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OBJECTIVES: To compare image quality between GRASP-VIBE (free-breathing) and CAIPIRINHA-VIBE (breath-hold) sequences in dynamic liver MRI in a pediatric population. MATERIALS AND METHODS: This retrospective study included 70 children who underwent dynamic liver MRI at 3 T with either GRASP-VIBE (n = 40) or CAIPIRINHA-VIBE (n = 40) acquisition. Ten patients underwent both imaging protocols at different time points. Image pairs were matched at four representative anatomical levels using vascular landmarks. Four dynamic contrast phases (pre-contrast, arterial, portal venous, delayed venous) at each anatomic level were independently reviewed by two radiologists, leading to a total of 640 comparisons per reader. Reader preference was assessed using a two-alternative forced-choice paradigm. Inter- and intra-reader agreement were analyzed using binomial tests and Cohen's κ. RESULTS: GRASP-VIBE was preferred over CAIPIRINHA-VIBE across all contrast-enhanced phases of pediatric liver MRI: 82.2% 526/640 in the arterial, 83.1% 532/640 in the portal venous, 71.3% 456/640 in the delayed venous (all p < 0.001). No significant difference was observed for the pre-contrast phase with 59.4% 380/640 GRASP-VIBE preference (p = 0.45). Strongest GRASP-VIBE preferences were observed in older children and adolescents and in examinations performed without anesthesia. Across all anatomical levels, GRASP consistently outperformed Caipirinha-VIBE in contrast-enhanced phases. Inter-reader agreement was moderate in the arterial (κ = 0.51) and delayed venous (κ = 0.48) phases, and slight in pre-contrast (κ = 0.19) and portal venous (κ = 0.20) phases (intra-reader agreement, κ = 0.56, κ = 0.60, κ = 0.28 and κ = 0.42). CONCLUSION: GRASP-VIBE offered superior subjective image quality compared to CAIPIRINHA-VIBE in pediatric liver MRI, especially in early contrast phases. Its free-breathing approach might be particularly advantageous regarding image quality in children unable to perform breath-holds. KEY POINTS: Question Does free-breathing GRASP-VIBE provide superior image quality compared to breath-hold CAIPIRINHA-VIBE for dynamic liver MRI in pediatric patients? Findings GRASP-VIBE was preferred across all contrast phases, delivering consistently higher-quality images than CAIPIRINHA-VIBE, particularly in children unable to perform breath-holds. Clinical relevance Using GRASP-VIBE enables high-quality dynamic pediatric liver MRI. Further research is needed to determine whether this sequence can reduce the need for sedation or general anesthesia in children.
Veldhoen et al. (Thu,) studied this question.