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

This study evaluates the reproducibility and image quality of a three-dimen sional (3D) gradient-echo sequence for imaging the lung parenchyma, with an d without gadolinium administration, using a 2D spoiled gradient-echo seque nce for comparison. Twenty patients without lung disease (normals) and five patients with lung disease [lung disease] underwent paired 2D and 3D gradi ent-echo sequences, without contrast (24 patients) and with contrast (18 pa tients). Images were retrospectively reviewed independently in a blinded fa shion by two Investigators. Artifacts and demonstration of central lung, pe ripheral lung, heart, pulmonary arteries, and esophagus were evaluated. Ima ge 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 patien ts with non-contrast 3D gradient-echo, 3 and 1 patient(s) with contrast-enh anced 2D gradient-echo, and 19 and 19 patients with contrast-enhanced 3D gr adient-echo imaging. Differences in image quality between 2D and 3D sequenc es were significant (P < 0.001). Heart-related phase artifacts were negligi ble in 2 and 0 patients with non-contrast 2D gradient-echo, 23 and 25 patie nts with non-contrast 3D gradient-echo, 0 and 0 patients with contrast-enha nced 2D gradient-echo, and 17 and 19 patients with contrast-enhanced 3D gra dient-echo imaging. Differences in heart-related phase artifact in the cent ral lung between 2D and 3D sequences were significant (P = 0.001). Infiltra tes, lung cancer, and pulmonary metastasis were better shown on the gadolin ium-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. Preli minary results in patients with disease appear promising.