High-contrast 3D neonatal brain imaging with combined T1- and T2-weighted MP-RAGE.

Optimization of magnetization-prepared rapid gradient-echo (MP-RAGE) sequence variations for maximum white matter (WM) versus gray matter (GM) contrast in neonates at 3T was investigated. Numerical simulations were applied to optimize and compare three contrast preparation modules and to assess the effect of phase encoding (PE) order on contrast between WM and thin cortical GM layers. Simulations predict that a new sequence, which combines both T(1)- and T(2)-weighting into the contrast preparation and utilizes an interleaved elliptical-spiral PE order, should provide the strongest contrast between neonatal WM and cortical GM. This sequence was compared to a conventional MP-RAGE acquisition (i.e., T(1)-weighted preparation, centric PE order) for in vivo imaging of seven preterm newborn infants. Regional measurements of the contrast-to-noise ratio (CNR) between WM and GM demonstrated an increase of 50-70% (depending on GM region) using the new sequence, in good agreement with theoretical predictions. This improved contrast resulted in superior WM versus GM discrimination in intensity-based brain tissue segmentations.