Comparison of high spatial resolution respiratory triggered inversion recovery‐prepared spoiled gradient echo sequence with standard breathhold T1 sequence MRI of the liver using gadoxetic acid

Purpose:

To assess if a high resolution respiratory triggered inversion recovery prepared GRE sequence (RT) improved image quality and detection of lesions compared with breathhold GRE T1 weighted MR sequence (BH) in the hepatobiliary uptake phase of MR of the liver using gadoxetic acid (Gd‐EOB‐DTPA).

Materials and Methods:

Thirty‐eight consecutive patients from July 2009 to September 2010 who had undergone Gd‐EOB‐DTPA enhanced liver exams were retrospectively identified. Qualitative assessment performed on reference lesions and background liver by two independent readers. Quantitative assessment performed by one reader.

Results:

Liver parenchyma signal‐to‐noise ratio for BH was 90.3 ± 23.9 (mean ± SD) and RT, 106.1 ± 40.4 (P = 0.119). For BH, 320 lesions were detected compared with 257 for RT. Lesion to liver contrast was significantly better on RT sequences (0.26 ± 0.24; mean ± SD) compared with BH sequence (0.21 ± 0.20; P = 0.044). Fifty‐seven reference lesions assessed. Both reviewers rated BH better for lesion margin and hepatic vessel sharpness. BH was rated with less artifact (P < 0.05). Lesion to liver contrast on BH was significantly better for one reviewer.

Conclusion:

BH sequence had better overall image quality than RT in several quantitative and qualitative factors including number of lesions detected and level of artifact. J. Magn. Reson. Imaging 2013;37:700—706. © 2013 Wiley Periodicals, Inc.     

Vertebrobasilar insufficiency

Opinion statement Vertebrobasilar insufficiency presents with characteristic symptoms and signs due to impaired perfusion of the cerebellum, the brain stem, and the occipital cortex. This may be due to reduced perfusion usually due to atherosclerosis or thromboembolism. Choice of treatment depends on understanding the different underlying pathophysiologic mechanisms. Antiplatelet therapy; reduction of risk factors such as diabetes, hypertension, hypercholesterolemia, and cigarette smoking; and a healthy lifestyle form the first line of management. Systemic anticoagulation in the short term also has a key role in selected cases. In patients with refractory symptoms on maximal medical therapy and underlying focal stenotic lesions, endovascular revascularization using stents and balloon angioplasty may be indicated. Bypass surgery is another option if there are factors that render endovascular therapy unsuitable.