Hepatic MR imaging using IDEAL-IQ sequence:Will Gd-EOB-DTPA interfere with reproductivity of fat fraction quantification?

BACKGROUND Iterative decomposition of water and fat with echo asymmetry and least squares estimation quantification sequence(IDEAL-IQ)is based on chemical shift-based water and fat separation technique to get proton density fat fraction.Multiple studies have shown that using IDEAL-IQ to test the stability and repeatability of liver fat is acceptable and has high accuracy.AIM To explore whether Gadoxetate Disodium(Gd-EOB-DTPA)interferes with the measurement of the hepatic fat content quantified with the IDEAL-IQ and to evaluate the robustness of this technique.METHODS IDEAL-IQ was used to quantify the liver fat content at 3.0T in 65 patients injected with Gd-EOB-DTPA contrast.After injection,IDEAL-IQ was estimated four times,and the fat fraction(FF)and R2* were measured at the following time points:Precontrast,between the portal phase(70 s)and the late phase(180 s),the delayed phase(5 min)and the hepatobiliary phase(20 min).One-way repeated-measures analysis was conducted to evaluate the difference in the FFs between the four time points.Bland-Altman plots were adopted to assess the FF changes before and after injection of the contrast agent.P<0.05 was considered statistically significant.RESULTS The assessment of the FF at the four time points in the liver,spleen and spine showed no significant differences,and the measurements of hepatic FF yielded good consistency between T1 and T2[95%confidence interval:-0.6768%,0.6658%],T1 and T3(-0.3900%,0.3178%),and T1 and T4(-0.3750%,0.2825%).R2* of the liver,spleen and spine increased significantly after injection(P<0.0001).CONCLUSION Using the IDEAL-IQ sequence to measure the FF,we can obtain results that will not be affected by Gd-EOB-DTPA.The high reproducibility of the IDEAL-IQ sequence makes it available in the scanning interval to save time during multiphase examinations.

Two-point Dixon and six-point Dixon magnetic resonance techniques in the detection,quantification and grading of hepatic steatosis

BACKGROUND Hepatic steatosis is a very common problem worldwide.AIM To assess the performance of two-and six-point Dixon magnetic resonance(MR)techniques in the detection,quantification and grading of hepatic steatosis.METHODS A single-center retrospective study was performed in 62 patients with suspected parenchymal liver disease.MR sequences included two-point Dixon,six-point Dixon,MR spectroscopy(MRS)and MR elastography.Fat fraction(FF)estimates on the Dixon techniques were compared to the MRS-proton density FF(PDFF).Statistical tests used included Pearson’s correlation and receiver operating characteristic.RESULTS FF estimates on the Dixon techniques showed excellent correlation(≥0.95)with MRS-PDFF,and excellent accuracy[area under the receiver operating characteristic(AUROC)≥0.95]in:(1)Detecting steatosis;and(2)Grading severe steatosis,(P<0.001).In iron overload,two-point Dixon was not evaluable due to confounding T2*effects.FF estimates on six-point Dixon vs MRS-PDFF showed a moderate correlation(0.82)in iron overload vs an excellent correlation(0.97)without iron overload,(P<0.03).The accuracy of six-point Dixon in grading mild steatosis improved(AUROC:0.59 to 0.99)when iron overload cases were excluded.The excellent correlation(>0.9)between the Dixon techniques vs MRSPDFF did not change in the presence of liver fibrosis(P<0.01).CONCLUSION Dixon techniques performed satisfactorily for the evaluation of hepatic steatosis but with exceptions.