X‐PROP: A fast and robust diffusion‐weighted propeller technique

Diffusion‐weighted imaging (DWI) has shown great benefits in clinical MR exams. However, current DWI techniques have shortcomings of sensitivity to distortion or long scan times or combinations of the two. Diffusion‐weighted echo‐planar imaging (EPI) is fast but suffers from severe geometric distortion. Periodically rotated overlapping parallel lines with enhanced reconstruction diffusion‐weighted imaging (PROPELLER DWI) is free of geometric distortion, but the scan time is usually long and imposes high Specific Absorption Rate (SAR) especially at high fields. TurboPROP was proposed to accelerate the scan by combining signal from gradient echoes, but the off‐resonance artifacts from gradient echoes can still degrade the image quality. In this study, a new method called X‐PROP is presented. Similar to TurboPROP, it uses gradient echoes to reduce the scan time. By separating the gradient and spin echoes into individual blades and removing the off‐resonance phase, the off‐resonance artifacts in X‐PROP are minimized. Special reconstruction processes are applied on these blades to correct for the motion artifacts. In vivo results show its advantages over EPI, PROPELLER DWI, and TurboPROP techniques. Magn Reson Med, 2011. © 2011 Wiley‐Liss, Inc.     

High resolution diffusion‐weighted imaging using readout‐segmented echo‐planar imaging,parallel imaging and a two‐dimensional navigator‐based reacquisition

Single‐shot echo‐planar imaging (EPI) is well established as the method of choice for clinical, diffusion‐weighted imaging with MRI because of its low sensitivity to the motion‐induced phase errors that occur during diffusion sensitization of the MR signal. However, the method is prone to artifacts due to susceptibility changes at tissue interfaces and has a limited spatial resolution. The introduction of parallel imaging techniques, such as GRAPPA (GeneRalized Autocalibrating Partially Parallel Acquisitions), has reduced these problems, but there are still significant limitations, particularly at higher field strengths, such as 3 Tesla (T), which are increasingly being used for routine clinical imaging. This study describes how the combination of readout‐segmented EPI and parallel imaging can be used to address these issues by generating high‐resolution, diffusion‐weighted images at 1.5T and 3T with a significant reduction in susceptibility artifact compared with the single‐shot case. The technique uses data from a 2D navigator acquisition to perform a nonlinear phase correction and to control the real‐time reacquisition of unusable data that cannot be corrected. Measurements on healthy volunteers demonstrate that this approach provides a robust correction for motion‐induced phase artifact and allows scan times that are suitable for routine clinical application. Magn Reson Med, 2009. © 2009 Wiley‐Liss, Inc.     

High‐resolution human diffusion tensor imaging using 2‐D navigated multishot SENSE EPI at 7 T

The combination of parallel imaging with partial Fourier acquisition has greatly improved the performance of diffusion‐weighted single‐shot EPI and is the preferred method for acquisitions at low to medium magnetic field strength such as 1.5 or 3 T. Increased off‐resonance effects and reduced transverse relaxation times at 7 T, however, generate more significant artifacts than at lower magnetic field strength and limit data acquisition. Additional acceleration of k‐space traversal using a multishot approach, which acquires a subset of k‐space data after each excitation, reduces these artifacts relative to conventional single‐shot acquisitions. However, corrections for motion‐induced phase errors are not straightforward in accelerated, diffusion‐weighted multishot EPI because of phase aliasing. In this study, we introduce a simple acquisition and corresponding reconstruction method for diffusion‐weighted multishot EPI with parallel imaging suitable for use at high field. The reconstruction uses a simple modification of the standard sensitivity‐encoding (SENSE) algorithm to account for shot‐to‐shot phase errors; the method is called image reconstruction using image‐space sampling function (IRIS). Using this approach, reconstruction from highly aliased in vivo image data using 2‐D navigator phase information is demonstrated for human diffusion‐weighted imaging studies at 7 T. The final reconstructed images show submillimeter in‐plane resolution with no ghosts and much reduced blurring and off‐resonance artifacts. Magn Reson Med, 2013. © 2012 Wiley Periodicals, Inc.     

Two‐dimensional phase cycled reconstruction for inherent correction of echo‐planar imaging nyquist artifacts

The inconsistency of k‐space trajectories results in Nyquist artifacts in echo‐planar imaging (EPI). Traditional techniques often only correct for phase errors along the frequency‐encoding direction (one‐dimensional correction), which may leave significant residual artifacts, particularly for oblique‐plane EPI or in the presence of cross‐term eddy currents. As compared with one‐dimensional correction, two‐dimensional (2D) phase correction can be much more effective in suppressing Nyquist artifacts. However, most existing 2D correction methods require reference scans and may not be generally applicable to different imaging protocols. Furthermore, EPI reconstruction with these 2D phase correction methods is susceptible to error amplification due to subject motion. To address these limitations, we report an inherent and general 2D phase correction technique for EPI Nyquist removal. First, a series of images are generated from the original dataset, by cycling through different possible values of phase errors using a 2D reconstruction framework. Second, the image with the lowest artifact level is identified from images generated in the first step using criteria based on background energy in sorted and sigmoid‐weighted signals. In this report, we demonstrate the effectiveness of our new method in removing Nyquist ghosts in single‐shot, segmented and parallel EPI without acquiring additional reference scans and the subsequent error amplifications. Magn Reson Med, 2011. © 2011 Wiley‐Liss, Inc.     

DWI of the spinal cord with reduced FOV single‐shot EPI

Single‐shot echo‐planar imaging (ss‐EPI) has not been used widely for diffusion‐weighted imaging (DWI) of the spinal cord, because of the magnetic field inhomogeneities around the spine, the small cross‐sectional size of the spinal cord, and the increased motion in that area due to breathing, swallowing, and cerebrospinal fluid (CSF) pulsation. These result in artifacts with the usually long readout duration of the ss‐EPI method. Reduced field‐of‐view (FOV) methods decrease the required readout duration for ss‐EPI, thereby enabling its practical application to imaging of the spine. In this work, a reduced FOV single‐shot diffusion‐weighted echo‐planar imaging (ss‐DWEPI) method is proposed, in which a 2D spatially selective echo‐planar RF excitation pulse and a 180° refocusing pulse reduce the FOV in the phase‐encode (PE) direction, while suppressing the signal from fat simultaneously. With this method, multi slice images with higher in‐plane resolutions (0.94 × 0.94 mm² for sagittal and 0.62 × 0.62 mm² for axial images) are achieved at 1.5 T, without the need for a longer readout. Magn Reson Med 60:468–473, 2008. © 2008 Wiley‐Liss, Inc.     

3D isotropic high‐resolution diffusion‐weighted MRI of the whole brain with a motion‐corrected steady‐state free precession sequence

The main obstacle to high‐resolution (<1.5 mm isotropic) 3D diffusion‐weighted MRI is the differential motion‐induced phase error from shot‐to‐shot. In this work, the phase error is addressed with a hybrid 3D navigator approach that corrects motion‐induced phase in two ways. In the first, rigid‐body motion is corrected for every shot. In the second, repeatable nonrigid‐body pulsation is corrected for each portion of the cardiac cycle. These phase error corrections were implemented with a 3D diffusion‐weighted steady‐ state free precession pulse sequence and were shown to mitigate signal dropouts caused by shot‐to‐shot phase inconsistencies compared to a standard gridding reconstruction in healthy volunteers. The proposed approach resulted in diffusion contrast more similar to the contrast observed in the reference echo‐planer imaging scans than reconstruction of the same data without correction. Fractional anisotropy and Color fractional anisotropy maps generated with phase‐corrected data were also shown to be more similar to echo‐planer imaging reference scans than those generated without phase correction. Magn Reson Med 70:466–478, 2013. © 2012 Wiley Periodicals, Inc.     

Targeted single-shot methods for diffusion-weighted imaging in the kidneys

Purpose:

To investigate the feasibility of combining the inner‐volume‐imaging (IVI) technique with single‐shot diffusion‐weighted (DW) spin‐echo echo‐planar imaging (SE‐EPI) and DW‐SPLICE (split acquisition of fast spin‐echo) sequences for renal DW imaging.

Materials and Methods:

Renal DWI was performed in 10 healthy volunteers using single‐shot DW‐SE‐EPI, DW‐SPLICE, targeted‐DW‐SE‐EPI, and targeted‐DW‐SPLICE. We compared the quantitative diffusion measurement accuracy and image quality of these targeted‐DW‐SE‐EPI and targeted DW‐SPLICE methods with conventional full field of view (FOV) DW‐SE‐EPI and DW‐SPLICE measurements in phantoms and normal volunteers.

Results:

Compared with full FOV DW‐SE‐EPI and DW‐SPLICE methods, targeted‐DW‐SE‐EPI and targeted‐DW‐SPLICE approaches produced images of superior overall quality with fewer artifacts, less distortion, and reduced spatial blurring in both phantom and volunteer studies. The apparent diffusion coefficient (ADC) values measured with each of the four methods were similar and in agreement with previously published data. There were no statistically significant differences between the ADC values and intravoxel incoherent motion (IVIM) measurements in the kidney cortex and medulla using single‐shot DW‐SE‐EPI, targeted‐DW‐EPI, and targeted‐DW‐SPLICE (P > 0.05).

Conclusion:

Compared with full‐FOV DWI methods, targeted‐DW‐SE‐EPI and targeted‐DW‐SPLICE techniques reduced image distortion and artifacts observed in the single‐shot DW‐SE‐EPI images, reduced blurring in DW‐SPLICE images, and produced comparable quantitative DW and IVIM measurements to those produced with conventional full‐FOV approaches. J. Magn. Reson. Imaging 2011;33:1517–1525. © 2011 Wiley‐Liss, Inc.     

Robust GRAPPA‐accelerated diffusion‐weighted readout‐segmented (RS)‐EPI

Readout segmentation (RS‐EPI) has been suggested as a promising variant to echo‐planar imaging (EPI) for high‐resolution imaging, particularly when combined with parallel imaging. This work details some of the technical aspects of diffusion‐weighted (DW)‐RS‐EPI, outlining a set of reconstruction methods and imaging parameters that can both minimize the scan time and afford high‐resolution diffusion imaging with reduced distortions. These methods include an efficient generalized autocalibrating partially parallel acquisition (GRAPPA) calibration for DW‐RS‐EPI data without scan time penalty, together with a variant for the phase correction of partial Fourier RS‐EPI data. In addition, the role of pulsatile and rigid‐body brain motion in DW‐RS‐EPI was assessed. Corrupt DW‐RS‐EPI data arising from pulsatile nonlinear brain motion had a prevalence of ～7% and were robustly identified via k‐space entropy metrics. For DW‐RS‐EPI data corrupted by rigid‐body motion, we showed that no blind overlap was required. The robustness of RS‐EPI toward phase errors and motion, together with its minimized distortions compared with EPI, enables the acquisition of exquisite 3 T DW images with matrix sizes close to 512². Magn Reson Med, 2009. © 2009 Wiley‐Liss, Inc.     

SNR‐optimized phase‐sensitive dual‐acquisition turbo spin echo imaging: A fast alternative to FLAIR

Phase‐sensitive dual‐acquisition single‐slab three‐dimensional turbo spin echo imaging was recently introduced, producing high‐resolution isotropic cerebrospinal fluid attenuated brain images without long inversion recovery preparation. Despite the advantages, the weighted‐averaging‐based technique suffers from noise amplification resulting from different levels of cerebrospinal fluid signal modulations over the two acquisitions. The purpose of this work is to develop a signal‐to‐noise ratio‐optimized version of the phase‐sensitive dual‐acquisition single‐slab three‐dimensional turbo spin echo. Variable refocusing flip angles in the first acquisition are calculated using a three‐step prescribed signal evolution while those in the second acquisition are calculated using a two‐step pseudo‐steady state signal transition with a high flip‐angle pseudo‐steady state at a later portion of the echo train, balancing the levels of cerebrospinal fluid signals in both the acquisitions. Low spatial frequency signals are sampled during the high flip‐angle pseudo‐steady state to further suppress noise. Numerical simulations of the Bloch equations were performed to evaluate signal evolutions of brain tissues along the echo train and optimize imaging parameters. In vivo studies demonstrate that compared with conventional phase‐sensitive dual‐acquisition single‐slab three‐dimensional turbo spin echo, the proposed optimization yields 74% increase in apparent signal‐to‐noise ratio for gray matter and 32% decrease in imaging time. The proposed method can be a potential alternative to conventional fluid‐attenuated imaging. Magn Reson Med, 2013. © 2012 Wiley Periodicals, Inc.     

Single‐shot T1 mapping using simultaneous acquisitions of spin‐ and stimulated‐echo‐planar imaging (2D ss‐SESTEPI)

The conventional stimulated‐echo NMR sequence only measures the longitudinal component while discarding the transverse component, after tipping up the prepared magnetization. This transverse magnetization can be used to measure a spin echo, in addition to the stimulated echo. Two‐dimensional single‐shot spin‐ and stimulated‐echo‐planar imaging (ss‐SESTEPI) is an echo‐planar‐imaging‐based single‐shot imaging technique that simultaneously acquires a spin‐echo‐planar image and a stimulated‐echo‐planar image after a single radiofrequency excitation. The magnitudes of the spin‐echo‐planar image and stimulated‐echo‐planar image differ by T₁ decay and diffusion weighting for perfect 90° radiofrequency and thus can be used to rapidly measure T₁. However, the spatial variation of amplitude of radiofrequency field induces uneven splitting of the transverse magnetization for the spin‐echo‐planar image and stimulated‐echo‐planar image within the imaging field of view. Correction for amplitude of radiofrequency field inhomogeneity is therefore critical for two‐dimensional ss‐SESTEPI to be used for T₁ measurement. We developed a method for amplitude of radiofrequency field inhomogeneity correction by acquiring an additional stimulated‐echo‐planar image with minimal mixing time, calculating the difference between the spin echo and the stimulated echo and multiplying the stimulated‐echo‐planar image by the inverse functional map. Diffusion‐induced decay is corrected by measuring the average diffusivity during the prescanning. Rapid single‐shot T₁ mapping may be useful for various applications, such as dynamic T₁ mapping for real‐time estimation of the concentration of contrast agent in dynamic contrast enhancement MRI. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.     

Efficient fat suppression by slice‐selection gradient reversal in twice‐refocused diffusion encoding

Most diffusion imaging sequences rely on single‐shot echo‐planar imaging (EPI) for spatial encoding since it is the fastest acquisition available. However, it is sensitive to chemical‐shift artifacts due to the low bandwidth in the phase‐encoding direction, making fat suppression necessary. Often, spectral‐selective RF pulses followed by gradient spoiling are used to selectively saturate the fat signal. This lengthens the acquisition time and increases the specific absorption rate (SAR). However, in pulse sequences that contain two slice‐selective 180° refocusing pulses, the slice‐selection gradient reversal (SSGR) method of fat suppression can be implemented; i.e., using slice‐selection gradients of opposing polarity for the two refocusing pulses. We combined this method with the twice‐refocused spin‐echo sequence for diffusion encoding and tested its performance in both phantoms and in vivo. Unwanted fat signal was entirely suppressed with this method without affecting the water signal intensity or the slice profile. Magn Reson Med 60:1256–1260, 2008. © 2008 Wiley‐Liss, Inc.     

Robust fat suppression at 3T in high‐resolution diffusion‐weighted single‐shot echo‐planar imaging of human brain

Single‐shot echo‐planar imaging is the most common acquisition technique for whole‐brain diffusion tensor imaging (DTI) studies in vivo. Higher field MRI systems are readily available and advantageous for acquiring DTI due to increased signal. One of the practical issues for DTI with single‐shot echo‐planar imaging at high‐field is incomplete fat suppression resulting in a chemically shifted fat artifact within the brain image. Unsuppressed fat is especially detrimental in DTI because the diffusion coefficient of fat is two orders of magnitude lower than that of parenchyma, producing brighter appearing fat artifacts with greater diffusion weighting. In this work, several fat suppression techniques were tested alone and in combination with the goal of finding a method that provides robust fat suppression and can be used in high‐resolution single‐shot echo‐planar imaging DTI studies. Combination of chemical shift saturation with slice‐select gradient reversal within a dual‐spin‐echo diffusion preparation period was found to provide robust fat suppression at 3 T. Magn Reson Med, 2011. © 2011 Wiley Periodicals, Inc.     

Single‐shot 3D GRASE with cylindrical k‐space trajectories

Development of GRASE (gradient‐ and spin‐echo) pulse sequences for single‐shot 3D imaging has been motivated by physiologic studies of the brain. The duration of echo‐planar imaging (EPI) subsequences between RF refocusing pulses in the GRASE sequence is determinant of image distortions and susceptibility artifacts. To reduce these artifacts the regular Cartesian trajectory is modified to a circular trajectory in 2D and a cylindrical trajectory in 3D for reduced echo train time. Incorporation of “fly‐back” trajectories lengthened the time of the subsequences and proportionally increased susceptibility artifact but the unipolar readout gradients eliminate all ghost artifacts. The modified cylindrical trajectory reduced susceptibility artifact and distortion artifact while raising the signal‐to‐noise ratio in both phantom and human brain images. Magn Reson Med 60:976–980, 2008. © 2008 Wiley‐Liss, Inc.     

Simultaneous phase correction and SENSE reconstruction for navigated multi-shot DWI with non-cartesian k-space sampling.

Phase-navigated multi-shot acquisition and parallel imaging are two techniques that have been applied to diffusion-weighted imaging (DWI) to diminish distortions and to enhance spatial resolution. Specifically, sensitivity encoding (SENSE) has been combined with single-shot echo planar imaging (EPI). Thus far, it has been difficult to apply parallel imaging methods, like SENSE, to multi-shot DWI because motion-induced phase error varies from shot to shot and interferes with sensitivity encoding. Although direct phase subtraction methods have been introduced to correct this phase error, they generally are not suitable for SENSE reconstruction, and they cannot remove all the motion artifacts even if the phase error is fully known. Here, an effective algorithm is proposed to correct the motion-induced phase error using an iterative reconstruction. In this proposed conjugate-gradient (CG) algorithm, the phase error is treated as an image encoding function. Given the complex perturbation terms, diffusion-weighted images can be reconstructed using an augmented sensitivity map. The mathematical formulation and image reconstruction procedures of this algorithm are similar to the SENSE reconstruction. By defining a dynamic composite sensitivity, the CG phase correction method can be conveniently incorporated with SENSE reconstruction for the application of multi-shot SENSE DWI. Effective phase correction and multi-shot SENSE DWI (R = 1 to 3) are demonstrated on both simulated and in vivo data acquired with PROPELLER and SNAILS.     

Three‐dimensional diffusion tensor microimaging for anatomical characterization of the mouse brain

Diffusion tensor imaging is gaining increasing importance for anatomical imaging of the developing mouse brain. However, the application of diffusion tensor imaging to mouse brain imaging at microscopic levels is hindered by the limitation on achievable spatial resolution. In this study, fast diffusion tensor microimaging of the mouse brain, based on a diffusion‐weighted gradient and spin echo technique with twin‐navigator echo phase correction, is presented. Compared to echo planar and spin echo acquisition, the diffusion‐weighted gradient and spin echo acquisition resulted in significant reduction in scan time and had minimal image distortion, thereby allowing acquisition at higher spatial resolution. In this study, three‐dimensional diffusion tensor microimaging of the mouse brains at spatial resolutions of 50‐60 μm revealed unprecedented anatomical details. Thin fiber bundles in the adult striatum and white matter tracts in the embryonic day 12 mouse brains were visualized for the first time. The study demonstrated that data acquired using the diffusion tensor microimaging technique allow three‐dimensional mapping of gene expression data and can serve as a platform to study gene expression patterns in the context of neuroanatomy in the developing mouse brain. Magn Reson Med 64:249–261, 2010. © 2010 Wiley‐Liss, Inc.     

High‐resolution functional MRI at 3 T: 3D/2D echo‐planar imaging with optimized physiological noise correction

High‐resolution functional MRI (fMRI) offers unique possibilities for studying human functional neuroanatomy. Although high‐resolution fMRI has proven its potential at 7 T, most fMRI studies are still performed at rather low spatial resolution at 3 T. We optimized and compared single‐shot two‐dimensional echo‐planar imaging (EPI) and multishot three‐dimensional EPI high‐resolution fMRI protocols. We extended image‐based physiological noise correction from two‐dimensional EPI to multishot three‐dimensional EPI. The functional sensitivity of both acquisition schemes was assessed in a visual fMRI experiment. The physiological noise correction increased the sensitivity significantly, can be easily applied, and requires simple recordings of pulse and respiration only. The combination of three‐dimensional EPI with physiological noise correction provides exceptional sensitivity for 1.5 mm high‐resolution fMRI at 3 T, increasing the temporal signal‐to‐noise ratio by more than 25% compared to two‐dimensional EPI. Magn Reson Med, 2013. © 2012 The Authors. Magnetic Resonance in Medicine Published by Wiley Periodicals, Inc. on behalf of International Society of Medicine in Resonance.     

Correction for eddy current induced Bo shifts in diffusion‐weighted echo‐planar imaging

The importance of diffusion‐weighted MRI in the assessment of acute stroke is well‐recognized, and quantitative maps of the apparent diffusion coefficient (ADC) are now widely used. Echo‐planar imaging provides a robust method of acquiring diffusion‐weighted images free of motion artifact. However, initial experience with clinical MRI systems indicates that calculation of artifact‐free ADC maps from a series of echo‐planar diffusion‐weighted images is not necessarily straight‐forward. One of the problems is that frequency shifts resulting from eddy currents can cause misregistration of base diffusion‐weighted images. In this study, an on‐line correction method that overcomes this problem is described, and phantom and human images that demonstrate the validity of the technique are presented. The method uses a non‐phase‐encoded reference scan to correct the phase of each echo in the echo train, and can provide ADC maps that are free of misregistration artifacts, without the need for off‐line postprocessing. Magn Reson Med 41:95‐102, 1999. © 1999 Wiley‐Liss, Inc.     

A Modified EPI sequence for high‐resolution imaging at ultra‐short echo time

A robust modification of echo‐planar imaging dubbed double‐shot echo‐planar imaging with center‐out trajectories and intrinsic navigation (DEPICTING) is proposed, which permits imaging at ultra‐short echo time. The k‐space data is sampled by two center‐out trajectories with a minimal delay achieving a temporal efficiency similar to conventional single‐shot echo‐planar imaging. Intersegment phase and intensity imperfections are corrected by exploiting the intrinsic navigator information from both central lines, which are subsequently averaged for image reconstruction. Phase errors induced by inhomogeneities of the main magnetic field are corrected in k‐space, recovering the superior point‐spread function achieved with center‐out trajectories. The minimal echo time (<2 msec) is nearly independent of the acquisition matrix permitting applications, which simultaneously require high spatial and temporal resolution. Examples of demonstrated applications include anatomical imaging, BOLD‐based functional brain mapping, and quantitative perfusion imaging. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.     

Diffusion weighted vertical gradient and spin echo

In this work, diffusion weighting and parallel imaging is combined with a vertical gradient and spin echo data readout. This sequence was implemented and evaluated on healthy volunteers using a 1.5 and a 3 T whole‐body MR system. As the vertical gradient and spin echo trajectory enables a higher k‐space velocity in the phase‐encoding direction than single‐shot echo planar imaging, the geometrical distortions are reduced. When combined with parallel imaging such as generalized autocalibrating partially parallel acquisition, the geometric distortions are reduced even further, while also keeping the minimum echo time reasonably low. However, this combination of a diffusion preparation and multiple refocusing pulses during the vertical gradient and spin echo readout, generally violates the Carr–Purcell–Meiboom–Gill condition, which leads to interferences between echo pathways. To suppress the stimulated echo pathway, refocusing pulses with a sharper slice profiles and an odd/even crusher variation scheme were implemented and evaluated. Being a single‐shot acquisition technique, the reconstructed images are robust to rigid‐body head motion and spatially varying brain motion, both of which are common sources of artifacts in diffusion MRI. Magn Reson Med, 2012. © 2012 Wiley Periodicals, Inc.     

Comparison of ferucarbotran‐enhanced fluid‐attenuated inversion‐recovery echo‐planar,T2‐weighted turbo spin‐echo,T2*‐weighted gradient‐echo,and diffusion‐weighted echo‐planar imaging for detection of malignant liver lesions

Purpose:

To compare the diagnostic accuracy of superparamagnetic iron oxide (SPIO)‐enhanced fluid‐attenuated inversion‐recovery echo‐planar imaging (FLAIR EPI) for malignant liver tumors with that of T2‐weighted turbo spin‐echo (TSE), T2*‐weighted gradient‐echo (GRE), and diffusion‐weighted echo‐planar imaging (DW EPI).

Materials and Methods:

SPIO‐enhanced magnetic resonance imaging (MRI) that included FLAIR EPI, T2‐weighted TSE, T2*‐weighted GRE, and DW EPI sequences was performed using a 3 T system in 54 consecutive patients who underwent surgical exploration with intraoperative ultrasonography. A total of 88 malignant liver tumors were evaluated. Images were reviewed independently by two blinded observers who used a 5‐point confidence scale to identify lesions. Results were correlated with results of histopathologic findings and surgical exploration with intraoperative ultrasonography. The accuracy of each MRI sequence was measured with jackknife alternative free‐response receiver operating characteristic analysis. The sensitivity of each observer with each MRI sequence was compared with McNemar's test.

Results:

Accuracy values were significantly higher with FLAIR EPI sequence (0.93) than with T2*‐weighted GRE (0.80) or DW EPI sequences (0.80) (P < 0.05). Sensitivity was significantly higher with the FLAIR EPI sequence than with any of the other sequences.

Conclusion:

SPIO‐enhanced FLAIR EPI sequence was more accurate in the diagnosis of malignant liver tumors than T2*‐weighted GRE and DW EPI sequences. SPIO‐enhanced FLAIR EPI sequence is helpful for the detection of malignant liver tumors. J. Magn. Reson. Imaging 2010;31:607–616. ©2010 Wiley‐Liss, Inc.