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Abstract - Diagnostic Performance of T2- weighted sequences in Upper Abdominal Magnetic Resonance Imaging: BLADE Technique or HASTE Technique?
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Safiye Sanem Dereli Bulut, Fuad Nurili, Hadi Sasani, Omer Aras, Yasar Bukte


Objective:  To evaluate T2-weighted  BLADE tecnique for evaluating intra-abdominal organs and lesions, especially the gastrointestinal wall and pathologies, and to compare the findings with HASTE.

Material and Methods: Sixty patients (mean age: 47.2 years, range 19-88) (32 males, 28 females) referred to our institution for upper abdominal Magnetic Resonance Imaging (MRI) examinations with various indications between January 2015 and May 2015 were included in our study. All examinations were performed on a 1.5 Tesla MR device and no anti-peristaltic drug was administered. Images were retrospectively and independently evaluated by two radiologists. A qualitative evaluation was performed to assess images regarding the presence of artifacts and diagnostic quality, the anatomical detail of the upper abdominal organs and structures (contour sharpness, contrast of tissue, parenchyma and internal wall structure) and any present pathologies and lesions in the organs (lesion contour sharpness and size, internal structure properties, morphological characteristics). A quantitative evaluation was performed to calculate the contrast-to-muscle ratios (CMR) of the internal organs and lesions. The distribution of the variables was statistically checked by Kolmogorov Smirnov test. Paired-samples t- test was used for quantitative data.

Results: BLADE was significantly associated with reduced artifacts (p <0.0001) and increased image quality compared with HASTE. The highest agreement between both observers was that motion artifacts were reduced (Gwet's AC2 = 0.94). In addition, observers agreed that the parenchymal structure of the upper abdominal solid organs and the anatomic details of the stomach wall structure were better with BLADE (Gwet's AC2 = 0.87). In most cases, both observers preferred BLADE (p <0.0001) for evaluating images and lesion morphology.

Conclusion: In upper abdominal MRI examination, artifacts, especially movement artifacts, were significantly reduced by BLADE, yielding more valuable data for the evaluation of the gastrointestinal system wall structure and its pathologies, especially considering the organs near to the diaphragm and retroperitoneal organs as well as vascular structures.

Keywords: Upper abdominal MR imaging tecniques,  BLADE/ PROPELLER,  HASTE, MR artifacts

Corresponding Author: Safiye Sanem Dereli Bulut, MD, Department of Radiology, Health Sciences University, Istanbul Umraniye Training and Research Hospital, Istanbul, 34668, Turkey. Tel.: +905327763354. Email: ssanembulut@gmail.com


1. Bayramoglu S, Kilickesmez Ö, Cimilli T, Kayhan A, Yirik G, Islim F, et al. T2-weighted MRI of the Upper Abdomen:. Comparison of Four Fat-Suppressed T2-weighted Sequences Including PROPELLER (BLADE) Technique. Acad Radiol. 2010; 17(3):368–74. https://doi.org/10.1016/j.acra.2009.10.015

2. Bellon EM, Haacke EM, Coleman PE, Steiger DA, Gangarosa E. MR Artifacts : Clin Sci. 1986.

3. Finkenzeller T, Menzel C, Fellner F, Fellner C, Stroszczynski C, Schuierer G, et al. {BLADE} Sequences in Sagittal T2-Weighted {MR} Imaging of the Cervical Spine and Spinal Cord Lesion Detection and Clinical Value. {RöFo} - Fortschritte auf dem Gebiet der Röntgenstrahlen und der Bildgeb Verfahren [Internet]. 2013; 186(01):47–53. https://doi.org/10.1055%2Fs-0033-1350346

4. Forbes KPN, Pipe JG, Bird CR, Heiserman JE. PROPELLER MRI: Clinical testing of a novel technique for quantification and compensation of head motion. J Magn Reson Imaging. 2001; 14(3):215–22. https://doi.org/10.1002/jmri.1176

5. Fujimoto K, Koyama T, Tamai K, Morisawa N, Okada T, Togashi K. BLADE acquisition method improves T2-weighted MR images of the female pelvis compared with a standard fast spin-echo sequence. Eur J Radiol [Internet]. 2011; 80(3):796–801. http://dx.doi.org/10.1016/j.ejrad.2010.08.002

6. Froehlich JM, Metens T, Chilla B, Hauser N, Klarhoefer M, Kubik-Huch RA. Should less motion sensitive T2-weighted BLADE TSE replace Cartesian TSE for female pelvic MRI? Insights Imaging. 2012; 3(6):611–8. https://doi.org/10.1007/s13244-012-0193-9

7. Haneder S, Dinter D, Gutfleisch A, Schoenberg SO, Michaely HJ. Image quality of T2w-TSE of the abdomen and pelvis with Cartesian or BLADE-type k-space sampling: A retrospective interindividual comparison study. Eur J Radiol. 2011; 79(2):177–82. https://doi.org/10.1016/j.ejrad.2009.12.028

8. Hirokawa Y, Isoda H, Maetani YS, Arizono S, Shimada K, Togashi K. MRI artifact reduction and quality improvement in the upper abdomen with PROPELLER and Prospective Acquisition Correction (PACE) technique. Am J Roentgenol. 2008; 191(4):1154–8. https://doi.org/10.2214/AJR.07.3657

9. Lane BF, Vandermeer FQ, Oz RC, Irwin EW, McMillan AB, Wong-You-Cheong JJ. Comparison of sagittal T2-weighted BLADE and fast spin-echo MRI of the female pelvis for motion artifact and lesion detection. Am J Roentgenol. 2011; 197(2):307–13. https://doi.org/10.2214/AJR.10.5918

10. Lewis CE, Prato FS, Drost DJ, Nicholson RL. Comparison of respiratory triggering and gating techniques for the removal of respiratory artifacts in MR imaging. Radiology [Internet]. 1986; 160(3):803–10. https://doi.org/10.1148/radiology.160.3.3737921

11. Michaely HJ, Kramer H, Weckbach S, Dietrich O, Reiser MF, Schoenberg SO. Renal T2-weighted turbo-spin-echo imaging with BLADE at 3.0 Tesla: Initial experience. J Magn Reson Imaging. 2008; 27(1):148–53. https://doi.org/10.1002/jmri.21240

12. Mirowitz SA. Diagnostic pitfalls and artifacts in abdominal MR imaging: a review. Radiology. 1998; 208(3):577–89. https://doi.org/10.1148/radiology.208.3.9722832

13. Ojeda-Fournier H, Choe KA, Mahoney MC. Recognizing and interpreting artifacts and pitfalls in MR imaging of the breast. Radiographics [Internet]. 2007;27(1):147-164. https://doi.org/10.1148/rg.27si075516

14. Pipe J. Periodically Rotated Overlapping ParallEL Lines with Enhanced Reconstruction (PROPELLER) MRI; Application to Motion Correction. 7th Sci Meet ISMRM, Philadelphia [Internet]. 1999;1(1991):1998.

15. Rosenkrantz AB, Mannelli L, Mossa D, Babb JS. Breath-hold T2-weighted MRI of the liver at 3 T using the BLADE technique: Impact upon image quality and lesion detection. Clin Radiol [Internet]. 2011; 66(5):426–33. https://doi.org/10.1016/j.crad.2010.10.018

16. Sandhu GS, Blackham KA, Sunshine JL. Comparison of Brain MR Images at 1 . 5T Using BLADE and Rectilinear Techniques for Patients. Ajnr. 2012; 33(1):77–82.  https://doi.org/10.3174/ajnr.A2737

17. Tamhane AA, Arfanakis K. Motion correction in periodically-rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) and turboprop MRI. Magn Reson Med. 2009; 62(1):174–82.

18. Zhang L, Tian CM, Wang PY, Chen L, Mao XJ, Wang SS, et al. Comparative study of image quality between axial T2-weighted BLADE and turbo spin-echo MRI of the upper abdomen on 3.0 T. Jpn J Radiol. 2015; 33(9):585–90. https://doi.org/10.1007/s11604-015-0463-9


Volume 1, Number 51 (2019)