Claudia Fellner PhD, Presenter: Nothing to Disclose

Niels Zorger MD, Abstract Co-Author: Nothing to Disclose

Thomas Finkenzeller MD, Abstract Co-Author: Nothing to Disclose

PROPELLER or BLADE techniques proved to be highly beneficial in MRI of the head, abdomen, and cervical spine to reduce motion artifacts – mainly for T2-weighted imaging. The aim of our study was to evaluate its possible role for post-contrast T1-weighted imaging with fat suppression in the neck because those images are especially prone to several kinds of motion artifacts even in cooperative patients.

40 patients (27 men, 13 women; 25-85 years old) referred for MRI of the neck were included and examined on a 1.5 T scanner. Based on the routine neck MR examination oral cancer (n=13), pathologic lymph nodes (n=9), thyroid nodules (n=6), or other neck lesions (n=12) were diagnosed. After application of Gd-DTPA fat suppressed T1-weighted images were acquired in coronal orientation using TSE (TR/TE/ETL 607/10/3), BLADE (607/23/9), and IR-BLADE (2670/56/19, TI 860) in all patients. Overall motion artifacts, vessel pulsations, delineation of thoracic structures as well as muscle/fat, lymph node/fat, and lesion contrast were assessed by 2 independent readers on a scale from 1 (excellent, no artifacts) to 5 (poor, non-diagnostic). Differences with p<0.05 (Wilcoxon test) were regarded as statistically significant.

BLADE and IR-BLADE were significantly superior to TSE regarding vessel pulsations and delineation of thoracic structures, no significant differences were seen for overall motion artifacts and muscle/fat contrast. Regarding lymph node/fat and lesion contrast both BLADE techniques yielded significantly inferior results compared to TSE, one tongue lesions was even missed using BLADE and IR-BLADE. Lesion contrast in patients with thyroid nodules, however, was significantly superior in IR-BLADE. These results were true for each individual reader as well as for the mean values of both readers.

Using the BLADE technique for post-contrast T1-weighted imaging with fat suppression can not be generally recommended for coronal neck imaging – at least with the parameters presented in this work. But in selected cases with severe pulsation artifacts or for evaluation of thyroid nodules BLADE might be a helpful adjunct.

Application of the BLADE technique for post-contrast T1-weighted imaging with fat suppression is still demanding.

Fellner, C, Zorger, N, Finkenzeller, T, BLADE in Post Contrast T1-weighted Imaging with Fat Suppression of the Neck.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9010392.html