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Lung parenchyma and structure visualisation in paediatric chest MRI: a comparison of different short and ultra-short
D Papp1, B Elders2, P A Wielopolski1
1Department of Radiology and Nuclear Medicine, Erasmus Medical Centre, Rotterdam, the Netherlands.
Aim:
To evaluate image quality acquired at lung imaging using magnetic resonance imaging (MRI) sequences using short and ultra-short (UTE) echo times (TEs) with different acquisition strategies (breath-hold, prospective, and retrospective gating) in paediatric patients and in healthy volunteers.
Materials And Methods:
End-inspiratory and end-expiratory three-dimensional (3D) spoiled gradient (SPGR3D) and 3D zero echo-time (ZTE3D), and 3D UTE free-breathing (UTE3D), prospective projection navigated radial ZTE3D (ZTE3D vnav), and four-dimensional ZTE (ZTE4D) were performed using a 1.5 T MRI system. For quantitative assessment, the contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) values were calculated. To evaluate image quality, qualitative scoring was undertaken on all sequences to evaluate depiction of intrapulmonary vessels, fissures, bronchi, imaging noise, artefacts, and overall acceptability.
Results:
Eight cystic fibrosis (CF) patients (median age 14 years, range 13-17 years), seven children with history of prematurity with or without bronchopulmonary dysplasia (BPD; median 10 years, range 10-11 years), and 10 healthy volunteers (median 32 years, range 20-52 years) were included in the study. ZTE3D vnav provided the most reliable output in terms of image quality, although scan time was highly dependent on navigator triggering efficiency and respiratory pattern.
Conclusions:
Best image quality was achieved with prospective ZTE3D and UTE3D readouts both in children and volunteers. The current implementation of retrospective ZTE3D readout (ZTE4D) did not provide diagnostic image quality but rather introduced artefacts over the entire imaging volume mimicking lung pathology.
Insights
Prospective zero echo-time 3D (ZTE3D) and ultra-short echo time 3D (UTE3D) magnetic resonance imaging (MRI) sequences provide the best lung image quality in children and adults. Retrospective ZTE3D (ZTE4D) sequences introduce artifacts that mimic lung pathology.
Area of Science:
- Radiology
- Medical Imaging
- Pulmonary Imaging
Background:
- Lung imaging with MRI is challenging due to respiratory motion.
- Short and ultra-short echo time (TE) sequences aim to improve image quality by minimizing motion artifacts.
Purpose of the Study:
- To evaluate and compare the image quality of various lung MRI sequences with different echo times and acquisition strategies.
- To assess image quality in pediatric patients and healthy adult volunteers.
Main Methods:
- Acquisition of 3D spoiled gradient (SPGR3D), 3D zero echo-time (ZTE3D), 3D UTE free-breathing (UTE3D), prospective ZTE3D navigated radial (ZTE3D vnav), and 4D ZTE (ZTE4D) sequences.
- Quantitative assessment of contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR).
- Qualitative scoring of intrapulmonary vessels, fissures, bronchi, noise, artifacts, and overall acceptability.
Main Results:
- ZTE3D vnav demonstrated reliable image quality, though scan time varied with navigator efficiency.
- Prospective ZTE3D and UTE3D sequences yielded the best image quality in both pediatric and adult subjects.
- Retrospective ZTE3D (ZTE4D) resulted in diagnostic image quality issues, with artifacts mimicking lung pathology.
Conclusions:
- Prospective ZTE3D and UTE3D are superior for pediatric and adult lung MRI.
- Current retrospective ZTE3D implementations (ZTE4D) are not suitable for diagnostic lung imaging due to artifact generation.
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