voxel non-water-suppressed MRS. Pixel-by-pixel maps of fat fraction were produced and mean values compared to MRS-determined measurements. Preliminary in vivo examinations were subsequently performed in the breast and spine to compare the best imaging technique with MRS. RESULTS: All imaging methods significantly correlated with MRS (P < 0.001): IDEAL (r(2) = 0.985), IOP (r(2) = 0.888), WS (r(2) = 0.939), and FS (r(2) = 0.938). In addition, IDEAL provided artifact-free maps of fat fraction with superior uniformity. In vivo results using IDEAL produced values that were between 9% to 16% of the corresponding MRS values. CONCLUSION: This work demonstrates that imaging may be utilized as a high-resolution alternative to MRS for the quantification of fat content. In the future we intend to replace MRS with IDEAL in our clinical studies involving fat measurement.     

Invited. Ultrafast T2-weighted imaging of the abdomen and pelvis: Use of single shot fast spin-echo imaging

Single shot (SS) rapid acquisition with relaxation enhancement (RARE) and half Fourier SS-RARE (HFSS-RARE, HASTE, or SS-FSE) sequences allow ultrafast imaging acquisition and generate high imaging quality. Images can be acquired within a very short time, without artifacts from physiologic motion. They are widely applied in the abdominal MRI. Clinical application of the ultrafast SS-RARE imaging techniques provide not only improved temporal resolution but better spatial resolution, higher SNR, and higher tissue contrast. Imaging parameters must be optimized for different MR scanners to obtain diagnostic images.     

Age, gender, and skeletal variation in bone marrow composition: a preliminary study at 3.0 Tesla

PURPOSE: To evaluate the efficacy of MR Spectroscopy (MRS) at 3.0 Tesla for the assessment of normal bone marrow composition and assess the variation in terms of age, gender, and skeletal site. MATERIALS AND METHODS: A total of 16 normal subjects (aged between eight and 57 years) were investigated on a 3.0 Tesla GE Signa system. To investigate axial and peripheral skeleton differences, non-water-suppressed spectra were acquired from single voxels in the calcaneus and lumbar spine. In addition, spectra were acquired at multiple vertebral bodies to assess variation within the lumbar spine. Data was also correlated with bone mineral density (BMD) measured in six subjects using dual-energy X-ray absorptiometry (DXA). RESULTS: Fat content was an order of magnitude greater in the heel compared to the spine. An age-related increase was demonstrated in the spine with values greater in men compared to female subjects. Significant trends in vertebral bodies within the same subjects were also shown, with fat content increasing L5 > L1. Population coefficient of variation (CV) was greater for fat fraction (FF) compared to BMD. CONCLUSION: Significant normal variations of marrow composition have been demonstrated, which provide important data for the future interpretation of patient investigations.     

GRE OP和SE T1加权像在腰椎间盘突出症中的检查对比

目的比较梯度回波反相位T1加权(GRE OP T1WI)和自旋回波T1加权(SE T1WI)在腰椎间盘突出症中的应用效果。方法50例腰椎间盘突出症患者进行GRE OP T1WI和SE T1WI扫描。分别观察正常椎体、椎间盘、脑脊液、脊髓、腰椎附件在GREOP T1WI的表现,并对GRE OP T1WI和SE T1WI序列对突出椎间盘的信号和显示的清晰度进行比较。结果GRE OP T1WI所有椎间盘的信号均高于SE T1WI,GRE OP T1WI对椎间盘突出的显示比SE T1WI更清晰。结论GRE OP T1WI比SE T1WI更清晰快速地显示椎间盘突出症。     

T2-weighted breath-hold MRI of the liver at 1.0 T: Comparison of turbo spin-echo and HASTE sequences with and without fat suppression

To compare the clinical usefulness of T2-weighted breath-hold sequences for imaging the liver, 33 patients with 97 focal hepatic lesions were studied with a 1.0-T scanner by using T2-weighted breath-hold turbo spin-echo (SE) sequences and T2-weighted breath-hold half-Fourier single-shot turbo SE (HASTE) sequences with and without fat suppression. Images were quantitatively analyzed for liver signal-to-noise ratio (SNR) and lesion-to-liver contrast-to-noise ratios (CNR). Qualitative analysis was performed for lesion conspicuity, motion artifacts, and anatomic sharpness of extrahepatic structures. Breath-hold turbo SE imaging with fat suppression showed the highest CNR for cystic lesions and the best lesion conspicuity for cystic and solid lesions among the four sequences. For solid lesions, there was no significant difference of lesion-to-liver CNR between them. HASTE sequence was superior to turbo SE sequences in terms of motion artifacts; however, the usefulness for evaluating focal hepatic lesions was limited compared with turbo SE sequence with fat suppression. Addition of fat suppression was not helpful for HASTE imaging because of decreased lesion conspicuity and extrahepatic details without the advantage of reducing motion artifacts. This study suggests that turbo SE sequence with fat suppression is most useful for breath-hold T2-weighted liver imaging at 1.0 T. Addition of imaging without fat suppression can be considered for evaluating extrahepatic structures. HASTE sequence may have a role for imaging uncooperative patients due to absence of motion artifacts.     

3.0T磁共振IVIM-DWI参数与直肠中分化腺癌T分期相关性的初步研究

目的：探讨3.0T MR 体素内不相干运动-扩散加权成像(IVIM-DWI)参数与直肠中分化腺癌 T 分期的关系。方法收集37例直肠中分化腺癌患者的直肠 MRI 图像(包括 IVIM-DWI 序列)及临床资料;根据肿瘤是否突破固有肌层,将 T 分期分为未突破组(T1、T2期)和突破组(T3、T4期);测量直肠癌与正常直肠壁真实扩散系数(D)、假扩散系数(D?)、灌注分数(f)和表观扩散系数(ADC)值,比较直肠癌与正常直肠壁,不同 T 分期,不同分组直肠癌各参数值之间的差异,分析 IVIM-DWI 参数和 ADC 值与直肠中分化腺癌 T 分期的关系。结果直肠癌的 D、D?、f 和 ADC 值均低于正常直肠壁,其中 D、f 和 ADC 值差异有统计学意义(P <0.05);不同 T 分期肿瘤 D 和 D?值的差异有统计学意义,LSD 法两两比较显示 T1期与 T4期,T3期与 T4期肿瘤的 D?值差异有统计学意义(P =0.017、0.003),T2期与 T3期肿瘤 D 值差异有统计学意义(P =0.005);未突破组与突破组肿瘤 D 值分别约(0.93±0.16)×10-3 mm2/s、(0.77±0.19)×10-3 mm2/s,D?值分别约(12.6±2.44)×10-3 mm2/s、(12.3±3.49)×10-3 mm2/s,f值分别约(27.1±2.94)%、(24.6±4.13)%,ADC 值分别约(0.95±0.09)×10-3 mm2/s、(0.87±0.12)×10-3 mm2/s,其中 D 值的差异有统计学意义(t=2.512,P =0.017)。结论IVIM-DWI 参数和 ADC 值能够区分直肠癌和正常直肠壁,D 值可以辅助鉴别直肠癌是否突破固有肌层。     

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.     

Monitoring of laser and freezing-induced ablation in the liver with T1-weighted MR imaging.

During both interstitial laser ablation therapy and cryoablation therapy for liver tumors, real-time monitoring is necessary for assessment of ongoing thermal effects in tissue. With single-section images obtained every 30 seconds with a T1-weighted RARE (rapid acquisition with relaxation enhancement) sequence, signal intensity changes in both ex vivo and in vivo animal liver were readily seen. The reversible loss of signal intensity that took place during laser irradiation and the increased intensity at the beginning of cooling can be explained mainly by altered T1 due to temperature change. The frozen area was seen as a sudden decrease in signal intensity at 0 degrees C due to a T2 decrease. This preliminary work showed that the protocol provides enough temporal and temperature resolution to accurately depict the extent of thermal damage, as confirmed at histologic examination. Signal intensity decreased linearly with temperature in the range 10 degrees C-50 degrees C, yielding a pixel-to-pixel temperature resolution of 5.37 degrees C.     

Solitary hepatic metastasis: Comparison of dynamic contrast-enhanced CT and MR imaging with fat-suppressed T2-weighted,Breath-hold T1-weighted FLASH,and dynamic gadolinium-enhanced FLASH sequences

Twenty consecutive cancer patients with a solitary hepatic metastasis detected with dynamic contrast-material—enhanced computed tomography (CT) who were considered for hepatic resection underwent magnetic resonance (MR) imaging within 18 days after CT. Histologic confirmation was obtained in all lesions. CT depicted 20 solitary lesions. MR imaging showed a solitary lesion in 14 patients, two lesions in three patients, and more than two lesions in three patients, for a total of 37 lesions. Twenty-three lesions less than 2 cm in diameter were missed with CT, and six lesions less than 1.3 cm in diameter were missed with MR imaging. MR imaging was superior to CT in the detection of hepatic metastases on a patient-by-patient basis (P <.01). The results suggest that MR imaging is superior to dynamic contrast-enhanced CT for the detection of hepatic metastases.     

Contrast-enhanced peripheral MR angiography at 3.0 Tesla: initial experience with a whole-body scanner in healthy volunteers

PURPOSE: To report preliminary experience with contrast-enhanced magnetic resonance angiography (CE-MRA) of the peripheral arteries on a 3.0 T whole-body scanner equipped with a prototype body coil. MATERIALS AND METHODS: Four healthy volunteers were imaged on the 3.0 T system and, for comparative purposes, two of the subjects were also imaged on a commercially available 1.5 T whole-body system. To investigate field strength influence on objective image quality, signal-to-noise (SN) and contrast-to-noise (CN) ratios were calculated for named vessels from the infrarenal aorta to the ankles at both field strengths. Comparable imaging protocols were used at both field strengths. In addition, two reviewers, blinded for field strength, gave subjective image quality scores (three-point scale). RESULTS: SN and CN ratios were approximately equal on both systems (variation < or =9%) for the iliac and proximal upper leg stations. For the popliteal and lower leg stations SN ratios were 36% and 97% higher, and CN ratios were 44% and 127% higher, at 3.0 T. Subjective image quality at 3.0 T was substantially better for the distal upper and lower legs. CONCLUSION: Contrast-enhanced peripheral MRA is possible at 3.0 T when an imaging protocol similar to a current state-of-the-art 1.5 T protocol is used. Objective and subjective image quality at 3.0 T is comparable for the iliac and upper legs but better for the popliteal and lower leg arteries.     

Liver-vessel cancellation artifact on in-phase and out-of-phase MRI imaging: a sign of ultra-high liver fat content

Purpose:

To describe a new MRI sign, the liver‐vessel cancellation artifact, on In‐Phase and Out‐of‐Phase gradient‐echo sequences related to ultra‐high liver fat content (>90%) by qualitative histology.

Materials and Methods:

Institutional review board approval was obtained for this retrospective HIPAA‐compliant study with waived informed consent. Patients with liver steatosis were searched in MRI (n = 195) and pathology (n = 116) databases between January 1, 2008, and June 20, 2010. Two readers blindly reviewed all MR images for the presence of the liver‐vessel cancellation sign. Cross‐reference of patients with biopsy‐proven steatosis and MRI within one month was performed (n = 54; 25 males, 29 females; mean age 41.0 ± 18.9), with a population of 6 patients with ultra‐high liver fat content (1 male, 5 females; mean age 15.5 ± 11.2). Performance diagnostic tests, including sensitivity and specificity, were performed.

Results:

Liver‐vessel cancellation sign was present in all patients with ultra‐high liver fat content but in none of the remaining patients. Calculated sensitivity and specificity for the detection of ultra‐high liver fat content with this sign were 100% (95% confidence interval [CI]: 69.1–100%) and 100% (95% CI: 98.4–100%), respectively.

Conclusion:

The presence of liver‐vessel cancellation artifact around intra‐hepatic vessels is a feature of ultra‐high liver fat content. J. Magn. Reson. Imaging 2012;35:1112‐1118. © 2011 Wiley Periodicals, Inc.     

T2-weighted MR imaging of focal hepatic lesions: Comparison of various RARE and fat-suppressed spin-echo sequences

The authors prospectively compared four T2-weighted magnetic resonance (MR) sequences, including high-resolution 512 × 512 (matrix size) RARE (rapid acquisition with relaxation enhancement), 256 × 256 RARE, 128 × 256 breath-hold RARE, and 192 × 256 fat-suppressed spin-echo (T2FS) sequences, in the evaluation of 16 patients with focal hepatic masses. MR images were evaluated by quantitative lesion-liver signal difference-to-noise ratios (SDNRs) and subjective evaluation of image artifact and image quality. No significant differences were observed between RARE sequences in SDNR values. The T2FS sequence had a significantly higher SDNR than the 512 × 512 RARE sequence (24.6 ± 15.0 vs 14.5 ± 9.7) (P =.008). Image quality was rated highest for the 512 × 512 RARE and T2FS sequences (P =.006). The inherent advantage of high spatial resolution suggests that the 512 × 512 RARE sequence may be of value in detecting hepatic lesions.     

Preoperative detection of hepatic metastases: Comparison of diffusion-weighted, T2-weighted fast spin echo and gadolinium-enhanced MR imaging using surgical and histopathologic findings as standard of reference

Purpose

The purpose of this study was to retrospectively compare the respective sensitivities of diffusion-weighted (DW), T2-weighted fast spin-echo (T2WFSE) and gadolinium chelate-enhanced MR imaging in the preoperative detection of hepatic metastases using intraoperative ultrasonographic and histopathologic findings as the standard of reference.

Materials and methods

Twenty-seven patients with 64 surgically and histopathologically proven hepatic metastases had MR imaging of the liver, including DW, T2WFSE and dynamic gadolinium chelate-enhanced MR imaging. Images from each MR sequence were separately analyzed by two readers with disagreements resolved by consensus readings. The findings on MR images were compared with intraoperative ultrasonographic and histopathologic findings on a lesion-by-lesion basis to determine the sensitivity of each MR sequence. Statistical review of the lesion-by-lesion analysis was performed with the McNemar test.

Results

DW, T2WFSE and gadolinium chelate-enhanced MR imaging allowed the depiction of 54/64 (84.4%; 95% CI: 73.1-92.2%), 44/64 (68.8%; 95% CI: 55.9-79.8%), and 51/64 (79.7%; 95% CI: 67.8-88.7%) hepatic metastases respectively. DW MR images allowed depiction of significantly more hepatic metastases than did T2WFSE and was equivalent to gadolinium chelate-enhanced MR imaging (P = .002 and P = .375, respectively).

Conclusion

DW MR imaging is superior to T2WFSE imaging and equivalent to gadolinium chelate-enhanced MR imaging for the preoperative detection of hepatic metastases. Further studies however are needed to determine at what extent DW MR imaging can be used as an alternative to gadolinium chelate-enhanced MR imaging for the preoperative depiction of hepatic metastases.     

Magnetic resonance imaging of the brain with gadopentetate dimeglumine-DTPA: Comparison of T1-weighted spin-echo and 3D gradient-echo sequences

Short TR, short TE, high resolution, 3D gradient-recalled echo (GRE) imaging was evaluated for lesion detection in the brain. High resolution 3D GRE data acquisition was used to reduce partial volume effects and flow artifacts, to better visualize smaller structures, to minimize signal losses caused by field inhomogeneities, and to allow better image reformatting. Spin-echo (SE) and 3D GRE approaches were compared for lesion detection after the administration of an MR contrast agent, gadopentetate dimeglumine. Preliminary clinical studies demonstrated that the signal-to-noise ratio (SNR) in each slice of the GRE scan was worse than that of the SE scan because of the much thicker slices acquired with the SE technique. However, by averaging two adjacent 3D slices, the SNR of the two methods was essentially equivalent. In the averaged GRE slices, large lesions were seen just as well as in the SE images. More importantly, small lesions were better visualized in the thin 3D GRE images than in the thick SE images for the lesions studied in this work and the protocols used. These observations were confirmed by theoretical simulations.     

Imaging of inflammatory lesions at 3.0 Tesla in patients with clinically isolated syndromes suggestive of multiple sclerosis: a comparison of fluid-attenuated inversion recovery with T2 turbo spin-echo

The aims of this study were to determine and compare the sensitivity of T2 turbo spin-echo (T2 TSE) and fluid-attenuated inversion recovery (FLAIR) sequences at 3.0 T in the detection of inflammatory lesions in patients with clinically isolated syndromes suggestive of multiple sclerosis. Forty-nine patients were examined with a 3.0 T MRI system using 5 mm axial sections of T2 TSE (2:19 min), FLAIR (4:00 min) and pre- and postcontrast T1 spin-echo sequences (3:37 min). Brain lesions were counted and categorized according to their anatomic location. Patients were classified according to Barkhof MRI criteria for FLAIR and T2 TSE sequences. The FLAIR sequence detected more lesions in every anatomic region except for the infratentorial region. The higher sensitivity was significant for the total number of lesions (p<0.01), the juxtacortical (p<0.01), and the periventricular (p=0.01) region. A 9% increase of infratentorial lesions using the T2 TSE sequence was not significant. The higher sensitivity using the FLAIR sequence resulted in one additional MRI criterion in nine patients, whereas the better detection of infratentorial lesions using the T2 TSE sequence resulted in additional MRI criteria in three patients. In conclusion, FLAIR provides the highest sensitivity when compared with the T2 TSE, although T2 TSE still has a diagnostic relevance in terms of MRI criteria classification.     

T2-weighted MR imaging of the liver: Qualitative and quantitative comparison of SPACE MR imaging with turbo spin-echo MR imaging

Objective

To qualitatively and quantitatively compare T2-weighted MR imaging of the liver using volumetric spin-echo with sampling perfection with application-optimized contrast using different flip angle evolutions (SPACE) with conventional turbo spin-echo (TSE) sequence for fat-suppressed T2-weighted MR imaging of the liver.

Materials and methods

Thirty-three patients with suspected focal liver lesions had SPACE MR imaging and conventional fat-suppressed TSE MR imaging. Images were analyzed quantitatively by measuring the lesion-to-liver contrast-to-noise ratio (CNR), and the signal-to-noise ratio (SNR) of main focal hepatic lesions, hepatic and splenic parenchyma and qualitatively by evaluating the presence of vascular, respiratory motion and cardiac artifacts. Wilcoxon signed rank test was used to search for differences between the two sequences.

Results

SPACE MR imaging showed significantly greater CNR for focal liver lesions (median = 22.82) than TSE MR imaging (median = 14.15) (P < .001). No differences were found for SNR of hepatic parenchyma (P = .097), main focal hepatic lesions (P = .35), and splenic parenchyma (P = .25). SPACE sequence showed less artifacts than TSE sequence (vascular, P < .001; respiratory motion, P < .001; cardiac, P < .001) but needed a longer acquisition time (228.4 vs. 162.1 s; P < .001).

Conclusion

SPACE MR imaging provides a significantly increased CNR for focal liver lesions and less artifacts by comparison with the conventional TSE sequence. These results should stimulate further clinical studies with a surgical standard of reference to compare the two techniques in terms of sensitivity for malignant lesions.     

Magnetization exchange with water and T1 relaxation of the downfield resonances in human brain spectra at 3.0 T

The use of water suppression for in vivo proton MR spectroscopy diminishes the signal intensities from resonances that undergo magnetization exchange with water, particularly those downfield of water. To investigate these exchangeable resonances, an inversion transfer experiment was performed using the metabolite cycling technique for non‐water‐suppressed MR spectroscopy from a large brain voxel in 11 healthy volunteers at 3.0 T. The exchange rates of the most prominent peaks downfield of water were found to range from 0.5 to 8.9 s^?1, while the T₁ relaxation times in absence of exchange were found to range from 175 to 525 ms. These findings may help toward the assignments of the downfield resonances and a better understanding of the sources of contrast in chemical exchange saturation transfer imaging. Magn Reson Med, 2011. © 2011 Wiley‐Liss, Inc.     

Water excitation MPRAGE: an alternative sequence for postcontrast imaging of the abdomen in noncooperative patients at 1.5 Tesla and 3.0 Tesla MRI

PURPOSE: To evaluate the diagnostic image quality of postgadolinium water excitation-magnetization-prepared rapid gradient-echo (WE-MPRAGE) sequence in abdominal examinations of noncooperative patients at 1.5 Tesla (T) and 3.0T MRI. MATERIALS AND METHODS: Eighty-nine consecutive patients (48 males and 41 females; mean age +/- standard deviation, 54.6 +/- 16.6 years) who had MRI examinations including postgadolinium WE-MPRAGE were included in the study. Of 89 patients, 33 underwent noncooperative protocol at 1.5T, 10 underwent noncooperative protocol at 3.0T, and 46 underwent cooperative protocol at 3.0T. Postgadolinium WE-MPRAGE, MPRAGE, and three-dimensional gradient-echo sequences of these three different groups were qualitatively evaluated for image quality, extent of artifacts, lesion conspicuity, and homogeneity of fat-attenuation by two reviewers retrospectively, independently, and blindly. The results were compared using Wilcoxon signed rank and Mann-Whitney U tests. Kappa statistics were used to measure the extent of agreement between the reviewers. RESULTS: The average scores indicated that the images were diagnostic for WE-MPRAGE at 1.5T and 3.0T in noncooperative patients. WE-MPRAGE achieved homogenous fat-attenuation in 31/33 (94%) of noncooperative patients at 1.5T and 10/10 (100%) of noncooperative patients at 3.0T. WE-MPRAGE at 3.0T had better results for image quality, extent of artifacts, lesion conspicuity and homogeneity of fat-attenuation compared with WE-MPRAGE at 1.5T, in noncooperative patients (P = 0.0008, 0.0006, 0.0024, and 0.0042; respectively). Kappa statistics varied between 0.76 and 1.00, representing good to excellent agreement. CONCLUSION: WE-MPRAGE may be used as a T1-weighted postgadolinium fat-attenuated sequence in noncooperative patients, particularly at 3.0T MRI.