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AKIN M, YILMAZ C, GÜLEK B, KAYA Ö, DILEK O, SÖKER G. The comparison of the efficacy of the single shot spin echo, fiesta, and propeller T 2 - weighted MRI sequences in the detection of focal liver lesions. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.908532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Ramalho M, Hithaya I, AlObaidy M, Kalubowila J, Jeon YH, Manikkavasakar S, Semelka RC. MRI Evaluation of cooperative and non-cooperative patients with non-traumatic acute abdominal pain – preliminary observations. Clin Imaging 2016; 40:707-13. [DOI: 10.1016/j.clinimag.2016.02.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 01/29/2016] [Accepted: 02/10/2016] [Indexed: 01/31/2023]
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Heyn C, Sue-Chue-Lam D, Jhaveri K, Haider MA. MRI of the pancreas: problem solving tool. J Magn Reson Imaging 2013; 36:1037-51. [PMID: 23090915 DOI: 10.1002/jmri.23708] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Advances in MR hardware and pulse sequence design over the years have improved the quality and robustness of MR imaging of the pancreas. Today, MRI is an indispensible tool for studying the pancreas and can provide useful information not attainable with other noninvasive or minimally invasive imaging techniques. In the present review, specific cases are reviewed where the strengths of MRI demonstrate the utility of this imaging modality as a problem solving tool.
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Affiliation(s)
- Chris Heyn
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
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Rief M, Wagner M, Franiel T, Bresan V, Taupitz M, Klessen C, Hamm B, Asbach P. Detection of focal liver lesions in unenhanced and ferucarbotran-enhanced magnetic resonance imaging: a comparison of T2-weighted breath-hold and respiratory-triggered sequences. Magn Reson Imaging 2009; 27:1223-9. [DOI: 10.1016/j.mri.2009.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2008] [Revised: 02/02/2009] [Accepted: 05/06/2009] [Indexed: 11/17/2022]
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MRI Artifact Reduction and Quality Improvement in the Upper Abdomen with PROPELLER and Prospective Acquisition Correction (PACE) Technique. AJR Am J Roentgenol 2008; 191:1154-8. [DOI: 10.2214/ajr.07.3657] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Glockner JF. Hepatobiliary MRI: current concepts and controversies. J Magn Reson Imaging 2007; 25:681-95. [PMID: 17352396 DOI: 10.1002/jmri.20844] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Evaluation of the liver and biliary system is a frequent indication for abdominal MRI. Hepatobiliary MRI comprises a set of noninvasive techniques that are usually very effective in answering most clinical questions. There are significant limitations, however, as well as considerable variation and disagreement regarding the optimal protocols for standard hepatic MRI and magnetic resonance cholangiopancreaticography (MRCP). This review discusses pulse sequences most often used in hepatic MRI and MRCP, examines a few sources of controversy in the current literature, and summarizes some recent and future developments in the field.
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Affiliation(s)
- James F Glockner
- Department of Radiology, Mayo Clinic, Rochester, Minnesota 55905, USA.
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Yoshikawa T, Mitchell DG, Hirota S, Ohno Y, Yoshigi J, Maeda T, Fujii M, Sugimura K. Focal liver lesions: Breathhold gradient- and spin-echo T2-weighted imaging for detection and characterization. J Magn Reson Imaging 2006; 23:520-8. [PMID: 16523481 DOI: 10.1002/jmri.20544] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
PURPOSE To evaluate breathhold gradient- and spin-echo (GRASE) T2-weighted imaging for the detection and characterization of focal liver lesions. MATERIALS AND METHODS Two GRASE sequences with different echo times (75 and 90 msec, GRASE75 and GRASE90) were compared with respiratory-triggered fast spin-echo (SE) and breathhold fast SE in 64 patients with 103 malignant and 51 benign lesions. Compared with respiratory-triggered and breathhold fast SE, GRASE reduced scan time by 77% to 82% and 21% to 27%, respectively. Two independent readers evaluated image quality and reviewed 504 liver segments on a segment-by-segment basis. Observer performance was evaluated with receiver operating characteristic (ROC) curve analysis. The signal-to-noise ratio (SNR) of liver and spleen, and lesion-to-liver contrast-to-noise ratio (CNR) were also measured. RESULTS The overall quality of the GRASE images was higher than that of the respiratory-triggered and breathhold fast SE images, although signal inhomogeneities were more frequently observed with GRASE. No significant difference in the values of the area under the ROC curve (Az) for malignant lesion detection was found. The mean SNR and CNR were highest for respiratory-triggered fast SE. CONCLUSION T2-weighted breathhold GRASE has the potential to provide faster liver imaging.
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Affiliation(s)
- Takeshi Yoshikawa
- Department of Radiology, Division of Magnetic Resonance Imaging, Thomas Jefferson University, Philadelphia, Philadelphia, Pennsylvania 19107, USA.
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Abstract
MR imaging is establishing a role as a primary diagnostic technique, with increasing evidence showing MR imaging to have advantages over CT regarding diagnostic sensitivity and specificity for many pathologies of solid organs, bile and pancreatic ducts, bowel, peritoneum, and retroperitoneum. In addition, there are increasing concerns regarding the risks of radiation and iodinated contrast associated with CT imaging of the abdomen. The incidence of contrast-induced nephropathy associated with iodinated contrast used for CT scanning is difficult to ascertain because reporting is spurious and variable in interpretation.
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Affiliation(s)
- Diego R Martin
- Department of Radiology, Emory University School of Medicine, 1364 Clifton Road NE, Atlanta, GA 30322, USA.
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Abstract
This article discusses MR imaging sequences that are used for the evaluation of diffuse liver diseases, including processes that lead to abnormal lipid metabolization, iron de-position disease, and perfusion abnormalities.
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Affiliation(s)
- Raman Danrad
- Department of Radiology, Emory University School of Medicine, 1365 Clifton Road NE, Atlanta, GA 30322, USA
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Martin DR, Semelka RC. Magnetic Resonance Imaging of the Liver: Review of Techniques and Approach to Common Diseases. Semin Ultrasound CT MR 2005; 26:116-31. [PMID: 15987062 DOI: 10.1053/j.sult.2005.02.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
MR imaging examination of the liver should use a combination of single-shot T2W and breath-hold T1W images, and include gadolinium enhancement with acquisition of multiple phases. MR provides superior characterization of liver masses than CT, and multi-phase gadolinium enhancement including a properly timed arterial phase is critical. The T1 weighted pre-contrast images must include in-phase/out-of-phase acquisitions, to assess hepatic lipid and or iron content, and dynamically enhanced post-gadolinium images. Timing of the arterial phase images is also critical for demonstration of acute hepatitis. The timing of the venous and equilibrium phase images are less critical, and are important for grading more severe acute hepatitis, demonstration of fibrosis, and for delineating vascular abnormalities. In cirrhosis, dynamic post-gadolinium images are critical for detection and characterization of regenerative or dysplastic nodules, and HCC. The same sequences useful for liver evaluation provide a comprehensive evaluation of all the soft tissues of the abdomen, and allow depiction of most of the important diseases, thus facilitating use of a universal protocol for abdominal imaging.
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Affiliation(s)
- Diego R Martin
- Department of Radiology, Emory University Hospital, Atlanta, GA 30322, USA.
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Klessen C, Asbach P, Kroencke TJ, Fischer T, Warmuth C, Stemmer A, Hamm B, Taupitz M. Magnetic resonance imaging of the upper abdomen using a free-breathing T2-weighted turbo spin echo sequence with navigator triggered prospective acquisition correction. J Magn Reson Imaging 2005; 21:576-82. [PMID: 15834908 DOI: 10.1002/jmri.20293] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
PURPOSE To evaluate a free-breathing navigator triggered T2-weighted turbo spin-echo sequence with prospective acquisition correction (T2w-PACE-TSE) for MRI of the upper abdomen in comparison to a conventional T2-weighted TSE (T2w-CTSE), a single-shot TSE (T2w-HASTE), and a T1-weighted gradient-echo sequence (T1w-FLASH). MATERIALS AND METHODS A total of 40 consecutive patients were examined at 1.5 T using free-breathing T2w-PACE-TSE, free-breathing T2w-CTSE, and breath-hold T2w-HASTE and T1w-FLASH acquisition. Images were evaluated qualitatively by three radiologists regarding motion artifacts, liver-spleen contrast, depiction of intrahepatic vessels, the pancreas and the adrenal glands, and overall image quality on a four-point scale. Quantitative analysis of the liver-spleen contrast was performed. RESULTS Depiction and sharpness of intrahepatic vessels were rated significantly better (P < 0.01) using T2w-PACE-TSE compared to T2w-CTSE and T2w-HASTE sequences. Significantly higher contrast values were measured for T2w-PACE-TSE images compared to T2w-CTSE, T2w-HASTE, and T1w-FLASH images (P < 0.01). Mean examination time of the T2w-PACE-TSE was 7.91 minutes, acquisition time of the T2w-CTSE sequence was 4.52 minutes. CONCLUSION Prospective acquisition correction is an efficient method for reducing respiratory movement artifacts in T2w-TSE imaging of the upper abdomen. Compared to T2w-CTSE and T2w-HASTE sequences recognition of anatomical details and contrast can be significantly improved.
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Affiliation(s)
- Christian Klessen
- Department of Radiology, Charité-Universitary Medicine Berlin, Campus Charité Mitte, Humboldt-University of Berlin, Berlin, Germany.
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Herborn CU, Vogt F, Lauenstein TC, Goyen M, Debatin JF, Ruehm SG. MRI of the liver: can True FISP replace HASTE? J Magn Reson Imaging 2003; 17:190-6. [PMID: 12541226 DOI: 10.1002/jmri.10248] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To determine the diagnostic accuracy of two fast breath-hold magnetic resonance (MR) imaging sequences, half-Fourier acquired single turbo spin-echo (HASTE) and true fast imaging with steady state precession (TrueFISP), for the detection and characterization of focal liver lesions MATERIALS AND METHODS A total of 186 patients with suspected focal liver lesions were enrolled in this study. All patients underwent the same standardized study protocol including HASTE and TrueFISP. A consensus reading based on all available image data served as a standard of reference for classifying lesions into cysts, hemangiomas, focal nodular hyperplasia, or malignant/other lesions. All malignant lesions, as well as hepatic adenomas and abscesses, were histologically verified. Each separated by an eight-week interval, HASTE and TrueFISP images were retrospectively reviewed in random order for the detection and characterization of focal hepatic lesions. Finally, a receiver operating characteristic (ROC) analysis was calculated. RESULTS HASTE images had an overall sensitivity of 0.86 and a specificity of 0.91, whereas TrueFISP showed an overall sensitivity and specificity of 0.79 and 0.83, respectively (p>0.1). CONCLUSION Neither HASTE nor TrueFISP alone are sufficient for the detection and characterization of hepatic lesions.
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Affiliation(s)
- Christoph U Herborn
- Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, D-45122 Essen, Germany.
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Palácio GAES, Abbehusen CL, Tiferes DA, D'Ippolito G, Szejnfeld J. O valor da ressonância magnética na detecção de nódulos hepáticos utilizando-se diversas técnicas ponderadas em T2: existe consenso? Radiol Bras 2002. [DOI: 10.1590/s0100-39842002000600004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Desde o início da década de 80 a ressonância magnética vem sendo utilizada para o estudo do abdome e principalmente na detecção de nódulos hepáticos. As imagens ponderadas em T2 são as que trouxeram maior benefício quando comparadas à tomografia computadorizada com contraste. Inúmeras técnicas e seqüências de ressonância magnética ponderadas em T2 surgiram desde então, na tentativa de aumentar a eficácia diagnóstica, com menores tempos de exame. Neste sentido, foram publicados inúmeros trabalhos demonstrando a utilidade de seqüências rápidas e ultra-rápidas, com e sem supressão de gordura, em apnéia, com sincronizador respiratório e com bobinas de sinergia, entre outros avanços tecnológicos. No entanto, não há um consenso sobre qual a técnica mais apropriada e sensível para a detecção de lesões hepáticas focais. Neste artigo fazemos uma revisão bibliográfica e análise crítica das diversas técnicas de imagens ponderadas em T2, no que diz respeito às suas sensibilidades na detecção de nódulos hepáticos.
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Altbach MI, Outwater EK, Trouard TP, Krupinski EA, Theilmann RJ, Stopeck AT, Kono M, Gmitro AF. Radial fast spin-echo method for T2-weighted imaging and T2 mapping of the liver. J Magn Reson Imaging 2002; 16:179-89. [PMID: 12203766 DOI: 10.1002/jmri.10142] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To evaluate a multishot radial fast-spin echo (RAD-FSE) method developed to improve the quality of abdominal T2-weighted imaging as well as the characterization of focal liver lesions. MATERIALS AND METHODS The RAD-FSE sequence used in this work consisted of a preparatory period followed by a short echo train (ETL = 16). A novel radial k-space trajectory was used to minimize streaking artifacts due to T2 variations and motion. Small diffusion gradients (b = 1.2 mm/s(2)) were used to improve flow suppression. The quality of images obtained with RAD-FSE was compared to multishot 2DFT fast spin-echo (2DFT-FSE) and half-Fourier acquisition single-shot turbo-spin-echo (HASTE) images using data from 16 patients. A postprocessing algorithm was used to generate multiple high-resolution images (at different effective TE values) as well as a T2 map from a single RAD-FSE data set. The T2 maps were used to differentiate malignant from benign lesions for a set of 33 lesions ranging from 0.8-194 cm(3). RESULTS RAD-FSE produces high-resolution images of the liver in a breath-hold without the motion artifacts of 2DFT-FSE methods, and without the blurriness and loss of small lesion detectability of HASTE. The inclusion of diffusion weighting in RAD-FSE decreases the signal from blood in hepatic vessels, which improves lesion visualization. The T2 values obtained by postprocessing a single RAD-FSE data set can differentiate malignant from benign lesions. The mean T2 values obtained for malignancies, hemangiomas, and cysts are 108 +/- 30 msec, 240 +/- 14 msec, and 572 +/- 334 msec, respectively. CONCLUSION These results indicate that RAD-FSE produces abdominal images of higher quality than 2DFT-FSE and HASTE. In addition, lesions can be characterized using T2 maps generated from a single RAD-FSE data set.
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Affiliation(s)
- Maria I Altbach
- Department of Radiology, University of Arizona, Tucson, Arizona 85724, USA.
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Abstract
In this article we describe state-of-the art techniques for magnetic resonance imaging of the liver. T1-weighted, T2-weighted, and heavily T2-weighted pulse sequences are discussed. Gadolinium-enhanced hepatic parenchymal imaging and magnetic resonance angiography are also described. A comprehensive MR imaging examination of the liver affords evaluation of focal and diffuse hepatic parenchymal disease, biliary disease, and vascular pathology.
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Affiliation(s)
- Adam R Fisher
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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