Clinical feasibility of simultaneous multislice acceleration in knee MRI

To find the best simultaneous multislice (SMS) accelerated setting for clinical application in knee MRI.

Thirty-three patients (mean age, 54 years; 21 women) who underwent knee MRI (conventional/SMS sequences) between June and October 2020 were enrolled. Two radiologists retrospectively evaluated sagittal T1- and T2-weighted conventional (2-fold parallel acquisition technique [PAT-2]) and SMS (SMS-2 [PAT-2 with 2-fold SMS], SMS-3, and SMS-4) images. For qualitative analysis, artifacts (zebra/residual aliasing) and diagnostic confidence for internal derangement of knee (bone marrow, cartilage, meniscus, anterior cruciate ligament, and synovium abnormalities) were evaluated. For quantitative analysis, contrast-to-noise ratios of bone marrow, meniscus, joint effusion, and ligament were evaluated.

Compared to PAT-2 (2 min 32 s), mean acquisition time was reduced by 47% in SMS-2; 64%, SMS-3; and 70%, SMS-4. In qualitative analysis, zebra artifacts were only seen on T2-weighted SMS images. The more SMS was applied, the more zebra and residual aliasing artifacts were seen and the lower diagnostic confidence was for internal derangement. However, qualitative analysis showed acceptable image quality in SMS-2 and SMS-3 images, but not in SMS-4 images. In quantitative analysis, SMS-4 images showed the lowest contrast-to-noise ratios and there were no significant differences among PAT-2, SMS-2, and SMS-3 images.

Applying SMS-3 to knee MRI reduced scan time and showed acceptable image quality compared to conventional (PAT-2). However, when evaluating SMS images, radiologists should know that when more SMS is applied, more zebra and residual aliasing artifacts appear.