Abstract
Background
Faster and motion robust magnetic resonance imaging (MRI) sequences are desirable in pediatric brain MRI as they can help reduce the need for monitored anesthesia care, which is a costly and limited resource that carries medical risks.
Objective
To evaluate the diagnostic equivalency of commercially available accelerated motion robust MR sequences relative to standard sequences.
Materials and methods
This was an institutional review board-approved prospective study. Subjects underwent a clinical brain MRI using conventional multiplanar images at 3 Tesla followed by fast axial T2 and FLAIR (fluid-attenuated inversion recovery) sequences optimized for an approximately 50% reduction in acquisition time. Conventional and fast images from each subject were reviewed by two blinded pediatric neuroradiologists. The readers evaluated the presence of 12 findings. Intra-observer agreement was estimated for fast versus conventional sequences. For each set of sequences, interobserver agreement calculations and chi-square tests were used to evaluate differences between fast and conventional acquisitions. An independent third reader reviewed the intra-observer discrepancies and adjudicated them as being more conspicuous on fast sequence, conventional sequence or the equivalent. The readers also were asked to rate motion artifacts with a previously validated score.
Results
Images from 77 children (mean age: 11.3 years) were analyzed. Intra-observer agreement (fast versus conventional) ranged between 89.2% and 92.3%. Interobserver agreement ranged between 86.1% and 88.4%. Interobserver agreement was significantly higher for conventional FLAIR relative to fast FLAIR for small (<5 mm) foci of T2 in the white matter. Otherwise, interobserver agreement was not different between the fast and conventional sequences. For awake subjects, fast sequences had significantly fewer artifacts (P<0.05).
Conclusion
Conventional T2 and FLAIR sequences can be optimized to shorten acquisition while maintaining diagnostic equivalency. These faster sequences were also less susceptible to motion artifacts.
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Acknowledgments
Camilo Jaimes was partially supported by the Ralph Schlaeger Fellowship in Neuroimaging Endowment and the Young Investigator Award of the Society for Pediatric Radiology.
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Jaimes, C., Yang, E., Connaughton, P. et al. Diagnostic equivalency of fast T2 and FLAIR sequences for pediatric brain MRI: a pilot study. Pediatr Radiol 50, 550–559 (2020). https://doi.org/10.1007/s00247-019-04584-1
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DOI: https://doi.org/10.1007/s00247-019-04584-1