Morphological and functional assessment of the uterus: "one-stop shop imaging" using a compressed-sensing accelerated, free-breathing T1-VIBE sequence. (May 2021)

• Record Type: Journal Article
• Authors: Hausmann, Daniel; Kreul, Diana; Klarhöfer, Markus; Nickel, Dominik; Grimm, Robert; Kiefer, Berthold; Riffel, Philipp; Attenberger, Ulrike I; Zöllner, Frank G; Kubik-Huch, Rahel A
• Is Part Of: Acta radiologica. Volume 62:Number 5(2021)
• Page Start: 695
• Page End: 704
• Publication Date: 2021-05
• Subjects: Magnetic resonance imaging -- female -- cervix uteri -- uterus -- artifacts -- magnetic resonance perfusion; Radiology, Medical -- Periodicals; Radiography, Medical -- Periodicals; Radiotherapy -- Periodicals; 616.0757
• DOI: 10.1177/0284185120936260
• Languages: English
• ISSNs: 0284-1851

Abstract

Background: The combination of motion-insensitive, high-temporal, and spatial resolution imaging with evaluation of quantitative perfusion has the potential to increase the diagnostic capabilities of magnetic resonance imaging (MRI) in the female pelvis. Purpose: To compare a free-breathing compressed-sensing VIBE (fbVIBE) with flexible temporal resolution (range = 4.6–13.8 s) with breath-hold VIBE (bhVIBE) and to evaluate the potential value of quantifying uterine perfusion. Material and Methods: A total of 70 datasets from 60 patients (bhVIBE: n = 30; fbVIBE: n = 40) were evaluated by two radiologists. Only temporally resolved reconstruction (fbVIBE) was performed on 30 of the fbVIBE datasets. For a subset (n = 10) of the fbVIBE acquisitions, a time- and motion-resolved reconstruction (mrVIBE) was evaluated. Image quality (IQ), artifacts, diagnostic confidence (DC), and delineation of uterine structures (DoS) were graded on Likert scales (IQ/DC/DoS: 1 (non-diagnostic) to 5 (perfect); artifacts: 1 (no artifacts) to 5 (severe artifacts)). A Tofts model was applied for perfusion analysis. Ktrans was obtained in the myometrium (Mm), junctional zone (Jz), and cervix (Cx). Results: The median IQ/DoS/DC scores of fbVIBE (4/5/5 κ >0.7–0.9) and bhVIBE (4/4/4; κ = 0.5–0.7; P > 0.05) were high, but Artifacts were graded low (fbVIBE/bhVIBE: 2/2; κ = 0.6/0.5; P > 0.05). Artifacts were only slightly improved by the additional motion-resolved reconstruction (fbVIBE/mrVIBE: 2/1.5; P = 0.08); fbVIBE was preferred in most cases (7/10). Significant differences of Ktrans values were found between Cx, Jz, and Mm (0.12/0.21/0.19; P < 0.05). Conclusion: The fbVIBE sequence allows functional and morphological assessment of the uterus at comparable IQ to bhVIBE.