Revisiting Liver Imaging with VIBE

Volume Interpolated Breath-hold Examination (VIBE) [1] offers three-dimensional multiphase image acquisition before and following contrast administration on a breath-hold time scale. The dynamic behavior of liver lesions and structures during the precontrast, arterial, portal venous, early equilibrium and 5-minutedelayed equilibrium phases of enhancement allows more accurate characterization than static preand postcontrast analysis. VIBE is specifically designed for this task, and is a central pulse sequence in the MR evaluation of the liver. However, routine clinical constraints present significant challenges in the acquisition of optimal diagnostic images. Delicate diagnostic decisions require fine image detail and appropriate anatomic coverage, but very ill patients preclude extended breath-holding, limiting matrix size and resolution. Short acquisition times are thus critical for both patient comfort and diagnostic success. The VIBE sequence can overcome these challenges and maintain image quality despite clinical realities. The VIBE protocol we use at Mallinckrodt Institute of Radiology/ Washington University School of Medicine in St. Louis provides the flexibility to ensure robust, high quality images in diverse clinical situations, on both open bore imaging systems such as the Siemens 1.5 Tesla MAGNETOM Espree and standard bore systems such as the 1.5 Tesla MAGNETOM Symphony, A Tim System.