Feasibility of fat-saturated T2-weighted magnetic resonance imaging with slice encoding for metal artifact correction (SEMAC) at 3T

Background and Purpose: Fluid-sensitive MR imaging in postoperative evaluation is important, however, metallic artifacts is inevitable. The purpose is to investigate the feasibility of fat-saturated slice encoding for metal artifact correction (SEMAC)-corrected T2-weighted magnetic resonance (MR) at 31 in patients with spinal prostheses. Methods: Following institutional review board approval, 27 SEMAC-encoded spinal MRs between September 2012 and October 2013 in patients with spinal metallic prostheses were analyzed. The MR images were scanned on a 3T MR system including SEMAC-corrected and uncorrected fast spin echo (FSE) T2-weighted MR images with fat-saturation. Two musculoskeletal radiologists compared the image sets and qualitatively analyzed the images using a five-point scale in terms of artifact reduction around the prosthesis, visualization of the prosthesis and pedicle, and intervertebral neural foramina. Quantitative assessments were performed by calculating the ratio of signal intensity from the fixated vertebra and that from upper level vertebra. For statistical analyses, paired t-test was used. Results: Fat-saturated SEMAC-corrected T2-weighted MR images enabled significantly improved metallic artifact reduction (P < 0.05). Quantitative evaluation of the signal intensity ratio of screw-fixated vertebra and upper level vertebra showed a significantly lower ratio on fat-saturated SEMAC images (P < 0.05), however, the high signal intensity of signal pile-up could be not completely corrected. Conclusion: SEMAC correction in fat-suppressed T2-weighted MR images can overcome the signal loss of metallic artifacts and provide improved delineation of the pedicle screw and pen-prosthetic region. Signal pile-up, however, could not be corrected completely, therefore readers should be cautious in the evaluation of marrow around the prosthesis. (C) 2014 Elsevier Inc. All rights reserved.