Purpose or Case Report: 3D mDIXON Gradient Echo (GRE) technical superiority has already been established: improved fat saturation, faster acquisition time, high spatial resolution, and volumetric data acquisition allowing for a comprehensive multiplanar and 3D post-contrast evaluation of vessels and soft tissue lesions. Vascular malformation imaging requires large field of view images that can adversely affect fat saturation, is frequently performed with a non-sedated patient resulting in motion artifact, and requires higher spatial resolution to better characterize a lesion and evaluate lesion extent. Additionally the interventional radiologists at our institution prefer 3D post-contrast imaging to assist in treatment planning. We believe that this sequence is well suited for vascular malformation MRI imaging. The primary purpose is to illustrate the clinical utility and superior image quality of the 3D mDIXON GRE sequence over more conventional mDIXON TSE sequence through a series of cases of a variety of vascular malformations in different body regions. The secondary purpose of this presentation is to validate the clinical superiority of this sequence through a blinded reviewer comparison to the more conventional mDIXON TSE sequence.
Methods & Materials: 25 sequential vascular malformation MRI examinations were performed which included postcontrast mDIXON TSE and postcontrast mDIXON GRE sequences. Matching single best image representative of pathology with the same plane of imaging for both mDIXON sequences was used for a direct side-by-side comparison. Six independent blinded reviewers rated image quality in four categories: fat suppression, contrast, motion artifact, and detail. Reviewers then chose the sequence they preferred for each of the categories as well as overall quality. Select cases will be shown to illustrate the image quality and clinical utility of the mDIXON GRE sequence.
Results: Reviewers preferred the mDIXON GRE sequence to the mDIXON TSE sequence for fat suppression (48 votes versus 12 votes), contrast (40 v. 20), motion artifact (51 v. 9), detail (37 v. 23), and overall image quality (48 v. 12).
Conclusions: The mDIXON GRE sequence is technically and clinically superior to mDIXON TSE for the evaluation of vascular malformations. In addition to decreasing scanning time, there was an increase in image quality and ability to obtain 3D reformatted images of vasculature and pathology.