Clinical Evaluation of Silent T1-Weighted MRI and Silent MR Angiography of the Brain : American Journal of Roentgenology : Vol. 210, No. 2 (AJR)

February 2018, Volume 210, Number 2

Neuroradiology/Head and Neck Imaging

Original Research

Clinical Evaluation of Silent T1-Weighted MRI and Silent MR Angiography of the Brain

Samantha J. Holdsworth^1,², Sarah J. Macpherson², Kristen W. Yeom³, Max Wintermark³ and Greg Zaharchuk²

+ Affiliations:

¹Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, University of Auckland, Auckland, NZ.

²Department of Radiology, Stanford University, Lucas Center, Stanford, CA.

³Lucile Packard Children's Hospital, Stanford University, Palo Alto, CA.

Citation: American Journal of Roentgenology. 2018;210: 404-411. 10.2214/AJR.17.18247

ABSTRACT :

OBJECTIVE. New MRI sequences based on rapid radial acquisition have reduced gradient noise. The purpose of this study was to compare Silent T1-weighted and unenhanced MR angiography (MRA) against conventional sequences in a clinical population.

MATERIALS AND METHODS. The study cohort consisted of 40 patients with suspected brain metastases (median age, 60 years; range, 23–91 years) who underwent T1-weighted contrast-enhanced MRI and 51 patients with suspected vascular lesions or cerebral ischemia (median age, 60 years; range, 16–94 years) who underwent unenhanced intracranial MRA. Three neuroradiologists reviewed the images blindly and rated several measures of image quality on a 5-point Likert scale. Reviewers recorded the number of enhancing lesions and whether Silent images were better than, worse than, or equivalent to conventional images.

RESULTS. For T1-weighted MR images, ratings were slightly lower for Silent versus conventional images, except for diagnostic confidence. Although more lesions were detected on conventional images, this difference was not statistically significant; agreement was seen in 88% of cases. In 48% of cases, T1-weighted scans were deemed equivalent, but when a preference existed, it was usually for conventional images (38% vs 14%). Conventional MRA images were rated higher on all image quality metrics and were strongly preferred (reviewers preferred conventional images in 69% of cases, rated the images as equivalent in 27% of cases, and preferred Silent images in 4% of cases). In some cases, artifacts on Silent images caused reduced vessel caliber, vessel irregularities, and even absent vessels.

CONCLUSION. Although conventional T1-weighted images were preferred overall, most Silent T1-weighted images were rated as equivalent to or better than conventional images and represent a potential alternative for imaging of noise-averse patients. Silent MRA scored significantly worse and could not be recommended at this time, suggesting that it requires additional refinement before routine clinical use.

Keywords: brain, MR angiography, Silent T1-weighted MRI

Based on a presentation at the American Society of Neuroradiology 2016 annual meeting, Washington, DC.

Supported by grants R01NS066506, R01NS047607, 1R21HD083803, 5P41RR09784, and P41EB015891 from the National Institutes of Health, GE Healthcare, Center of Advanced MR Technology at Stanford, and the Lucas Foundation.

References

1. Hattori Y, Fukatsu H, Ishigaki T. Measurement and evaluation of the acoustic noise of a 3 Tesla MR scanner. Nagoya J Med Sci 2007; 69:23–28 [Google Scholar]

2. Price DL, De Wilde JP, Papadaki AM, Curran JS, Kitney RI. Investigation of acoustic noise on 15 MRI scanners from 0.2 T to 3 T. J Magn Reson Imaging 2001; 13:288–293 [Google Scholar]

3. Villoria EM, Francio LA, Rocha LR, et al. Study about the consequences of different sound pressure levels emitted by magnetic resonance imaging equipment. Rev CEFAC 2016; 18:27–32 [Google Scholar]

4. Enders J, Zimmermann E, Rief M, et al. Reduction of claustrophobia during magnetic resonance imaging: methods and design of the “ CLAUSTRO” randomized controlled trial. BMC Med Imaging 2011; 11:4 [Google Scholar]

5. Dewey M, Schink T, Dewey C. Claustrophobia during magnetic resonance imaging: cohort study in over 55,000 patients. J Magn Reson Imaging 2007; 26:1322–1327 [Google Scholar]

6. Heismann B, Ott M, Grodzki D. Sequence-based acoustic noise reduction of clinical MRI scans. Magn Reson Med 2015; 73:1104–1109 [Google Scholar]

7. Edelstein WA, Kidane TK, Taracila V, et al. Active-passive gradient shielding for MRI acoustic noise reduction. Magn Reson Med 2005; 53:1013–1017 [Google Scholar]

8. Alibek S, Vogel M, Sun W, et al. Acoustic noise reduction in MRI using Silent Scan: an initial experience. Diagn Interv Radiol 2014; 20:360–363 [Google Scholar]

9. Solana AB, Menini A, Sacolick LI, Hehn N, Wiesinger F. Quiet and distortion-free, whole brain BOLD fMRI using T₂-prepared RUFIS. Magn Reson Med 2016; 75:1402–1412 [Google Scholar]

10. Madio DP, Lowe IJ. Ultra-fast imaging using low flip angles and FIDs. Magn Reson Med 1995; 34:525–529 [Google Scholar]

11. Ida M, Wakayama T, Nielsen ML, Abe T, Grodzki DM. Quiet T1-weighted imaging using PETRA: initial clinical evaluation in intracranial tumor patients. J Magn Reson Imaging 2015; 41:447–453 [Google Scholar]

12. Corcuera-Solano I, Doshi A, Pawha PS, Gui D, Gaddipati A, Tanenbaum L. Quiet PROPELLER MRI techniques match the quality of conventional PROPELLER brain imaging techniques. AJNR 2015; 36:1124–1127 [Google Scholar]

13. Rösch J, Ott M, Heismann B, et al. Quiet diffusion-weighted head scanning: initial clinical evaluation in ischemic stroke patients at 1.5T. J Magn Reson Imaging 2016; 44:1238–1243 [Google Scholar]

14. Irie R, Suzuki M, Yamamoto M, et al. Assessing blood flow in an intracranial stent: a feasibility study of MR angiography using a silent scan after stent-assisted coil embolization for anterior circulation aneurysms. AJNR 2015; 36:967–970 [Google Scholar]

15. Zaharchuk G, Bammer R, Straka M, et al. Arterial spin label images in patients with normal bolus perfusion-weighted magnetic resonance imaging: pilot identification of the “borderzone sign.” Radiology 2009; 252:797–807 [Google Scholar]

16. Mizuki K, Masui T, Katayama M, et al. Evaluation of patients of the cerebral vasculature: comparison with Silenz MRA and 3D TOF MRA. International Society for Magnetic Resonance in Medicine website. dev.ismrm.org/2014/3882.html. Published 2014. Accessed September 21, 2017 [Google Scholar]

17. Shang S, Qu J, Wu B, Zhang Y, Luo X, Wu J. Zero TE continuous ASL MRA in the characterization of cerebral aneurysm: a feasibility study. International Society for Magnetic Resonance in Medicine website. dev.ismrm.org/2016/1434.html. Published May 2016. Accessed September 21, 2017 [Google Scholar]

18. Chan CF, Keenan NG, Nielles-Vallespin S, et al. Ultra-short echo time cardiovascular magnetic resonance of atherosclerotic carotid plaque. J Cardiovasc Magn Reson 2010; 12:17 [Google Scholar]

19. Gönner F, Heid O, Remonda L, et al. MR angiography with ultrashort echo time in cerebral aneurysms treated with Guglielmi detachable coils. AJNR 1998; 19:1324–1328 [Google Scholar]

20. Gönner F, Lövblad KO, Heid O, et al. Magnetic resonance angiography with ultrashort echo times reduces the artefact of aneurysm clips. Neuroradiology 2002; 44:755–758 [Google Scholar]

Address correspondence to S. J. Holdsworth ([email protected])

Related Articles

Recommend & Share

February 2018, Volume 210, Number 2

Neuroradiology/Head and Neck Imaging

Original Research

Clinical Evaluation of Silent T1-Weighted MRI and Silent MR Angiography of the Brain

Recommended Articles

Clinical Evaluation of Silent T1-Weighted MRI and Silent MR Angiography of the Brain