Abstract

MPRAGE is the most commonly used sequence for high-resolution 3D T1-weighted imaging in pediatric patients. However, its longer scan time is a major drawback because pediatric patients are prone to motion and frequently require sedation. This study compared nonenhanced accelerated MPRAGE using wave-controlled aliasing in parallel imaging (wave-T1-MPRAGE) with standard MPRAGE in infants. We retrospectively evaluated 68 infants (mean age, 1.78 [SD. 1.70] months) who underwent nonenhanced standard and wave-T1-MPRAGE. Two neuroradiologists independently assessed each image for image quality, artifacts, myelination degree, and anatomic delineation using the 4-point Likert scale. For diagnostic performance, both observers determined whether nonenhancing lesions were present in the brain parenchyma in 2 types of nonenhanced MPRAGE sequences. Wave-T1-MPRAGE showed a significantly lower mean score and lower interobserver agreement for overall image quality and anatomic delineation than standard MPRAGE (P< .001 for each). However, there were no significant differences between the 2 types of MPRAGE sequences for motion artifacts (P = .90 for observer 1, P = .14 for observer 2) and degree of myelination (P = .16 for observer 1, P = .32 for observer 2). Among the nonenhancing pathologic lesions observed on standard MPRAGE by both observers, only 2 were missed on wave-T1-MPRAGE, and they were very tiny, faint, nonhemorrhagic WM injuries. Although wave-T1-MPRAGE showed lower overall image quality than standard MPRAGE, the diagnostic performance for nonenhancing parenchymal lesions was comparable. Wave-T1-MPRAGE could be an alternative for diagnosing intracranial lesions in infants, with marked scan time reduction.

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