Russell Norman Low MD, Presenter: Consultant, General Electric Company Consultant, Koninklijke Philips Electronics NV

Norman Chen MD, Abstract Co-Author: Nothing to Disclose

To evaluate the use of free breathing, fat suppressed, gadolinium-enhanced 2D FIESTA MRI for abdominal imaging in the uncooperative patient

Seventy-four patients referred for abdominal MRI were unable to cooperate with breath hold imaging techniques. Imaging sequences included T1-weighted, respiratory-triggered T2-weighted, SSFSE, gadolinium-enhanced single-slice SGE, and fat suppressed 2D FIESTA obtained imaging during free breathing. Conventional unenhanced and gadolinium-enhanced SGE images were evaluated for abnormalities at 17 anatomic locations. At a separate session the 2D FIESTA images were examined. Image quality was scored using a four-point scale and the preferred sequence was selected in a side-by-side comparison. Truth was established by review of surgical records, concurrent exams, and follow up imaging studies.

Conventional MR imaging detected 293 (68%) of 431 findings compared to 389 (90%) for the 2D FIESTA images. In 22 exams MRI and 2D FIESTA were equivalent, while in 42 exams 2D FIESTA depicted more findings, and in ten exams conventional MRI depicted more findings. There was no difference for depicting abnormalities of solid organs such as the liver, kidneys, pancreas, spleen, bones, or the peritoneum. The 2D FIESTA images showed more abnormalities of the biliary system, GI tract, vascular system, heart, ascites, pleural effusions, and pericardial effusions. After excluding minor findings including small volume ascites, small pleural effusions, pericardial effusions, and mild cardiomegaly the 2D FIESTA images depicted 220 (88%) of 249 findings compared to 189 (76%) for conventional MRI. Image quality was scored highest for the 2D FIESTA 1.49, compared to T1 2.25, T2 2.01, gadolinium-enhanced SGE 2.89, and SSFSE 1.71. The 2D FIESTA images were the preferred imaging sequence in 57 exams.

In the uncooperative patient free breathing, fat suppressed, 2D FIESTA MRI is an excellent sequence for depicting abdominal and pelvic disease.

For the patient who is unable to cooperate with breath-hold abdominal MRI, free breathing 2D FIESTA provides motion insensitive imaging with excellent depiction of anatomy and diseases.

Low, R, Chen, N, Balanced Steady State Free Precession Abdominal MR Imaging Used as a Free Breathing Technique in the Uncooperative Patient.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5008464.html