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Excellent, fast and robust fat suppression in head-neck MRI

Best Practice
Casselman, Jan, M.D., Ph.D. AZ St-Jan AV Brugge • Belgium

mDIXON provides four image types in just one scan: water, fat, in-phase and opposed-phase images. In body imaging, the 2-point mDIXON technique based on FFE provides great image quality and speed. In a more challenging area like the head and neck, the use of TSE sequences is usually preferred, which is why AZ St.-Jan looked at using mDIXON TSE in that area.

mDIXON TSE provides imaging with and without fat suppression in a single sequence

“We always want a T2-weighted sequence and a T1-weighted sequence, but we need to decide whether to do them with or without fat suppression. With the mDIXON sequence, we get both in the same sequence, in the same time, and we get in-phase and opposed-phase images as well,” says Dr. Casselman, AZ St.-Jan Bruges-Oostende, Belgium.

“mDIXON TSE imaging is excellent for visualizing pathology.“For instance, for lesions in the orbit behind the globe it can be difficult to detect the lesions on T2 and T1 without fatsat. But with fat suppression, we can easily visualize the lesion and/or the edema – everything becomes clear.”

“Similarly, we want imaging with and without fat suppression in the skull base; fat suppression will make the bone marrow disappear, which helps to see lesions in the bone very well, while the normal anatomy, the foramina and cranial nerves are better seen on the images without fat suppression. And mDIXON TSE provides both automatically, without having to make up our mind before the scan, with the risk of making a wrong decision and choosing only sequences without or with fat suppression.” 

Robust fat suppression that saves time

“mDIXON is fantastic in the areas above the mandible – the oral cavity, the face, the nasopharynx, the skull base, the orbit, the parotid gland. It provides robust fat suppression and saves us time. It’s most useful in areas where a lot of fat is present. That does also include arms, legs and breast.”

“In general, if we acquire T1W, T2W and post-contrast T1W images with mDIXON TSE, we have all we need for our diagnosis with excellent image quality, which is why we changed from using standard sequences to mDIXON TSE in our head and neck imaging. When previously doing only single contrast sequences we sometimes missed some information, or needed more sequences – and more time,” concludes Dr. Casselman.

Case study: mDIXON TSE in patient with oral cavity cancer

 mDIXON T2W TSE mDIXON T2W TSE water only
mDIXON T2W TSE water only
 mDIXON T1W TSE mDIXON T1W TSE water only
mDIXON T1W TSE water only

Transverse T2W and T1W images without and with fat saturation were
obtained using mDIXON TSE. The large lesion in the tongue on the right
side is better delineated on the fat saturated images.
The advantage of mDIXON is that images with and without fat
suppression are acquired together in the same sequence instead of in
separate sequences. Therefore, the radiologist no longer needs to
choose whether images with or without fat saturation, or both, are desired.

mDIXON TSE always provides the fat saturation “for free” in the same
sequence, resulting in time gain – no need for running two sequences to
get without and with fat saturation – and always having all necessary
images by avoiding incomplete information when there is only time
for one sequence.

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Mar 20, 2014

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Best Practice
Ingenia 3.0T
dStream, Fat suppression, Head/neck, mDIXON, Neuro, Oncology, oral cavity

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