title: Contrast-Enhanced Dixon Fat-Water Separation Imaging of the Spine: Added Value of Fat, In-Phase and Opposed-Phase Imaging in Marrow Lesion Detection.
abstract: OBJECTIVE
  Beyond fat suppression (FS), the efficacy of (fat-water separation or Dixon [FWD]) Dixon imaging in gadolinium-enhanced spine imaging has yet to be validated. This study evaluated enhanced opposed-phase (OP) and fat-only (FO) images along with water-only (WO; FS) images against traditional unenhanced techniques and rated the incremental value of in-phase imaging in patients with presumed neoplastic focal spine lesions.
  
  
  METHODS
  A retrospective cohort study of 36 subjects with focal spine lesions imaged with FWD was evaluated qualitatively and quantitatively.
  
  
  RESULTS
  Enhanced OP, WO, and FO images were of significant value in detection of osseous lesions, surpassing the lesion conspicuity with conventional techniques both qualitatively and quantitatively, although the impact of in-phase imaging was limited. Water-only imaging performed well for FS.
  
  
  CONCLUSIONS
  Contrast-enhanced FO, WO, and OP outperform traditional techniques, providing reliable lesion characterization and highest conspicuity. In-phase imaging offered limited impact on the subjective assessment of enhancement. The added value and robustness of FWD, particularly the unique contrast provided by FO imaging, suggests consideration for routine use for postgadolinium spine imaging.
authors.affiliation: From the Department of Radiology, The Mount Sinai Medical Center, New York, NY.
authors.forename: Sergey I
authors.initials: SI
authors.lastname: Zhadanov
authors.forename: Amish H
authors.initials: AH
authors.lastname: Doshi
authors.forename: Puneet S
authors.initials: PS
authors.lastname: Pawha
authors.forename: Idoia
authors.initials: I
authors.lastname: Corcuera-Solano
authors.forename: Lawrence N
authors.initials: LN
authors.lastname: Tanenbaum
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D001834:Body Water / Q000000981:diagnostic imaging*; D001855:Bone Marrow Diseases / Q000000981:diagnostic imaging*; D015331:Cohort Studies; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013122:Spinal Diseases / Q000000981:diagnostic imaging*; D013382:Subtraction Technique
chemical_list: D003287:Contrast Media; D005682:Gadolinium