Keywords:
Tissue characterisation, Drugs / Reactions, Artifacts, Technical aspects, Imaging sequences, Comparative studies, MR, Image manipulation / Reconstruction, Pelvis, MR physics, Genital / Reproductive system female
Authors:
D. E. R. Freitas, C. S. D. S. M. Araújo, R. Themudo, E. M. Abreu; Porto/PT
DOI:
10.26044/ecr2019/C-2344
Results
The mean age of patients in this study was 37.8 years.
Three (10%) patients reported transitory blurred vision,
which is in concordance with previously published studies (11).
In the quantitative analysis,
the T2-TSE-BLADE had the higher CNR (47.89 ± 35.81) and higher SNR (71.74 ± 4911,
mean±SD) of the myometrium as compared to the other 2 sequences (p=0.004),
followed by the sagittal T2-TSE-iv,
with CNR (29.36 ± 15.80) and SNR (41.42 ± 16.97,
mean±SD),
as shown in table 1.
SD in was higher in T2-TSE-Blade in all measures,
with a mean of SD in air of 6.08 compared to 5.25 for the T2 TSE and 4.78 for the T2-TSE-iv,
reveling a higher basis noise.
Table 1: CNR and SNR of the myometrium and rectus abdominal muscle for each sequence.
|
N |
Minimum |
Maximum |
Mean |
SD |
p-value |
SAG T2-TSE CNR Myometrium |
30 |
1.54 |
52.52 |
27.05 |
14.39 |
0.004 |
SAG T2-TSE-BLADE CNR Myometrium |
30 |
1.50 |
170.03 |
47.89 |
35.81 |
0.004 |
SAG T2-TSE-iv CNR Myometrium |
30 |
1.28 |
67.81 |
29.36 |
15.80 |
0.004 |
SAG T2-TSE SNR Myometrium |
30 |
5.09 |
70.12 |
37.86 |
15.70 |
0.001 |
SAG T2-TSE-BLADE SNR Myometrium |
30 |
4.46 |
224.23 |
71.74 |
49.11 |
0.001 |
SAG T2-TSE-iv SNR Myometrium |
30 |
5.70 |
80.81 |
41.42 |
16.97 |
0.001 |
SAG T2-TSE SNR Muscle |
30 |
3.54 |
27.70 |
10.81 |
4.57 |
<0.001 |
SAG T2-TSE-BLADE SNR Muscle |
30 |
2.96 |
58.47 |
23.85 |
16.85 |
<0.001 |
SAG T2-TSE-iv SNR Muscle |
30 |
4.41 |
25.07 |
12.06 |
4.19 |
<0.001 |
Qualitatively,
T2-TSE-BLADE was the acquisition with fewer visible artifacts,
scoring above 4 (mean 4.17 with p = 0.003 for observer 1 and 4.13 with p = 0.001 for observer 2),
followed by the T2-TSE-iv with a score close to 4 (Table 2).
Figure 3 illustrates ghosting artifacts seen with T2-TSE and T2-TSE-iv,
which are absent in the T2-TSE-BLADE acquisition.
Table 2: Qualitative scoring per observer for each sequence with mean values of scoring.
|
Reader 1
|
Reader 2
|
|
TSE
|
TSE-Blade
|
TSE-iv
|
p-value
|
TSE
|
TSE-Blade
|
TSE-iv
|
p-value
|
Overall image quality
|
3.77
|
3.77
|
4.23
|
0.002
|
3.70
|
3.77
|
3.97
|
0.274
|
Presence of artifacts
|
3.60
|
4.17
|
3.97
|
0.003
|
3.60
|
4.13
|
3.70
|
0.001
|
Detail of uterine anatomy
|
3.90
|
3.83
|
4.20
|
0.114
|
3.97
|
3.87
|
4.23
|
0.098
|
Preferred sequence
|
17%
|
23%
|
70%
|
0.001
|
20%
|
17%
|
63%
|
0.002
|
Uterine anatomy was best characterized with the T2-TSE-iv (inter-observer agreement of 0.436 with p = 0.001),
with the T2-TSE-BLADE sequence having the lowest score.
This factor is assumed as the core for the superiority attributed to T2-TSE-iv in the parameter “overall image quality” (Fig.
4),
being the T2-TSE-is also the preferred sequence for both observers (70% with p = 0.001 for observer 1 and 63% with p = 0.002 for observer 2).