Role of spectral presaturation attenuated inversion‐recovery fat‐suppressed T2‐weighted MR imaging in active inflammatory bowel disease

Abstract

Purpose:To retrospectively evaluate the efficacy of spectral presaturation attenuated inversion-recovery (SPAIR) fatsuppressed (FS) partial Fourier single shot (SSH) T2-weighted (T2W) and gadolinium-enhanced (Gd) FS 3D-gradient echo (3DGRE) T1-weighted (T1W) delayed phase MRI to differentiate active bowel inflammation from fibrotic disease in patients with Crohn's disease (CD). Materials and Methods:MRI studies of 81 patients (mean age, 43 years; range, 22-77 years; M:F ratio 33:48) had T2W and T1W imaging including SPAIR-SSH and delayed Gd-3DGRE. The ability to assess disease activity in bowel segments affected were retrospectively evaluated by a grading scheme based on subjective analysis of signal intensities. These results were compared against the standard clinical parameters of disease activity.Results: SPAIR-SSH images correlated better (r ϭ 0.74, P Ͻ 0.0001) with activity than delayed Gd-3DGRE (r ϭ 0.39, P ϭ 0.0003), with a significant difference between the two techniques (P Ͻ 0.0001). SPAIR-SSH images showed higher specificity in detection of severely active disease in per patient (98%) and segmental (98%) analysis compared to Gd-3DGRE (57%, 70%). Gd-3DGRE technique showed significantly higher sensitivity (P ϭ 0.01) in identifying active disease in per patient (83%) and segmental (85%) analysis compared to SPAIR-SSH (70%, 64%).Conclusion: SPAIR-SSH detects actively diseased CD bowel segments with a high level of specificity. Noninflammatory bowel fibrosis corresponds to abnormal uptake on delayed phase Gd-3DGRE images but without associated elevated abnormal signal on SPAIR-SSH.

MRI of hepatocellular carcinoma: an update of current practices

“…T2-weighted images may be acquired with a single-shot fast spin-echo technique in the coronal and axial plane without fat saturation, and in the axial plane with fat saturation using a spectral adiabatic inversion recovery (SPAIR) technique (21,22). While T2-weighted sequences are not critical for the diagnosis of the majority of focal HCC, the more aggressive infiltrative subtype of HCC is frequently best demonstrated on T2-weighted images.…”

Magnetic resonance enterography in crohn’s disease: techniques, interpretation, and utilization for clinical management

“…Our experience has led us to propose a relatively simple approach for the evaluation of Crohn's disease activity using FS T2W single-shot fast spin-echo MRI (16,17). FS T2W imaging is sensitive to edema in or adjacent to the bowel wall (22). Combining late vascular-or interstitial-phase gadolinium-enhanced T1W images with the FS T2W images allows for comprehensive evaluation and discrimination between quiescent disease and active inflammation (Figs.…”

“…Regular T2W single-shot images depict bowel wall morphology. Fatsuppressed single-shot T2W images are critical to assess edema and inflammation related to active Crohn's disease, optimized with a spectral adiabatic inversion recovery (SPAIR) fatsuppression technique (22).…”

“…However, progressive experience over the past 10 years has led to the following conclusions, which contrast both with the early descriptions of MRE and with CT and fluoroscopy techniques: 1) By achieving significant improvements in the diagnostic quality of MRE sequence techniques, active and chronic disease states may be visualized even with suboptimal bowel lumen distention (27). 2) These sequence techniques rely on T2W single-shot imaging, in combination with SPAIR for optimal fat suppression (22), and T1W contrast-enhanced imaging, using the latest-generation 3D GRE, which achieves improved soft tissue contrast and edge sharpness. 3) An enteroclysis level of distention is often not necessary, and pre-procedure oral contrast is sufficient in most patients (28).…”

A Study on Optimized MRI Fat-Saturation Technique for Brachial Plexus Patients : Focused on SPAIR and STIR Fat-Saturation

“…[17][18][19] . 본 실험에서 SPAIR T2 기법은 낮은 신호대 잡 음비와 영상의 질을 떨어지는 영상을 획득하였지만, 기존 보고에 의하면 복부 검사 시 지방소거 기법으로 우수한 영상정보를 제공하기도 하였다 [20][21] . …”