title: Can a single-shot black-blood T2-weighted spin-echo echo-planar imaging sequence with sensitivity encoding replace the respiratory-triggered turbo spin-echo sequence for the liver? An optimization and feasibility study.
abstract: OBJECTIVE
  To optimize and assess the feasibility of a single-shot black-blood T2-weighted spin-echo echo-planar imaging (SSBB-EPI) sequence for MRI of the liver using sensitivity encoding (SENSE), and compare the results with those obtained with a T2-weighted turbo spin-echo (TSE) sequence.
  
  
  METHODS
  Six volunteers and 16 patients were scanned at 1.5T (Philips Intera). In the volunteer study, we optimized the SSBB-EPI sequence by interactively changing the parameters (i.e., the resolution, echo time (TE), diffusion weighting with low b-values, and polarity of the phase-encoding gradient) with regard to distortion, suppression of the blood signal, and sensitivity to motion. The influence of each change was assessed. The optimized SSBB-EPI sequence was applied in patients (N = 16). A number of items, including the overall image quality (on a scale of 1-5), were used for graded evaluation. In addition, the signal-to-noise ratio (SNR) of the liver was calculated. Statistical analysis was carried out with the use of Wilcoxon's signed rank test for comparison of the SSBB-EPI and TSE sequences, with P = 0.05 considered the limit for significance.
  
  
  RESULTS
  The SSBB-EPI sequence was improved by the following steps: 1) less frequency points than phase-encoding steps, 2) a b-factor of 20, and 3) a reversed polarity of the phase-encoding gradient. In patients, the mean overall image quality score for the optimized SSBB-EPI (3.5 (range: 1-4)) and TSE (3.6 (range: 3-4)), and the SNR of the liver on SSBB-EPI (mean +/- SD = 7.6 +/- 4.0) and TSE (8.9 +/- 4.6) were not significantly different (P > .05).
  
  
  CONCLUSIONS
  Optimized SSBB-EPI with SENSE proved to be feasible in patients, and the overall image quality and SNR of the liver were comparable to those achieved with the standard respiratory-triggered T2-weighted TSE sequence.
authors.affiliation: Department of Radiology, Erasmus MC, Rotterdam, The Netherlands. smhussain62@hotmail.com
authors.forename: Shahid M
authors.initials: SM
authors.lastname: Hussain
authors.forename: Jan
authors.initials: J
authors.lastname: De Becker
authors.forename: Wim C J
authors.initials: WC
authors.lastname: Hop
authors.forename: Soendersing
authors.initials: S
authors.lastname: Dwarkasing
authors.forename: Piotr A
authors.initials: PA
authors.lastname: Wielopolski
mesh_terms: D018248:Adenoma, Liver Cell / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016477:Artifacts; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis*; D003560:Cysts; D003937:Diagnosis, Differential; D017352:Echo-Planar Imaging / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006391:Hemangioma / Q000175:diagnosis*; D006432:Hemochromatosis / Q000175:diagnosis; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008099:Liver / Q000473:pathology*; D008107:Liver Diseases / Q000175:diagnosis; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000556:secondary; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric