Praktische Aspekte neuerer MRT-Techniken in der Neuroradiologie: Teil 1–3D, Dixon-Techniken und Artefaktreduktion

Zusammenfassung

Hintergrund Neuere MR-Techniken ermöglichen es, gestiegene Anforderungen an Bildqualität zu erfüllen, Patienten trotz zu erwartender Artefakte zu untersuchen und neue Untersuchungsstrategien in der Neuroradiologie zu entwickeln. Dies sind unter anderem verbesserte 3D-Techniken, Methoden zur Verminderung von Bewegungs- und Metall-Artefakten und Dixon-Techniken.

Methode Narrative Übersichtsarbeit mit Fortbildungsschwerpunkt basierend auf aktueller Literaturrecherche und praktischen Erfahrungen verschiedener Berufsgruppen (ärztliches Personal, MTRA, MR-Physik/Technik) und mit Geräten unterschiedlicher Hersteller.

Ergebnisse und Schlussfolgerungen Unter den 3D-Turbo-Spin-Echo-Techniken fällt insbesondere die 3D FLAIR-Sequenz durch vielfältige Einsatzmöglichkeiten in Routineprotokollen auf. Neben der Erkennbarkeit kleinerer Läsionen ermöglicht sie eine präzisere Verlaufsbeurteilung und eine gute Erkennbarkeit auch extrazerebraler Läsionen. 3D-Sequenzen sind zunehmend etabliert zur Beurteilung arterieller Gefäßwände, der Liquorräume und peripherer Nerven. Weiterentwickelte hybrid-radiale Sequenzen ermöglichen ein breiteres Anwendungsspektrum zur Vermeidung von Bewegungsartefakten. Für die Verringerung von Suszeptibilitätsartefakten stehen nun mehrere unterschiedliche Optionen zur Verfügung, die möglichst gezielt eingesetzt werden sollten. Die neuen Techniken ermöglichen zum Teil gezielte Anpassungen zur Erzielung der gewünschten diagnostischen Aussagefähigkeit. Dixon-Techniken ermöglichen es, über eine homogene Fettsättigung in Übergangsregionen hinaus, mit einer Messung mehrere Bildkontraste zu erzielen.

Kernaussagen: 

• 3D FLAIR des Gehirns kann 2 D FLAIR meist ersetzen und ermöglicht genauere und breiter einsetzbare Untersuchungsprotokolle.

• Andere 3D-TSE-Sequenzen ersetzen für bestimmte Indikationen zunehmend 2D-TSE-Sequenzen.

• Die Weiterentwicklung von Artefaktreduktionstechniken vergrößert bei Bewegungsunruhe und bei Implantaten kontinuierlich das Potenzial für diagnostisch aussagefähige Untersuchungen.

• Dixon ermöglicht homogene Fettsättigung und erzielt gleichzeitig mehrere Bildkontraste.

Zitierweise

• Sundermann B, Billebaut B, Bauer J et al. Practical Aspects of novel MRI Techniques in Neuroradiology: Part 1–3D Acquisitions, Dixon Techniques and Artefact Reduction. Fortschr Röntgenstr 2022; 194: 1100 – 1109

Key words

MR-imaging - neuroradiology - 3D imaging - metal artefact reduction - movement artefact reduction - Dixon

Publication History

Received: 31 August 2021

Accepted: 05 March 2022

Article published online:
11 May 2022

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