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To test the theoretical benefits of a spectral attenuated inversion-recovery (SPAIR) fat-suppression (FS) technique in clinical abdominal MRI by comparison to conventional inversion-recovery (IR) FS combined with T2-weighted (T2W) partial Fourier single shot fast spin echo (SSFSE).1.5T MRI studies of the abdomen were performed in 28 patients with liver lesions (hemangiomas n = 14; metastases n = 14). T2W sequences were acquired using IR and SPAIR SSFSE. Measurements included retroperitoneal and mesenteric fat signal-to-noise (SNR) to evaluate FS; liver lesion contrast-to-noise (CNR) to evaluate bulk water signal recovery effects; and bowel wall delineation to evaluate susceptibility and physiological motion effects.SPAIR-SSFSE images produce significantly improved FS and liver lesion CNR. The mean SNR of the retroperitoneal and mesenteric fat for SPAIR SSFSE was 20.5 ± 10.2 (±1 SD) and 12.7 ± 6.2, compared to 43.2 ± 24.1 (P = 0.000006) and 29.3 ± 16.8 (P = 0.0000005) for IR-SSFSE. SPAIR-SSFSE images produced higher CNR for both hemangiomas CNR = 164 ± 88 vs. 126 ± 83 (P = 0.00005) and metastases CNR = 75 ± 27 vs. 53 ± 19 (P = 0.007). Bowel wall visualization was significantly improved using SPAIR-SSFSE (P = 0.002).The theoretical benefits of SPAIR over conventional IR FS translate into significant multiple improvements that can be measured on clinical abdominal MRI scans. J. Magn. Reson. Imaging 2008;27:1448–1454. © 2008 Wiley-Liss, Inc.