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High-Fidelity T2 Relaxometry of the Developing Fetal Brain Using an 8-Second Single-Shot Multiple Overlapping-Echo
Nuowei Ge1, Qinqin Yang1, Chenyu Yan2
1Department of Electronic Science, Fujian Provincial Key Laboratory of Plasma and Magnetic Resonance, Xiamen University, Xiamen, China.
Background:
Although quantitative MRI can provide objective biomarkers for brain maturation assessment, unpredictable fetal movement limits its application on fetuses.
Purpose:
To evaluate single-shot multiple overlapping-echo detachment (MOLED) imaging for fetal brain T2 relaxometry and to quantify fetal brain maturation using T2 relaxation time.
Study Type:
Phantom and prospective in vivo assessment.
Subjects:
T2 phantom and 52 fetuses (mean gestational age [GA], 30.94 ± 3.62 weeks; range, 23-37 weeks).
Field Strength/Sequence:
3T; half-Fourier acquisition single-shot turbo spin-echo (HASTE) and MOLED sequences.
Assessment:
The accuracy, motion robustness, and repeatability of 8-s MOLED T2 relaxometry were assessed using motion-free and motion phantom acquisitions. In 15 fetuses, the MOLED scan was repeated within 5 min to assess scan-rescan repeatability. Regional T2 values were determined in fetal white matter (WM), deep gray matter (dGM) and brainstem, and their changes with GA evaluated.
Statistical Tests:
Bland-Altman analysis, linear regression analysis (Pearson correlation coefficient, r), coefficient of variation, repeated-measures analysis of variance, and intraclass correlation coefficient. p < 0.05 was considered statistically significant.
Results:
Motion-free and motion phantom acquisitions demonstrated that MOLED T2 significantly agreed with reference T2 (r = 0.99). In vivo studies reported mean T2 values for all fetuses (WM, 215.20 ms; dGM, 145.82 ms; brainstem, 125.80 ms). Scan-rescan acquisitions showed non-significant mean T2 differences (bias < 1%; limits of agreement, -8.51% to +7.78%). Regional T2 values showed significant negative correlations (r, -0.85 to -0.60) with GA. The brainstem exhibited a significantly higher rate of GA-related T2 change (3.43 ms per week) than WM and dGM (2.19 and 2.89 ms per week, respectively).
Data Conclusion:
MOLED imaging appears to allow motion-robust, clinically feasible, and highly repeatable T2 measurements for the whole fetal brain in 8 s. Regional differences in T2 values and age-related T2 changes demonstrate its potential for quantifying in utero brain maturation.
Evidence Level:
2.
Technical Efficacy:
Stage 1.
