title: High-resolution T2-weighted abdominal magnetic resonance imaging using respiratory triggering: impact of butylscopolamine on image quality.
abstract: BACKGROUND
  Respiratory triggering allows the acquisition of high-resolution magnetic resonance (MR) images of the upper abdomen. However, the depiction of organs close to the gastrointestinal tract can be considerably impaired by ghosting artifacts and blurring caused by bowel peristalsis.
  
  
  OBJECTIVE
  To evaluate the effect of gastrointestinal motion suppression by intramuscular butylscopolamine administration on the image quality of a respiratory-triggered T2-weighted turbo spin-echo (T2w TSE) sequence of the upper abdomen.
  
  
  METHODS
  Images of 46 patients were retrospectively analyzed. Twenty-four patients had received intramuscular injection of 40 mg butylscopolamine immediately before MR imaging. Fourteen of the 24 patients in the butylscopolamine group underwent repeat imaging after a mean of 29 min. Quantitative analysis of the ghosting artifacts was done by measuring signal intensities in regions of interest placed in air anterior to the patient. In addition, image quality was assessed qualitatively by two radiologists by consensus.
  
  
  RESULTS
  Spasmolytic medication with butylscopolamine reduced ghosting artifacts and significantly improved image quality of the respiratory-triggered T2w TSE sequence. The most pronounced effect of butylscopolamine administration on image quality was found for the pancreas and the left hepatic lobe. The rate of examinations with excellent or good depiction of the pancreas and the left hepatic lobe in the group without premedication and in the butylscopolamine group was 55% vs. 96% (pancreatic head), 35% vs. 88% (pancreatic body), 43% vs. 96% (pancreatic tail), and 45% vs. 83% (left hepatic lobe), respectively. Regarding the duration of the effect of intramuscular butylscopolamine, repeat imaging after a mean of 29 min did not result in a significant deterioration of image quality.
  
  
  CONCLUSIONS
  Intramuscular butylscopolamine administration significantly improves image quality of respiratory-triggered T2-weighted abdominal MR imaging by persistent reduction of peristaltic artifacts. MR imaging of the liver and pancreas in particular benefits from the suppression of gastrointestinal peristalsis by butylscopolamine.
authors.affiliation: Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany. moritz.wagner@charite.de
authors.forename: M
authors.initials: M
authors.lastname: Wagner
authors.forename: C
authors.initials: C
authors.lastname: Klessen
authors.forename: M
authors.initials: M
authors.lastname: Rief
authors.forename: T
authors.initials: T
authors.lastname: Elgeti
authors.forename: M
authors.initials: M
authors.lastname: Taupitz
authors.forename: B
authors.initials: B
authors.lastname: Hamm
authors.forename: P
authors.initials: P
authors.lastname: Asbach
mesh_terms: D002086:Butylscopolammonium Bromide / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D003287:Contrast Media; D003911:Dextrans; D004066:Digestive System Diseases / Q000175:diagnosis*; D005260:Female; D052203:Ferrosoferric Oxide; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted; D007273:Injections, Intramuscular; D007501:Iron; D008279:Magnetic Resonance Imaging / Q000379:methods*; D058185:Magnetite Nanoparticles; D008297:Male; D008875:Middle Aged; D010087:Oxides; D010276:Parasympatholytics / Q000008:administration & dosage*; D012119:Respiration; D012189:Retrospective Studies; D018709:Statistics, Nonparametric
chemical_list: D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; D010087:Oxides; D010276:Parasympatholytics; D002086:Butylscopolammonium Bromide; D007501:Iron; C065507:ferumoxides; D052203:Ferrosoferric Oxide