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Conical ultrashort echo time (UTE) MRI in the evaluation of pediatric acute appendicitis

Albert T Roh1, Zhibo Xiao2, Joseph Y Cheng1

  • 1Radiology, Stanford University, 300 Pasteur Drive, Stanford, CA, 94305, USA.

Abdominal Radiology (New York)
|August 2, 2018
PubMed
Abstract

Insights

Free-breathing conical ultrashort echo time (UTE) MRI shows improved image quality and fewer artifacts for pediatric appendicitis evaluation compared to standard MRI sequences. This advanced technique offers better diagnostic confidence in assessing the pediatric pelvis.

Area of Science:

  • Radiology
  • Medical Imaging
  • Pediatric Imaging

Background:

  • Motion artifacts and long echo times can limit the diagnostic utility of standard MRI sequences.
  • Ultrashort echo time (UTE) MRI sequences with conical k-space trajectories offer potential for reduced motion artifacts and faster imaging.
  • Evaluating pediatric pelvic conditions like appendicitis requires high-quality imaging with minimal artifacts.

Purpose of the Study:

  • To assess the performance of free-breathing conical UTE MRI in evaluating the pediatric pelvis for suspected appendicitis.
  • To compare the efficacy of free-breathing conical UTE MRI against conventional breath-hold and free-breathing 3D SPGR sequences.

Main Methods:

  • Retrospective review of 84 pediatric patients with suspected appendicitis.
  • Comparison of three contrast-enhanced MRI sequences: free-breathing conical UTE, breath-hold 3D SPGR (BH-SPGR), and free-breathing high-resolution 3D SPGR (FB-SPGR).
  • Blinded, independent radiologist evaluation of image quality, anatomic delineation, and diagnostic confidence, with direct overall image quality comparisons.

Main Results:

  • Free-breathing conical UTE MRI demonstrated significantly better perceived signal-to-noise ratio (SNR) and fewer artifacts compared to both BH-SPGR and FB-SPGR.
  • While BH-SPGR and FB-SPGR showed better contrast, UTE performed significantly better in other assessed categories, particularly against FB-SPGR.
  • Radiologists significantly preferred the overall image quality of UTE MRI over both BH-SPGR and FB-SPGR.

Conclusions:

  • Free-breathing conical UTE MRI is a superior technique for evaluating suspected appendicitis in the pediatric pelvis compared to FB-SPGR.
  • UTE MRI offers improved perceived SNR and reduced artifacts when compared to BH-SPGR, enhancing diagnostic confidence.
Keywords:
AppendicitisNon-CartesianPediatricPelvisUltrashort echo time

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