Victoria Teresa, Johnson Ann M, Edgar J Christopher, Zarnow Deborah M, Vossough Arastoo, Jaramillo Diego
1 All authors: Radiology Department, The Children's Hospital of Philadelphia, 34th St and Civic Center Blvd, Philadelphia, PA 10104.
AJR Am J Roentgenol. 2016 Jan;206(1):195-201. doi: 10.2214/AJR.14.14205.
Fetal MRI at 3 T is emerging as a promising modality for evaluating fetal anatomy. The objective of this study was to compare the quality of images obtained with commonly used fetal imaging sequences at 1.5 T and 3 T. We hypothesized that the visualization and anatomic detail of fetal structures would be better at 3 T than at 1.5 T.
A retrospective search of the radiology department database at our institution identified 58 fetal MRI examinations performed at 3 T to evaluate body abnormalities during the period from July 2012 to February 2014. A blind comparison was conducted between these examinations and 58 1.5-T MRI examinations of age-matched fetuses undergoing evaluation for similar abnormalities during the same period. The anatomic structures analyzed included the bowel, liver, kidney, airway, cartilage, and spine. Scores for the depiction of anatomic structures ranged from 0 to 4, with 4 denoting the best depiction.
Fetal imaging at 3 T was associated with higher imaging scores in the evaluation of the cartilage and spine when single-shot turbo spin-echo (SSTSE) and steady-state free precession (SSFP) sequences were used and in the assessment of most structures (e.g., bowel, liver, kidney, cartilage, and spine) when SSFP sequences were used. The mean scores for all structures evaluated with the use of SSTSE sequences were higher when MRI was performed at 3 T than at 1.5 T; similar findings were noted when SSFP sequences were used. Evaluation of imaging scores with regard to gestational age showed that scores improved with increasing gestational age on 1.5-T MRI but not on 3-T MRI. Overall, more imaging artifacts were found when imaging was performed at 3 T than at 1.5 T.
An overall advantage to performing fetal imaging at 3 T was made evident by the higher imaging scores obtained with 3-T MRI versus 1.5-T MRI when different fetal anatomic structures were evaluated. These higher scores were predominantly associated with use of SSFP sequences. The findings of this study and future advancements in MRI software and 3-T protocols may allow optimal visualization and examination of fetal pathologic abnormalities, thus better identifying fetal and maternal needs both prenatally and postnatally.
3T胎儿磁共振成像正成为评估胎儿解剖结构的一种有前景的检查方式。本研究的目的是比较在1.5T和3T条件下使用常用胎儿成像序列所获得图像的质量。我们假设在3T条件下胎儿结构的可视化效果及解剖细节会优于1.5T。
对我们机构放射科数据库进行回顾性检索,确定了2012年7月至2014年2月期间进行的58例3T胎儿磁共振成像检查,以评估身体异常情况。将这些检查与同期进行的58例年龄匹配的、因类似异常情况接受评估的1.5T胎儿磁共振成像检查进行盲法比较。分析的解剖结构包括肠道、肝脏、肾脏、气道、软骨和脊柱。解剖结构描绘的评分范围为0至4分,4分表示最佳描绘。
当使用单次激发快速自旋回波(SSTSE)和稳态自由进动(SSFP)序列时,3T胎儿成像在评估软骨和脊柱方面以及使用SSFP序列评估大多数结构(如肠道、肝脏、肾脏、软骨和脊柱)时,成像评分更高。使用SSTSE序列评估所有结构时,3T磁共振成像的平均评分高于1.5T磁共振成像;使用SSFP序列时也有类似发现。关于孕周的成像评分评估显示,1.5T磁共振成像的评分随孕周增加而提高,但3T磁共振成像并非如此。总体而言,3T成像时发现的成像伪影比1.5T成像时更多。
在评估不同胎儿解剖结构时,3T胎儿磁共振成像获得的成像评分高于1.5T磁共振成像,这表明3T进行胎儿成像具有总体优势。这些更高的评分主要与使用SSFP序列有关。本研究结果以及磁共振成像软件和3T检查方案的未来进展可能会使胎儿病理异常得到最佳可视化和检查,从而在产前和产后更好地识别胎儿和母体的需求。