Investigation of transient severe motion artifacts on gadoxetic acid-enhanced MRI: frequency and risk factors.

Objective: To evaluate the frequency and independent risk factors associated with transient severe motion artifact (TSM) during the arterial phase of gadoxetic acid-enhanced liver MRI in a Southeast Asian population.

Methods: This retrospective study included 836 consecutive studies who underwent gadoxetic acid-enhanced MRI between October 2022 and October 2024 at a tertiary academic hospital. Two abdominal radiologists reviewed arterial phase images and graded motion artifacts using a validated 5-point scale; grades 4 and 5 were classified as TSM. Clinical and laboratory data were extracted from the electronic medical record. Univariable and multivariable logistic regression analyses were performed to identify predictors of TSM. Subgroup analyses were conducted based on age and body mass index (BMI).

Results: TSM artifacts were observed in 43 of 836 studies (5.14%). In multivariable analysis, older age (> 65 years) (adjusted OR 4.59; 95% CI 1.268-16.710; p = 0.021) and lower serum albumin (adjusted OR 0.33; 95% CI 0.143-0.761; p = 0.009) were independent predictors of TSM. Subgroup analyses demonstrated higher TSM incidence in patients aged ≥ 65 years (7.07% vs. 3.41%; p = 0.019) and in those with BMI > 30 kg/m2 (11.11% vs. 4.73%; p = 0.052). Other variables, including sex, comorbidities, liver disease etiology, and fluid overload, were not significantly associated with TSM.

Conclusions: TSM during gadoxetic acid-enhanced liver MRI occurs in approximately 5% of patients and is independently associated with older age and lower serum albumin. Awareness of these risk factors can guide protocol optimization and personalized imaging strategies to improve arterial phase image quality.