title: Increased sensitivity to low concentration gadolinium contrast by optimized heavily T2-weighted 3D-FLAIR to visualize endolymphatic space.
abstract: OBJECTIVE
  To increase the sensitivity of 3-dimensional fluid-attenuated inversion recovery (3D-FLAIR) to low concentration gadolinium (Gd)-based contrast medium, we optimized sequence parameters on a phantom and evaluated the optimized sequence in patients suspicious for endolymphatic hydrops.
  
  
  METHODS
  All scans were performed on a 3-tesla magnetic resonance (MR) unit using a 32-channel head coil. We optimized sequence parameters using a phantom filled with diluted Gd and compared the optimized protocol with 3D-FLAIR using conventional turbo spin echo sequence (3D-FLAIR-CONV). Nine patients underwent scanning using the newly optimized sequence and 3D-FLAIR-CONV 4 hours after double-dose administration of intravenous Gd. We subjectively scored separation of endo- and perilymph space and measured contrast-to-noise ratio (CNR) between endo- and perilymph.
  
  
  RESULTS
  The optimized sequence in the phantom study consisted of: repetition time, 9000 ms; echo time, 540 ms; inversion time, 2400 ms; low constant readout flip angle, 120 degrees in the later part of the echo train. Image contrast became heavily T(2)-weighted (hT(2)W-3D-FLAIR). In patients, we recognized endolymphatic space for both the cochlea and vestibule significantly better by hT(2)W-3D-FLAIR than 3D-FLAIR-CONV (P<0.01). The mean CNR of the new method was also better than that of 3D-FLAIR-CONV (P<0.01).
  
  
  CONCLUSIONS
  The newly optimized hT(2)W-3D-FLAIR was more sensitive than the previous method to low concentration of Gd. Visualization of the endolymphatic space by double-dose administration of intravenous Gd would be more reliable using hT(2)W-3D-FLAIR.
authors.affiliation: Department of Radiology, Nagoya University Graduate School of Medicine, Shouwa-ku, Nagoya, Japan. naganawa@med.nagoya-u.ac.jp
authors.forename: Shinji
authors.initials: S
authors.lastname: Naganawa
authors.forename: Hisashi
authors.initials: H
authors.lastname: Kawai
authors.forename: Michihiko
authors.initials: M
authors.lastname: Sone
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nakashima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003051:Cochlea / Q000473:pathology; D003287:Contrast Media / Q000008:administration & dosage; D004710:Endolymph; D018159:Endolymphatic Hydrops / Q000473:pathology*; D005260:Female; D005682:Gadolinium / Q000008:administration & dosage; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010498:Perilymph; D019047:Phantoms, Imaging; D013997:Time Factors
chemical_list: D003287:Contrast Media; D005682:Gadolinium