Sub-1-min relaxation-enhanced non-contrast non-triggered cervical MRA using compressed SENSE with deep learning...

We evaluated the acceleration of a three-dimensional isotropic flow-independent magnetic resonance angiography (MRA) (relaxation-enhanced angiography without contrast and triggering, REACT) of neck arteries using compressed SENSE (CS) combined with deep learning (adaptive intelligence, AI)-based reconstruction (CS-AI).

Thirty-four volunteers received 3-T REACT MRA, acquired threefold: (i) CS acceleration factor 7 (CS7), scan time 1:20 min:s; (ii) CS acceleration factor 10 (CS10), scan time 0:55 min:s; and (iii) CS-AI acceleration factor 10 (CS10-AI), scan time 0:55 min:s. Two radiologists rated the image quality of seven arterial segments and overall image noise. Additionally, a pairwise forced-choice comparison was conducted. Apparent signal-to-noise ratio (aSNR) and contrast-to-noise ratio (aCNR) were measured, and image sharpness was assessed using the edge-rise distance (ERD). Multiple t-tests and nonparametric tests with Bonferroni correction were performed for comparison to CS7 as the reference standard.

Compared to CS7, CS10 showed lower image quality (p < 0.001) while CS10-AI obtained higher scores (p = 0.010). Image noise was similar between CS7 and CS10 (p = 0.138) while CS10-AI yielded a lower noise (p = 0.008). Forced choice revealed preferences for CS7 over CS10 (p < 0.001), but no preference between CS7 and CS10-AI (p > 0.999). Compared to CS7, aSNR and aCNR were lower in CS10 (p < 0.001) and the ERD was longer (p = 0.004), while CS10-AI provided better aSNR and aCNR (p = 0.001) and showed no difference in ERD (p = 0.776).

Sub-1-min CS-AI cervical REACT MRA was acquired without compromising image quality.

The implementation of a fast and reliable non-contrast MRA has the potential to reduce costs and time while increasing patient comfort and safety. Clinical studies evaluating the diagnostic performance for stenosis or dissection are needed.

DRKS00030210 (German Clinical Trials Register; https://drks.de/ ) KEY POINTS: Deep learning reconstruction enables sub-1-min non-contrast-enhanced MRA of extracranial arteries. Acceleration without deep learning reconstruction causes inferior image quality. Acceleration with deep learning reconstruction exceeds, in part, the clinical standard.