01-01-2012 | Urogenital
Effectiveness of a three-dimensional dual gradient echo two-point Dixon technique for the characterization of adrenal lesions at 3 Tesla
Published in: European Radiology | Issue 1/2012
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Objective
To compare the sensitivity, specificity, and diagnostic accuracy of fat-only datasets reconstructed using a two-point Dixon technique, with corresponding opposed-phase (OP) and in-phase (IP) datasets for characterization of adrenal lesions at 3 Tesla (T).
Methods
Fifty-nine patients (21 male, 38 female) with 66 adrenal lesions (49 adenomas, 17 nonadenomas) underwent 3D dual gradient-echo 3-T adrenal MR imaging with reconstruction of OP/IP and fat/water datasets. Sensitivity, specificity, and diagnostic accuracy were compared between OP/IP datasets, using the signal intensity index (SII), and fat/water datasets, using the fat fraction and fat ratio. Four radiologists qualitatively assessed OP/IP and fat-only datasets for reader confidence in lesion characterization and image quality.
Results
There were significant differences between adenomas and nonadenomas with regard to mean SII, fat fraction, and fat ratio (P < 0.001). There was no significant difference in mean diagnostic accuracy among different evaluation methods using OP/IP and fat/water datasets. Mean readers’ scores for lesion characterization were significantly higher for adenomas than for nonadenomas using OP/IP and fat-only datasets. There was no significant difference between the two datasets regarding mean readers’ scores for image quality.
Conclusion
Fat-only images can readily differentiate adrenal adenomas from nonadenomas, with diagnostic accuracy comparable to OP/IP images.
Key Points
• Incidental adrenal lesions are commonly encountered in radiology practice
• MR has been used to identify lesions giving cause for concern.
• 3T MR provides excellent demonstration of the effects of fat within structures
• Fat-only 3T MR images can readily differentiate adrenal adenomas from nonadenomas