Wichtmann Barbara Daria, Katemann Christoph, Kadrija Mergim, Layer Yannik C, Bischoff Leon M, Scheuver Yvonne, Mezger Madeleine, Weber Oliver M, Luetkens Julian A, Attenberger Ulrike I, Radbruch Alexander, Paech Daniel
Clinic of Neuroradiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany.
Pediatr Radiol. 2025 Jan;55(1):183-194. doi: 10.1007/s00247-024-06088-z. Epub 2024 Nov 26.
In pediatric magnetic resonance imaging (MRI), reducing the rate of non-diagnostic scans due to artifacts and shortening acquisition time are crucial not only for economic reasons but also to minimize sedation or general anesthesia.
Enabling faster and motion-robust MRI of the brain in infants and children using a novel, enhanced compressed sensing (CS) algorithm in combination with a turbo-spin-echo T2-weighted sequence utilizing the PROPELLER-technique (periodically rotated overlapping parallel lines with enhanced reconstruction; T2).
This prospective study included 31 patients (8.0 ± 4.7 years, 15 males) undergoing a clinically indicated MRI examination of the brain on a 3-T scanner. The T2 sequence was compared to a conventional, CS-accelerated Cartesian turbo-spin-echo T2-weighted sequence (T2). Apparent contrast-to-noise ratio (aCNR) and signal-to-noise ratio (aSNR) were calculated. Three blinded radiologists independently rated both sequences twice qualitatively on a 5-point Likert-scale from 1-5 (non-diagnostic-excellent) for artifacts, image sharpness, basal ganglia delineation, lesion conspicuity, and overall image quality. Statistical analysis was performed using the Wilcoxon signed-rank test and paired sample t test. Intra- and interrater reliability of qualitative image assessment was evaluated by computing Krippendorff's reliability estimates.
The average acquisition time of the T2 (189 ± 27 s) was 31% shorter than that of the T2 sequence (273 ± 21 s; P < 0.001). aCNR (7.7 ± 4.6 vs. 6.2 ± 2.8; P = 0.004) and aSNR (24.8 ± 9.7 vs. 18.8 ± 5.5; P < 0.001) were higher for the T2 compared to the T2 sequence. The T2 sequence significantly reduced (motion-)artifacts (P < 0.001) and increased image sharpness (P < 0.001), basal ganglia delineation (P<0.001), lesion conspicuity (raters 1 and 2, P < 0.001; rater 3, P = 0.004), and overall image quality (P < 0.001). Metal artifacts were prominent in both sequences, though slightly more pronounced in the T2 sequence.
The T2 sequence enables faster and motion-robust imaging of the brain in infants and children, reducing the rate of non-diagnostic scans and potentially allowing sedation or general anesthesia to be minimized in the future.
在儿科磁共振成像（MRI）中，降低因伪影导致的非诊断性扫描率并缩短采集时间不仅具有经济意义，而且对于尽量减少镇静或全身麻醉也至关重要。
使用一种新颖的增强型压缩感知（CS）算法与采用螺旋桨技术（周期性旋转重叠平行线并增强重建；T2加权）的涡轮自旋回波T2加权序列相结合，实现对婴幼儿和儿童大脑更快且抗运动的MRI检查。
这项前瞻性研究纳入了31例患者（8.0±4.7岁，15名男性），他们在3-T扫描仪上接受了临床指示的脑部MRI检查。将T2序列与传统的CS加速笛卡尔涡轮自旋回波T2加权序列（T2）进行比较。计算表观对比噪声比（aCNR）和信噪比（aSNR）。三名盲法放射科医生独立地对两个序列进行两次定性评估，采用1-5分的李克特量表（1分表示非诊断性，5分表示优秀），评估指标包括伪影、图像清晰度、基底节区勾画、病变清晰度和整体图像质量。使用Wilcoxon符号秩检验和配对样本t检验进行统计分析。通过计算Krippendorff可靠性估计值来评估定性图像评估的内部和评分者间可靠性。
T2序列的平均采集时间（189±27秒）比T2序列（273±21秒）短31%（P<0.001）。与T2序列相比，T2序列的aCNR（7.7±4.6对6.2±2.8；P=0.004）和aSNR（24.8±9.7对18.8±5.5；P<0.001）更高。T2序列显著减少了（运动）伪影（P<0.001），并提高了图像清晰度（P<0.001）、基底节区勾画（P<0.001）、病变清晰度（评分者1和2，P<0.001；评分者3，P=0.004）和整体图像质量（P<0.001）。两个序列中金属伪影都很明显，不过在T2序列中稍更明显。
T2序列能够对婴幼儿和儿童大脑进行更快且抗运动的成像，降低非诊断性扫描率，并有可能在未来尽量减少镇静或全身麻醉的使用。
