Reduction of Metal Artifacts in Patients with Total Hip Arthroplasty with Slice-encoding Metal Artifact Correction and View-Angle Tilting MR Imaging

Purpose: To compare the new warp sequence (slice-encoding metal artifact correction [SEMAC], view-angle tilting [VAT], and increased bandwidth) for the reduction of both through-plane and in-plane magnetic resonance (MR) artifacts with current optimized MR sequences in patients with total hip arthroplasty (THA). Materials and Methods: The institutional review board issued a waiver for this study. Forty patients with THA were prospectively included. SEMAC, VAT, and increased bandwidth were applied by using the warp turbo-spin-echo sequence at 1.5 T. Coronal short tau inversion-recovery (STIR)-warp and transverse T1-weighted warp (hereafter, T1-warp) images, as well as standard coronal STIR and transverse T1-weighted sequence images optimized with high bandwidth (STIR-hiBW and T1-hiBW), were acquired. Fifteen additional patients were examined to compare the T1-warp and T1-hiBW sequence with an identical matrix size. Signal void was quantified. Qualitative criteria (distinction of anatomic structures, blurring, and noise) were assessed on a five-point scale (1, no artifacts; 5, not visible due to severe artifacts) by two readers. Abnormal imaging findings were recorded. Quantitative data were analyzed with a t test and qualitative data with a Wilcoxon signed rank test. Results: Signal void around the acetabular component was smaller for STIR-warp than STIR-hiBW images (21.6 cm(2) vs 42.4 cm(2); P = .0001), and for T1-warp than T1-hiBW images (17.6 cm(2) vs 20.2 cm(2); P = .0001). Anatomic distinction was better on STIR-warp compared with STIR-hiBW images (1.9-2.8 vs 3.6-4.6; P = .0001), and on T1-warp compared with T1-hiBW images (1.3-2.8 vs 1.8-3.2; P < .002). Distortion, blurring, and noise were lower with warp sequences than with the standard sequences (P =.0001). Almost half of the abnormal imaging findings were missed on STIR-hiBW compared with STIR-warp images (55 vs 105 findings; P =.0001), while T1-hiBW was similar to T1-warp imaging (50 vs 55 findings; P = .06). Conclusion: STIR-warp and T1-warp sequences were significantly better according to quantitative and qualitative image criteria, but a clinically relevant artifact reduction was only present for STIR images. (C) RSNA, 2012