Differentiation of hypointense nodules on gadoxetic acid-enhanced hepatobiliary-phase MRI using T2 enhanced spin-echo imaging with the time-reversed gradient echo sequence: An initial experience |
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| Affiliation: | 1. Philips Electronics Japan, 2-13-37 Kounan, Minato-ku, Tokyo 108-8507, Japan;2. Department of Radiology Informatics and Network, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan;3. Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan;4. Philips Healthcare Asia Pacific, 2-13-37 Kounan, Minato-ku, Tokyo 108-8507, Japan;1. Glenfield Hospital, University Hospitals of Leicester, Groby Road, Leicester LE3 9QP, United Kingdom;2. Heartlands Hospitals, Heart of England NHS foundation Trust, Bordesley Green E, Birmingham B9 5SS, United Kingdom;3. Kettering General Hospital, Treatment Centre, Rothwell Rd, Kettering NN16 8UZ, United Kingdom;4. University Hospital of North Midlands, Newcastle Rd, Stoke-on-Trent, ST4 6QG, United Kingdom;5. Glenfield Hospital, University Hospitals of Leicester, Groby Road Leicester LE3 9QP, United Kingdom;6. Breast Unit, King’s Mill Hospital, Sherwood Forest Hospitals, Sutton-in-Ashfield, Nottinghamshire, NG17 4JL;1. Support Center for Advanced Neuroimaging – Institute for Diagnostic and Interventional Neuroradiology, University Hospital Inselspital and University of Bern, Bern, Switzerland;2. Department of Radiology, Division of Diagnostic and Interventional Neuroradiology, University Hospital, Basel, Switzerland;3. Institute of Surgical Technology and Biomechanics, University of Bern, Bern, Switzerland,;4. Department of Neurosurgery, University Hospital Inselspital and University of Bern, Bern, Switzerland;1. Centre for Applied Biomedical Engineering Research (CABER), Health Research Institute (HRI), School of Engineering, Bernal Institute, University of Limerick, Lonsdale Building, Limerick, Ireland;2. Department of Radiology, University Hospital Limerick, Ireland;3. Department of Vascular Surgery, University Hospital Limerick, Ireland;1. University of Ottawa School of Medicine, 451 Smyth Rd., Ottawa, ON, K1H 8M, Canada;2. The Ottawa Hospital Research Institute Clinical Epidemiology Program, 501 Smyth Rd., Ottawa, ON, K1H 8L6, Canada;1. Department of Radiology, Policlinico G.B. Rossi, University of Verona, Italy;2. Department of Radiology, Policlinico A. Gemelli, Catholic University, Rome, Italy;1. Department of Radiology, Hainan General Hospital, Haikou 570311, China;2. Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China;3. Department of Radiology, Keck School of Medicine, LAC + USC Medical Center, University of Southern California, 1200 North State Street, Los Angeles, CA 90033, USA;4. Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China |
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| Abstract: | PurposeTo optimize the flip angle (FA) of the T2 enhanced spin-echo imaging using the time reversed gradient echo (T2FFE) and evaluate its utility for differentiating hypointensity nodules in the hepatobiliary phase (HBP) of gadoxetic acid-enhanced (Gd-EOB) MRI.Materials and methodsFirst, FA optimization of the T2FFE in the HBP was investigated by comparing signal-to-noise ratio (SNR) among different FAs using phantoms. The liver-to-muscle contrast ratios (CRLiver-Muscle) and image quality among three FAs (20°, 50° and 80°) were compared using images of 10 patients. Next, the utility of the T2FFE with an optimized FA for differentiating hypointensity nodules in the HBP was assessed by comparing the lesion-to-liver contrast ratio (CRLesion-Liver) among cysts, hemangiomas, hepatocellular carcinomas, and metastatic tumors in 32 patients.ResultsSNR increased as FA increased, but leveled off at FAs of 50° and greater. The FA of 50° showed significantly better image quality scores than that of 80° (p < 0.05). After employing an FA of 50°, the CRLesion-Liver value indicated that the T2FFE depicted benign lesions as hyperintense and most malignant lesions as hypointense in relation with the liver parenchyma (p < 0.05).ConclusionThe T2FFE in the HBP of Gd-EOB-MRI is useful for differentiating benign and malignant liver lesions. |
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| Keywords: | Gadoxetic acid Gd-EOB-MRI Liver T2FFE |
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