Chemical shift imaging with paramagnetic contrast material enhancement for improved lesion depiction.

The depiction of contrast material-enhanced lesions with magnetic resonance imaging can be improved by using chemical shift imaging (CSI) for lipid suppression in combination with gadolinium diethylenetriaminepentaacetic acid (DTPA) enhancement. Gd-DTPA enhancement was combined with the hybrid technique for lipid suppression, which provides water-only images without increasing imaging time or postprocessing. Lesions with high signal intensity due to paramagnetic relaxation enhancement are easily distinguished from low-intensity lipid, which would otherwise dominate T1-weighted images. Preliminary studies were performed to compare Gd-DTPA-CSI images with conventional postcontrast T1-weighted images. In patients examined for orbital, pituitary, and musculoskeletal abnormalities, the Gd-DTPA-CSI technique enabled improved detection and finer anatomic staging of lesions. In theory, a similar result can be achieved by using any chemical shift-selective method that results in true lipid suppression together with paramagnetic contrast agents that generate high signal intensity. This general approach should be applicable to clinical studies in other tissues or organ systems dominated by lipid, including the pelvis, mediastinum, and breast.