Objectives <p>To compare image quality between GRASP-VIBE (free-breathing) and CAIPIRINHA-VIBE (breath-hold) sequences in dynamic liver MRI in a pediatric population.</p> Materials and methods <p>This retrospective study included 70 children who underwent dynamic liver MRI at 3 T with either GRASP-VIBE (<i>n</i> = 40) or CAIPIRINHA-VIBE (<i>n</i> = 40) acquisition. Ten patients underwent both imaging protocols at different time points. Image pairs were matched at four representative anatomical levels using vascular landmarks. Four dynamic contrast phases (pre-contrast, arterial, portal venous, delayed venous) at each anatomic level were independently reviewed by two radiologists, leading to a total of 640 comparisons per reader. Reader preference was assessed using a two-alternative forced-choice paradigm. Inter- and intra-reader agreement were analyzed using binomial tests and Cohen’s κ.</p> Results <p>GRASP-VIBE was preferred over CAIPIRINHA-VIBE across all contrast-enhanced phases of pediatric liver MRI: 82.2% [526/640] in the arterial, 83.1% [532/640] in the portal venous, 71.3% [456/640] in the delayed venous (all <i>p</i> &lt; 0.001). No significant difference was observed for the pre-contrast phase with 59.4% [380/640] GRASP-VIBE preference (<i>p</i> = 0.45). Strongest GRASP-VIBE preferences were observed in older children and adolescents and in examinations performed without anesthesia. Across all anatomical levels, GRASP consistently outperformed Caipirinha-VIBE in contrast-enhanced phases. Inter-reader agreement was moderate in the arterial (κ = 0.51) and delayed venous (κ = 0.48) phases, and slight in pre-contrast (κ = 0.19) and portal venous (κ = 0.20) phases (intra-reader agreement, κ = 0.56, κ = 0.60, κ = 0.28 and κ = 0.42).</p> Conclusion <p>GRASP-VIBE offered superior subjective image quality compared to CAIPIRINHA-VIBE in pediatric liver MRI, especially in early contrast phases. Its free-breathing approach might be particularly advantageous regarding image quality in children unable to perform breath-holds.</p> Key Points <p><Emphasis Type="BoldItalic">Question</Emphasis> <i>Does free-breathing GRASP-VIBE provide superior image quality compared to breath-hold CAIPIRINHA-VIBE for dynamic liver MRI in pediatric patients?</i></p> <p><Emphasis Type="BoldItalic">Findings</Emphasis> <i>GRASP-VIBE was preferred across all contrast phases, delivering consistently higher-quality images than CAIPIRINHA-VIBE, particularly in children unable to perform breath-holds.</i></p> <p><Emphasis Type="BoldItalic">Clinical relevance</Emphasis> <i>Using GRASP-VIBE enables high-quality dynamic pediatric liver MRI. Further research is needed to determine whether this sequence can reduce the need for sedation or general anesthesia in children.</i></p> Graphical Abstract <p></p>

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Dynamic contrast-enhanced liver MRI in children: image quality comparison between GRASP-VIBE and CAIPIRINHA-VIBE

  • Simon Veldhoen,
  • Anne Pohrt,
  • Matthias Stephan Anders,
  • Corona Metz

摘要

Objectives

To compare image quality between GRASP-VIBE (free-breathing) and CAIPIRINHA-VIBE (breath-hold) sequences in dynamic liver MRI in a pediatric population.

Materials and methods

This retrospective study included 70 children who underwent dynamic liver MRI at 3 T with either GRASP-VIBE (n = 40) or CAIPIRINHA-VIBE (n = 40) acquisition. Ten patients underwent both imaging protocols at different time points. Image pairs were matched at four representative anatomical levels using vascular landmarks. Four dynamic contrast phases (pre-contrast, arterial, portal venous, delayed venous) at each anatomic level were independently reviewed by two radiologists, leading to a total of 640 comparisons per reader. Reader preference was assessed using a two-alternative forced-choice paradigm. Inter- and intra-reader agreement were analyzed using binomial tests and Cohen’s κ.

Results

GRASP-VIBE was preferred over CAIPIRINHA-VIBE across all contrast-enhanced phases of pediatric liver MRI: 82.2% [526/640] in the arterial, 83.1% [532/640] in the portal venous, 71.3% [456/640] in the delayed venous (all p < 0.001). No significant difference was observed for the pre-contrast phase with 59.4% [380/640] GRASP-VIBE preference (p = 0.45). Strongest GRASP-VIBE preferences were observed in older children and adolescents and in examinations performed without anesthesia. Across all anatomical levels, GRASP consistently outperformed Caipirinha-VIBE in contrast-enhanced phases. Inter-reader agreement was moderate in the arterial (κ = 0.51) and delayed venous (κ = 0.48) phases, and slight in pre-contrast (κ = 0.19) and portal venous (κ = 0.20) phases (intra-reader agreement, κ = 0.56, κ = 0.60, κ = 0.28 and κ = 0.42).

Conclusion

GRASP-VIBE offered superior subjective image quality compared to CAIPIRINHA-VIBE in pediatric liver MRI, especially in early contrast phases. Its free-breathing approach might be particularly advantageous regarding image quality in children unable to perform breath-holds.

Key Points

Question Does free-breathing GRASP-VIBE provide superior image quality compared to breath-hold CAIPIRINHA-VIBE for dynamic liver MRI in pediatric patients?

Findings GRASP-VIBE was preferred across all contrast phases, delivering consistently higher-quality images than CAIPIRINHA-VIBE, particularly in children unable to perform breath-holds.

Clinical relevance Using GRASP-VIBE enables high-quality dynamic pediatric liver MRI. Further research is needed to determine whether this sequence can reduce the need for sedation or general anesthesia in children.

Graphical Abstract