(SHORT) Gradient echo sequences.

See Incoherent Gradient Echo (gradient spoiled.

Spoiled gradient echo sequences use a spoiler gradient on the slice select axis during the end module to destroy any remaining transverse magnetization after the readout gradient, which is the case for short repetition times.
As a result, only z-magnetization remains during a subsequent excitation. This types of sequences use semi-random changes in the phase of radio frequency pulses to produce a spatially independent phase shift.
Companies use different acronyms to describe certain techniques.

Different terms for these gradient echo pulse sequences:
CE-FFE-T1 Contrast Enhanced Fast Field Echo with T1 Weighting,
GFE Gradient Field Echo,
FLASH Fast Low Angle Shot,
PS Partial Saturation,
RF spoiled FAST RF Spoiled Fourier Acquired Steady State Technique,
RSSARGE Radio Frequency Spoiled Steady State Acquisition Rewound Gradient Echo
S-GRE Spoiled Gradient Echo,
SHORT Short Repetition Techniques,
SPGR Spoiled Gradient Recalled (spoiled GRASS),
STAGE T1W T1 weighted Small Tip Angle Gradient Echo,
T1-FAST T1 weighted Fourier Acquired Steady State Technique,
T1-FFE T1 weighted Fast Field Echo.
In this context, 'contrast enhanced' refers to the pulse sequence, it does not mean enhancement with a contrast agent.

(FRFSE, FR-FSE) The fast relaxation fast spin echo sequence provides high signal intensity of fluids even with short repetition times, and can be used with parallel imaging techniques for short breath hold imaging or respiratory gating for free-breathing, high isotropic resolution MR imaging. After signal decay at the end of the echo train, a negative 90° pulse align spins with long T2 from the transverse plane to the longitudinal plane, leading to a much faster recovery of tissues with long T2 time to the equilibrium and thus better contrast between tissues with long and short T2.
Fast relaxation FSE has advantages also for volumetric imaging as the TR can be substantially reduced and thus the scan time. The sequence can be post processed with maximum intensity projection, surface or volume rendering algorithms to visualize anatomical details in brain or spine MRI. Cerebro spinal fluid pulsation artifacts, often problematic in the cervical or thoracic spine may be reduced by radial sampling, in particular when combined with acquisitions of the PROPELLER type.

See also Fast spin echo, Driven Equilibrium.

Coherent gradient echo sequences can measure the free induction decay (FID), generated just after each excitation pulse or the echo formed prior to the next pulse. Coherent gradient echo sequences are very sensitive to magnetic field inhomogeneity. An alternative to spoiling is to incorporate residual transverse magnetization directly into the longitudinal steady state. These GRE sequences use a refocusing gradient in the phase encoding direction during the end module to maximize remaining transverse (xy) magnetization at the time when the next excitation is due, while the other two gradients are, in any case, balanced.
When the next excitation pulse is sent into the system with an opposed phase, it tilts the magnetization in the -a direction. As a result the z-magnetization is again partly tilted into the xy-plane, while the remaining xy-magnetization is tilted partly into the z-direction.
A fully refocused sequence with a properly selected and uniform f would yield higher signal, especially for tissues with long T2 relaxation times (high water content) so it is used in angiographic, myelographic or arthrographic examinations and is used for T2* weighting. The repetition time for this sequence has to be short. With short TR, coherent GE is also useable for breath hold and 3D technique. If the repetition time is about 200 msec there's no difference between spoiled or unspoiled GE. T1 weighting is better with spoiled techniques.
The common types include GRASS, FISP, FAST, and FFE.
The T2* component decreases with long TR and short TE. The T1 time is controlled by flip angle. The common TR is less than 50 ms and the common TE less than 15 ms
Other types have stronger T2 dependence but lower SNR. They include SSFP, CE-FAST, PSIF, and CE-FFE-T2.
Examples of fully refocused FID sequences are TrueFISP, bFFE and bTFE.

Liver imaging can be performed with sonography, computed tomography (CT) and magnetic resonance imaging (MRI). Ultrasound is, caused by the easy access, still the first-line imaging method of choice; CT and MRI are applied whenever ultrasound imaging yields vague results. Indications are the characterization of metastases and primary liver tumors e.g., benign lesions such as focal nodular hyperplasia (FNH), adenoma, hemangioma and malignant lesions (cancer) such as hepatocellular carcinomas (HCC). The decision, which medical imaging modality is more suitable, MRI or CT, is dependent on the different factors. CT is less costly and more widely available; modern multislice scanners provide high spatial resolution and short scan times but has the disadvantage of radiation exposure.
With the introduction of high performance MR systems and advanced sequences the image quality of MRI for the liver has gained substantially. Fast spin echo or single shot techniques, often combined with fat suppression, are the most common T2 weighted sequences used in liver MRI procedures. Spoiled gradient echo sequences are used as ideal T1 weighted sequences for evaluating of the liver. The repetition time (TR) can be sufficiently long to acquire enough sections covering the entire liver in one pass, and to provide good signal to noise. The TE should be the shortest in phase echo time (TE), which provides strong T1 weighting, minimizes magnetic susceptibility effects, and permits acquisition within one breath hold to cover the whole liver. A flip angle of 80° provides good T1 weighting and less of power deposition and tissue saturation than a larger flip angle that would provide comparable T1 weighting.
Liver MRI is very dependent on the administration of contrast agents, especially when detection and characterization of focal lesions are the issues. Liver MRI combined with MRCP is useful to evaluate patients with hepatic and biliary disease.
Gadolinium chelates are typical non-specific extracellular agents diffusing rapidly to the extravascular space of tissues being cleared by glomerular filtration at the kidney. These characteristics are somewhat problematic when a large organ with a huge interstitial space like the liver is imaged. These agents provide a small temporal imaging window (seconds), after which they begin to diffuse to the interstitial space not only of healthy liver cells but also of lesions, reducing the contrast gradient necessary for easy lesion detection. Dynamic MRI with multiple phases after i.v. contrast media (Gd chelates), with arterial, portal and late phase images (similar to CT) provides additional information.
An additional advantage of MRI is the availability of liver-specific contrast agents (see also Hepatobiliary Contrast Agents). Gd-EOB-DTPA (gadoxetate disodium, Gadolinium ethoxybenzyl dimeglumine, EOVIST Injection, brand name in other countries is Primovist) is a gadolinium-based MRI contrast agent approved by the FDA for the detection and characterization of known or suspected focal liver lesions.
Gd-EOB-DTPA provides dynamic phases after intravenous injection, similarly to non-specific gadolinium chelates, and distributes into the hepatocytes and bile ducts during the hepatobiliary phase. It has up to 50% hepatobiliary excretion in the normal liver.
Since ferumoxides are not eliminated by the kidney, they possess long plasmatic half-lives, allowing circulation for several minutes in the vascular space. The uptake process is dependent on the total size of the particle being quicker for larger particles with a size of the range of 150 nm (called superparamagnetic iron oxide). The smaller ones, possessing a total particle size in the order of 30 nm, are called ultrasmall superparamagnetic iron oxide particles and they suffer a slower uptake by RES cells. Intracellular contrast agents used in liver MRI are primarily targeted to the normal liver parenchyma and not to pathological cells. Currently, iron oxide based MRI contrast agents are not marketed.
Beyond contrast enhanced MRI, the detection of fatty liver disease and iron overload has clinical significance due to the potential for evolution into cirrhosis and hepatocellular carcinoma. Imaging-based liver fat quantification (see also Dixon) provides noninvasively information about fat metabolism; chemical shift imaging or T2*-weighted imaging allow the quantification of hepatic iron concentration.

See also Abdominal Imaging, Primovistâ„¢, Liver Acquisition with Volume Acquisition (LAVA), T1W High Resolution Isotropic Volume Examination (THRIVE) and Bolus Injection.

For Ultrasound Imaging (USI) see Liver Sonography at Medical-Ultrasound-Imaging.com.