Breath-hold 3D gradient-echo MR imaging of the lung parenchyma: Evaluation of reproducibility of image quality in normals and preliminary observations in patients with disease

This study evaluates the reproducibility and image quality of a three-dimensional (3D) gradient-echo sequence for imaging the lung parenchyma, with and without gadolinium administration, using a 2D spoiled gradient-echo sequence for comparison. Twenty patients without lung disease (normals) and five patients with lung disease [lung disease] underwent paired 2D and 3D gradient-echo sequences, without contrast (24 patients) and with contrast (18 patients). Images were retrospectively reviewed independently in a blinded fashion by two Investigators. Artifacts and demonstration of central lung, peripheral lung, heart, pulmonary arteries, and esophagus were evaluated. Image quality of the central lung was rated as fair or good in 5 and 4 (reader one and two) patients with non-contrast 2D gradient-echo, 24 and 25 patients with non-contrast 3D gradient-echo, 3 and 1 patient(s) with contrast-enhanced 2D gradient-echo, and 19 and 19 patients with contrast-enhanced 3D gradient-echo imaging. Differences in image quality between 2D and 3D sequences were significant (P < 0.001). Heart-related phase artifacts were negligible in 2 and 0 patients with non-contrast 2D gradient-echo, 23 and 25 patients with non-contrast 3D gradient-echo, 0 and 0 patients with contrast-enhanced 2D gradient-echo, and 17 and 19 patients with contrast-enhanced 3D gradient-echo imaging. Differences in heart-related phase artifact in the central lung between 2D and 3D sequences were significant (P = 0.001). Infiltrates, lung cancer, and pulmonary metastasis were better shown on the gadolinium-enhanced 3D gradient-echo sequences than on the other sequences. Breath-hold 3D gradient-echo imaging results in good image quality and negligible image artifacts and is superior to 2D spoiled gradient-echo imaging. Preliminary results in patients with disease appear promising.