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Large Numbers for Small Children-Up to What Age Do Infants Benefit from a Longer Echo Time in Cerebral T2 MRI
Anne Bettina Beeskow1, Franz Wolfgang Hirsch2, Timm Denecke1
1Department for Diagnostic and Interventional Radiology, University Hospital Leipzig, Liebigstrasse 20a, 04103 Leipzig, Germany.
Insights
For infants under six months, long echo time (TE) MRI sequences enhance grey-white matter contrast. After ten months, medium TE is superior for pediatric brain imaging.
Area of Science:
- Pediatric Radiology
- Neuroimaging
- Medical Physics
Background:
- White matter in newborns exhibits high T2-weighted (T2w) signal intensity on MRI, resulting in poor grey-white matter contrast.
- Extended echo time (TE) in T2w MRI is utilized in pediatric imaging to improve contrast, but optimal age ranges are unclear.
Purpose of the Study:
- To determine the optimal age for utilizing long echo time (TE) in T2-weighted (T2w) cranial MRI examinations for infants.
Main Methods:
- Prospective study involving 101 infants aged 0-18 months undergoing 3 Tesla cranial MRI.
- Acquisition of T2w Fast Spin Echo sequences with both long TE (200 ms) and medium TE (100 ms).
- Measurement of cortical and white matter signal intensities, calculation of grey-white matter contrast (MC), and determination of a cut-off age.
Main Results:
- Long TE sequences demonstrated statistically significantly higher MC in infants up to six months old compared to medium TE (Long TE: 0.19 ± 0.07 vs. Medium TE: 0.1 ± 0.05, p < 0.001).
- After ten months of age, medium TE sequences provided significantly better MC than long TE sequences (Medium TE: 0.1 ± 0.05 vs. Long TE: 0.05 ± 0.4, p < 0.001).
- A cut-off age for the utility of long TE in enhancing contrast was identified.
Conclusions:
- The use of long echo time (TE) in T2-weighted (T2w) MRI is beneficial for improving grey-white matter contrast exclusively within the first six months of life.
- For infants older than ten months, employing a medium TE, consistent with adult brain MRI protocols, is recommended for superior contrast.
- These findings provide age-specific guidance for optimizing pediatric brain MRI protocols.
Abstract:
In newborns, white matter shows a high T2-weighted (T2w) signal in MRI with poor grey-white matter contrast. To increase this contrast, an extremely long echo time (TE) is used in the examination of children. It is not known up to what age this long TE should be used. The purpose of this study was to find up to what age a long TE should be used in infants. In the prospective study, 101 infants (0-18 months) underwent cranial MRI at 3 Tesla. T2-weighted Fast Spin Echo sequences with long TE (200 ms) and medium TE (100 ms) were used. The signal intensities of the cortex and white matter were measured and the grey-white matter contrast (MC) was calculated. A cut-off age was determined. The T2w sequences with long TE had a statistically significantly higher MC until the age of six months (medium TE: 0.1 ± 0.05, Long TE: 0.19 ± 0.07; p < 0.001). After the tenth month, the T2w sequence with medium TE provided significantly better MC (Medium TE: 0.1 ± 0.05; long TE: 0.05 ± 0.4; p < 0.001). The use of a long TE is only helpful in the first six months of life. After the tenth month of life, a medium TE should be favored as is used in adult brain MRI.
