CAIPIRINHA-Dixon-TWIST (CDT)-VIBE MR imaging of the liver at 3.0T with gadoxetate disodium: a solution for transient arterial-phase respiratory motion-related artifacts?

Eur Radiol. 2018 May;28(5):2013-2021. doi: 10.1007/s00330-017-5210-4. Epub 2017 Dec 20.

Abstract

Purpose: To determine whether CAIPIRINHA-Dixon-TWIST (CDT) volume-interpolated breath-hold examination (VIBE) improves image quality by reducing gadoxetate-disodium-associated transient arterial-phase motion artefacts in magnetic resonance imaging (MRI) of the liver.

Materials and methods: MRI studies of the liver from 270 patients who had received gadoxetate disodium were retrospectively evaluated in regard to arterial timing accuracy and arterial phase motion artefact severity (VIBE: 90/270, CAIPIRINHA-VIBE: 90/270 and CDT-VIBE: 90/270 cases). Three independent and blinded readers assessed arterial phase timing and motion artefact severity (5-point scale). Interrater agreement was calculated by weighted kappa. Continuous variables were compared via a two-sided ANOVA, categorical variables via a χ2 test. An ordinal regression analysis was performed to identify other predictors of motion artefacts.

Results: CDT-VIBE improved correct late arterial timing rates and reduced motion-related image deterioration rates. Successful late arterial liver visualisation was achieved in 56.7% (VIBE) compared with 66.7% (CAIPIRINHA-VIBE) and 84.4% (CDT-VIBE) (P < 0.0001). Good/excellent image quality was achieved in 56.7% vs. 66.7% and 73.3%, respectively (P = 0.03). Male sex negatively influenced image quality (P = 0.03).

Conclusion: CDT-VIBE increases the diagnostic utility of gadoxetate disodium-based liver MRI by reducing respiratory motion artefacts and optimising late arterial visualisation compared with VIBE and CAIPIRINHA-VIBE.

Key points: • CAIPIRINHA-Dixon-TWIST-VIBE-MRI (CDT) mitigates effects of acute transient dyspnoea caused by gadoxetate disodium. • CDT improves late arterial imaging compared with VIBE and CAIPIRINHA-VIBE. • The rate of ideal late arterial images is higher with CDT-VIBE vs. VIBE or CAIPI-VIBE. • The impact of respiratory motion artefacts on arterial phase images can be reduced.

Keywords: Artefacts; Contrast media; Diagnostic imaging; Liver; Magnetic resonance imaging.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Artifacts*
  • Breath Holding
  • Child
  • Contrast Media*
  • Female
  • Gadolinium DTPA*
  • Humans
  • Image Enhancement / methods*
  • Image Interpretation, Computer-Assisted / methods*
  • Liver / diagnostic imaging
  • Liver Diseases / diagnostic imaging*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Motion
  • Reproducibility of Results
  • Retrospective Studies
  • Young Adult

Substances

  • Contrast Media
  • gadolinium ethoxybenzyl DTPA
  • Gadolinium DTPA