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  • Title: 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?
    Author: Gruber L, Rainer V, Plaikner M, Kremser C, Jaschke W, Henninger B.
    Journal: Eur Radiol; 2018 May; 28(5):2013-2021. PubMed ID: 29264636.
    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.
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