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18-05-2022 | MRI of the Abdomen | Perspective

Fat-only Dixon: how to use it in body MRI

Authors: Reza Salari, David H. Ballard, Mark J. Hoegger, Daniel Young, Anup S. Shetty

Published in: Abdominal Radiology | Issue 7/2022

Abstract

The Dixon method for fat/water separation is widely used to obtain uniform fat suppression using the water-only reconstruction. However, the fat-only reconstruction is potentially neglected in clinical practice, either not sent to the PACS or ignored upon imaging review. Fat-only Dixon provides a valuable tool for rapid screening for microscopic fat and problem-solving of lesions of interest. This work will review the physics of Dixon fat/water separation, some clinical applications, artifacts, and protocol design considerations of Dixon imaging, and how to integrate the Dixon method into the clinical practice of body MRI.

Graphical abstract

Dixon WT (1984) Simple proton spectroscopic imaging. Radiology 153:189–194. https://doi.org/10.1148/radiology.153.1.6089263CrossRefPubMed

Takatsu Y, Akasaka T, Miyati T (2015) The Dixon technique and the frequency-selective fat suppression technique in three-dimensional T 1 weighted MRI of the liver: a comparison of contrast-to-noise ratios of hepatocellular carcinomas-to-liver. BJR 88:20150117. https://doi.org/10.1259/bjr.20150117CrossRefPubMedPubMedCentral

Lins CF, Salmon CEG, Nogueira-Barbosa MH (2021) Applications of the Dixon technique in the evaluation of the musculoskeletal system. Radiol Bras 54:33–42. https://doi.org/10.1590/0100-3984.2019.0086CrossRefPubMedPubMedCentral

Shetty AS, Sipe AL, Zulfiqar M, et al (2019) In-Phase and Opposed-Phase Imaging: Applications of Chemical Shift and Magnetic Susceptibility in the Chest and Abdomen. RadioGraphics 39:115–135. https://doi.org/10.1148/rg.2019180043CrossRefPubMed

Del Grande F, Santini F, Herzka DA, et al (2014) Fat-Suppression Techniques for 3-T MR Imaging of the Musculoskeletal System. RadioGraphics 34:217–233. https://doi.org/10.1148/rg.341135130CrossRefPubMed

Schieda N, Davenport MS, Pedrosa I, et al (2019) Renal and adrenal masses containing fat at MRI: Proposed nomenclature by the society of abdominal radiology disease-focused panel on renal cell carcinoma. J Magn Reson Imaging 49:917–926. https://doi.org/10.1002/jmri.26542CrossRefPubMedPubMedCentral

Starekova J, Hernando D, Pickhardt PJ, Reeder SB (2021) Quantification of Liver Fat Content with CT and MRI: State of the Art. Radiology 301:250–262. https://doi.org/10.1148/radiol.2021204288CrossRefPubMed

Idilman IS, Ozdeniz I, Karcaaltincaba M (2016) Hepatic Steatosis: Etiology, Patterns, and Quantification. Seminars in Ultrasound, CT and MRI 37:501–510. https://doi.org/10.1053/j.sult.2016.08.003CrossRefPubMed

Vilgrain V, Ronot M, Abdel-Rehim M, et al (2013) Hepatic steatosis: A major trap in liver imaging. Diagnostic and Interventional Imaging 94:713–727. https://doi.org/10.1016/j.diii.2013.03.010CrossRefPubMed

10.

Katabathina VS, Menias CO, Shanbhogue AKP, et al (2011) Genetics and Imaging of Hepatocellular Adenomas: 2011 Update. RadioGraphics 31:1529–1543. https://doi.org/10.1148/rg.316115527CrossRefPubMed

11.

Cerny M, Bergeron C, Billiard J-S, et al (2018) LI-RADS for MR Imaging Diagnosis of Hepatocellular Carcinoma: Performance of Major and Ancillary Features. Radiology 288:118–128. https://doi.org/10.1148/radiol.2018171678CrossRefPubMed

12.

Schieda N, Siegelman ES (2017) Update on CT and MRI of Adrenal Nodules. American Journal of Roentgenology 208:1206–1217. https://doi.org/10.2214/AJR.16.17758CrossRefPubMed

13.

Craig WD, Fanburg-Smith JC, Henry LR, et al (2009) Fat-containing Lesions of the Retroperitoneum: Radiologic-Pathologic Correlation. RadioGraphics 29:261–290. https://doi.org/10.1148/rg.291085203CrossRefPubMed

14.

Park BK (2017) Renal Angiomyolipoma: Radiologic Classification and Imaging Features According to the Amount of Fat. American Journal of Roentgenology 209:826–835. https://doi.org/10.2214/AJR.17.17973CrossRefPubMed

15.

Jhaveri KS, Elmi A, Hosseini-Nik H, et al (2015) Predictive Value of Chemical-Shift MRI in Distinguishing Clear Cell Renal Cell Carcinoma From Non–Clear Cell Renal Cell Carcinoma and Minimal-Fat Angiomyolipoma. American Journal of Roentgenology 205:W79–W86. https://doi.org/10.2214/AJR.14.13245CrossRefPubMed

16.

Coulier B (2016) Pancreatic Lipomatosis: An Extensive Pictorial Review. Journal of the Belgian Society of Radiology 100:39. https://doi.org/10.5334/jbr-btr.1014CrossRefPubMedPubMedCentral

17.

Chang ST, Menias CO, Lubner MG, et al (2017) Molecular and Clinical Approach to Intra-abdominal Adverse Effects of Targeted Cancer Therapies. Radiographics 37:1461–1482. https://doi.org/10.1148/rg.2017160162CrossRefPubMed

18.

Harisinghani MG, Wittenberg J, Lee W, et al (2003) Bowel Wall Fat Halo Sign in Patients Without Intestinal Disease. American Journal of Roentgenology 181:781–784. https://doi.org/10.2214/ajr.181.3.1810781CrossRefPubMed

19.

Outwater EK, Siegelman ES, Hunt JL (2001) Ovarian Teratomas: Tumor Types and Imaging Characteristics. RadioGraphics 21:475–490. https://doi.org/10.1148/radiographics.21.2.g01mr09475CrossRefPubMed

20.

Kamaya A, Federle MP, Desser TS (2011) Imaging Manifestations of Abdominal Fat Necrosis and Its Mimics. RadioGraphics 31:2021–2034. https://doi.org/10.1148/rg.317115046CrossRefPubMed

21.

Singh AK, Gervais DA, Hahn PF, et al (2005) Acute Epiploic Appendagitis and Its Mimics. RadioGraphics 25:1521–1534. https://doi.org/10.1148/rg.256055030CrossRefPubMed

22.

Shi Y-J, Li X-T, Zhang X-Y, et al (2017) Differential diagnosis of hemangiomas from spinal osteolytic metastases using 3.0 T MRI: comparison of T1-weighted imaging, chemical-shift imaging, diffusion-weighted and contrast-enhanced imaging. Oncotarget 8:71095–71104. https://doi.org/10.18632/oncotarget.20533

23.

Saifuddin A, Shafiq H, Malhotra K, et al (2021) Comparison of in-phase and opposed-phase T1W gradient echo and T2W fast spin echo dixon chemical shift imaging for the assessment of non-neoplastic, benign neoplastic and malignant marrow lesions. Skeletal Radiol 50:1209–1218. https://doi.org/10.1007/s00256-020-03663-xCrossRefPubMed

24.

Inaoka T, Takahashi K, Mineta M, et al (2007) Thymic Hyperplasia and Thymus Gland Tumors: Differentiation with Chemical Shift MR Imaging 1. Radiology 243:869–876. https://doi.org/10.1148/radiol.2433060797CrossRefPubMed

25.

Priola AM, Priola SM, Ciccone G, et al (2015) Differentiation of Rebound and Lymphoid Thymic Hyperplasia from Anterior Mediastinal Tumors with Dual-Echo Chemical-Shift MR Imaging in Adulthood: Reliability of the Chemical-Shift Ratio and Signal Intensity Index. Radiology 274:238–249. https://doi.org/10.1148/radiol.14132665CrossRefPubMed

26.

Kirchgesner T, Acid S, Perlepe V, et al (2020) Two-point Dixon fat-water swapping artifact: lesion mimicker at musculoskeletal T2-weighted MRI. Skeletal Radiol 49:2081–2086. https://doi.org/10.1007/s00256-020-03512-xCrossRefPubMed

27.

Haneder S, Koziel K, Morelli JN, et al (2014) Clinical application of 3D VIBECAIPI-DIXON for non-enhanced imaging of the pancreas compared to a standard 2D fat-saturated FLASH. Clinical Imaging 38:142–147. https://doi.org/10.1016/j.clinimag.2013.11.005CrossRefPubMed

Title: Fat-only Dixon: how to use it in body MRI
Authors: Reza Salari
David H. Ballard
Mark J. Hoegger
Daniel Young
Anup S. Shetty
Publication date: 18-05-2022
Publisher: Springer US
Keyword: MRI of the Abdomen
Published in: Abdominal Radiology / Issue 7/2022
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI: https://doi.org/10.1007/s00261-022-03546-w

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