Mustafa Shadi Rifaat Bashir

DUKE, School of Medicine, Radiology, Abdominal Imaging

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Liver MRI in the hepatocyte phase with gadolinium-EOB-DTPA: Does increasing the flip angle improve conspicuity and detection rate of hypointense lesions?

Mustafa R. Bashir; Daniela B. Husarik; Tim J. Ziemlewicz; Rajan T. Gupta; Daniel T. Boll; Elmar M. Merkle (Profiled Authors: Mustafa Shadi Rifaat Bashir; Daniel Tobias Boll; Rajan Tilak Gupta)

Journal of Magnetic Resonance Imaging. 2012;35(3):611-616.

Purpose: To compare conspicuity and detection rate of hypointense lesions on T1-weighted (T1w) gradient echo (GRE) sequences with low and high flip angles (FA) in hepatocyte phase magnetic resonance imaging (MRI) using gadoxetate disodium. Materials and Methods: This Health Insurance Portability and Accountability Act (HIPAA)-compliant study was Institutional Review Board (IRB)-approved. The study population consisted of patients with hypointense liver lesions undergoing MRI with gadoxetate disodium, with hepatocyte-phase fat suppressed 3D T1w GRE sequences at both low (10-12°) and high (30-35°) FA. Contrast-to-noise ratios (CNRs) were calculated for liver parenchyma vs. large lesions and common bile duct (CBD) vs. liver. Three radiologists each assigned a conspicuity score (CS) for each lesion detected at low or high FA. Paired Student's t-tests compared the lesion detection (LD) rate using only the hepatocyte phase data set compared with the entire MRI examination, and CS for low and high FA. Results: In all, 57 large and 70 small lesions were identified in 18 patients. Average LD and CS were significantly greater at high FA versus low FA overall (LD 89.0% vs. 79.5%; CS 2.8 vs. 2.2; P < 0.05) and for small lesions (81.4% vs. 65.7%; 2.5 vs. 1.8; P < 0.05). Average liver-to-lesion CNR for large lesions and CBD-to-liver CNR was significantly greater at high FA (P < 0.05). Conclusion: Increasing the FA in hepatocyte phase MRI with gadoxetate disodium improves hypointense lesion detection and conspicuity, particularly for small lesions. Copyright © 2011 Wiley-Liss, Inc.

PMID: 22034383    

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