Three-Dimensional Fat-Suppressed Steady-State free precession imaging for female reproductive organs

Purpose: The balanced turbo field-echo (B-TFE) steady-state free precession sequence has a high signal-tonoise ratio (SNR), which makes it possible to obtain a high-resolution image within a reasonable scanning time. We used optimized three-dimensional (3D) B-TFE for the female reproductive organs. Materials and Methods: SNR of fat was measured with a phantom, and spectral attenuated inversion recovery (SPAIR) inversion delay time was set to the null point of the fat signal. Five healthy female volunteers aged 26-30 years (mean 28 years) were included in the study. Contrasts between mesenteric fat and myometrium, myometrium and junctional zone, junctional zone and endometrium, mesenteric fat and ovarian stroma, and ovarian stroma and follicles were subsequently determined. Two radiologists and two radiological technologists conducted the visual assessment of the images, with respect to the quality of the images, reviewed the four-point scale with regard to contrast, homogeneity of fat suppression, and artifacts. Furthermore, the best combinations of the contrasts for each flip angle (FA) were assessed using Steel-Dwass multiple comparison test. Results: The SPAIR inversion delay time was 120 ms with FA of 60 and 90° and 150 ms with FA of 30°. Suitable FA/number of startup echo combinations for contrast were 90°/10, 60°/20, and 30°/30; visual assessment indicated that the best combination was 90/10. The artifact was significantly different between 30°/30 and 60°/20 and between 90/10 and 30°/30 (p < 0.01). In clinical patients' images, the gestational sac, the endometrial polyp, and the attachment point with the stalk of the submucosal myoma and polypoid adenomyoma were depicted clearly in multi-planar reconstruction images. Conclusion: Optimizing sequence parameter of 3D B-TFE is applicable in study of the female reproductive organs.