Evaluation of the orbit using contrast-enhanced radial 3D fat-suppressed T1 weighted gradient echo (Radial-VIBE) sequence

Objective: Contrast-enhanced fat-suppressed T-1 weighted (T1W) two-dimensional (2D) turbo spin echo (TSE) and magnetization-prepared gradient echo (MPRAGE) sequences with water excitation are routinely obtained to evaluate orbit pathology. However, these sequences can be marred by artefacts. The radial-volume-interpolated breath-hold examination (VIBE) sequence is a motion-robust fat-suppressed T1W sequence which has demonstrated value in paediatric and body imaging. The purpose of our study was to evaluate its role in assessing the orbit and to compare it with routinely acquired sequences. Methods: A Health Insurance Portability and Accountability Act-compliant and institutional review board-approved retrospective study was performed in 46 patients (age range: 1-81 years) who underwent orbit studies on a 1.5-T MRI system using contrast-enhanced Radial-VIBE, MPRAGE and 2D TSE sequences. Two radiologists blinded to the sequence analysed evaluated multiple parameters of image quality including motion artefact, degree of fat suppression, clarity of choroidal enhancement, intra-orbital vessels, extraocular muscles, optic nerves, brain parenchyma and evaluation of pathology. Each parameter was assessed on a 5-point scale, with a higher score indicating the more optimal examination. Mix model analysis of variance and interobserver variability were assessed. Results: Radial-VIBE demonstrated superior quality (p<0.001) for all orbit parameters when compared with MPRAGE and 2D TSE. Interobserver agreement demonstrated average fair-to-good agreement for degree of motion artefact (0.745), fat suppression (0.678), clarity of choroidal enhancement (0.688), vessels (0.655), extraocular muscles (0.675), optic nerves (0.518), brain parenchyma (0.710) and evaluation of pathology (0.590). Conclusion: Radial-VIBE sequence demonstrates superior image quality when evaluating the orbits as compared with conventional MPRAGE and 2D TSE sequences. Advances in knowledge: Radial-VIBE employs unique non-Cartesian k-space sampling in a radial or spoke-wheel fashion which provides superior image quality improving diagnostic capability in the evaluation of the orbits.