Rofo 2006; 178 - A29
DOI: 10.1055/s-2006-931874

Ultrafast MR imaging of the female pelvis at 3 Tesla: Is i.v. butyl-scopolamine (buscopan) still necessary?

N Morakkabati-Spitz 1, J Gieseke 1, 2, C Kuhl 1, M von Falkenhausen 1, G Lutterbey 1, F Träber 1, O Zivanovic 3, HH Schild 1
  • 1Department of Radiology, University of Bonn, Germany
  • 2Philips Medical Systems, Best, The Netherlands
  • 3Department of Gynecology and Obstetrics, University of Bonn, Germany

Purpose: Recently it has been demonstrated that ultrafast MR imaging of the female pelvis is feasible at 3.0 T and leads to a significant reduction of motion artifacts. Aim of this study was to find out if buscopan is still necessary in case of ultrafast MR imaging of the pelvis.

Methods: We performed a prospective comparative intraindividual study on 26 patients with 16 benign and 10 malignant pelvic disorders. Patients had ultrafast MRI with a ssh T2-w TSE pulse sequence (3T-FAST: SENSE SF3; Flip angle sweep technique FAS 75°; TR/TE 4933/100 ms; 0.7×1.0×4mm; 39s scan time) of the female pelvis at 3.0T before and after i.v. application of buscopan.

In a first step, two radiologists evaluated motion artifacts related to peristalsis on the MR images with and without buscopan using a 3-point-scale (1 point=absent/ minimal artifacts; 2 points=moderate artifacts; 3 points=poor image quality). Mean values were calculated for each radiologist and Mc Nemar's Test was used to test for statistically significant differences. Furthermore, interobserver agreement was evaluated using a non-weighted kappa-statistic.

Finally, each radiologist compared the MR images with and without buscopan and evaluated if gynaecological disorders were detected better on the MR images with buscopan or not.

Results: Motion artifacts related to peristalsis were rated minimal or absent for all MR studies by both radiologists. Both radiologists did not notice any differences on the MR images with and without buscopan (mean score=1 point), consequently Mc Nemar's Test did not reveal statistically significant differences.

All gynaecological disorders were detected equally well on the MR images with and without buscopan, thus MR imaging diagnoses did not differ. Interobserver agreement was rated perfect.

Conclusion: Our data confirm, that ultrafast MR imaging of the female pelvis can be used routinely at 3.0T. The fast sequence is able to significantly reduce motion artifacts related to peristalsis also on the MR images without buscopan. Therefore, we conclude that buscopan is dispensable in case of ultrafast MR imaging of the female pelvis at 3.0T. This is advantageous for patients with contraindications for buscopan and for out-patients.