Prospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 28, 2015; 21(16): 5017-5022
Published online Apr 28, 2015. doi: 10.3748/wjg.v21.i16.5017
Usefulness of two-point Dixon fat-water separation technique in gadoxetic acid-enhanced liver magnetic resonance imaging
Ying Ding, Sheng-Xiang Rao, Cai-Zhong Chen, Ren-Chen Li, Meng-Su Zeng
Ying Ding, Sheng-Xiang Rao, Cai-Zhong Chen, Ren-Chen Li, Meng-Su Zeng, Department of Radiology, Zhongshan Hospital of Fudan University, Shanghai Institute of Medical Imaging, Shanghai 200032, China
Author contributions: Rao SX and Zeng MS designed the study; Ding Y and Chen CZ performed the research; Li RC and Rao SX analyzed the data; Ding Y wrote the paper; and Ding Y revised the manuscript for final submission.
Supported by National Natural Science Foundation of China, No. 81371543.
Ethics approval: The study was reviewed and approved by the Zhongshan Hospital Fudan University Institutional Review Board.
Clinical trial registration: This study is registered at Zhongshan Hospital Fudan University. The registration identification number is 2010-17.
Informed consent: The requirement for informed consent was waived for our study.
Conflict-of-interest: No potential conflicts of interest relevant to this article are reported.
Data sharing: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Sheng-Xiang Rao, MD, PhD, Department of Radiology, Zhongshan Hospital of Fudan University, Shanghai Institution of Medical Imaging, 180 Fenglin Road, Xuhui District, Shanghai 200032, China. raoxray@126.com
Telephone: +86-21-64041990 Fax: +86-21-64041990
Received: November 9, 2014
Peer-review started: November 10, 2014
First decision: December 11, 2014
Revised: December 22, 2014
Accepted: February 5, 2015
Article in press: February 5, 2015
Published online: April 28, 2015
Processing time: 168 Days and 21.2 Hours
Abstract

AIM: To compare differences between volumetric interpolated breath-hold examination (VIBE) using two-point Dixon fat-water separation (Dixon-VIBE) and chemically selective fat saturation (FS-VIBE) with magnetic resonance imaging examination.

METHODS: Forty-nine patients were included, who were scanned with two VIBE sequences (Dixon-VIBE and FS-VIBE) in hepatobiliary phase after gadoxetic acid administration. Subjective evaluations including sharpness of tumor, sharpness of vessels, strength and homogeneity of fat suppression, and artifacts that were scored using a 4-point scale. The liver-to-lesion contrast was also calculated and compared.

RESULTS: Dixon-VIBE with water reconstruction had significantly higher subjective scores than FS-VIBE in strength and homogeneity of fat suppression (< 0.0001) but lower scores in sharpness of tumor (P < 0.0001), sharpness of vessels (P = 0.0001), and artifacts (P = 0.034). The liver-to-lesion contrast on Dixon-VIBE images was significantly lower than that on FS-VIBE (16.6% ± 9.4% vs 23.9% ± 12.1%, P = 0.0001).

CONCLUSION: Dixon-VIBE provides stronger and more homogenous fat suppression than FS-VIBE, while has lower clarity of focal liver lesions in hepatobiliary phase after gadoxetic acid administration.

Keywords: Dixon-volumetric interpolated breath-hold examination; Fat saturation-volumetric interpolated breath-hold examination; Gadoxetic acid; Volumetric interpolated breath-hold examination; Magnetic resonance imaging

Core tip: The role of three dimensional gradient echo sequence with volumetric interpolated breath-hold examination (VIBE) by using chemically selective fat-saturation for abdominal magnetic resonance (MR) imaging is well established and it is now part of the standard clinical work-up, especially for dynamic contrast-enhanced liver MR imaging. The Dixon technique has been improved extensively in the aspects of phase errors, noise and artifacts. There are no reports yet on the potential value of two-point Dixon fat-water separation technique for image quality and focal liver lesions in hepatobiliary phase of gadoxetic acid-enhanced MR imaging. Therefore, we compare the image quality and liver-to-lesion contrast in hapatobiliary phase between VIBE using two-point Dixon fat-water separation and chemically selective fat saturation.