Abstract
Background and PurposeCT is considered the modality of choice in the assessment of the skull due to the fast and accurate depiction of bone structures. Nevertheless, MRI has evolved into a possible alternative due to optimal soft tissue contrast and recent advances with the ability to visualize tissues with shortest T2 times, such as osseous structures. In this study we compare skull bone visualization and fracture detection across two MRI sequences to CT as reference standard. Material and MethodsTwenty subjects underwent CT and MRI with less than 72 h between examination. The MRI protocol included a 2D ultrashort echo time (UTE) and a 3D multi-echo in-phase fast-field-echo (FRACTURE) sequence. Independent raters evaluated qualitative characteristics and fracture detectability in different skull subregions (skull vault, skull base and viscerocranium). Interrater and intermodality agreement was evaluated by calculating intraclass coefficients (ICC). ResultsFRACTURE ICC indicated a good agreement in all subregions (ICC = 0.83 – 0.88), whereas UTE had excellent results calculated in the skull vault and viscerocranium (ICC = 0.91 – 0.94). At the skull vault, both MRI sequences received an overall good rating (UTE: 2.63 ± 0.42 FRACTURE. 2.81 ± 0.32). Fracture detection using MRI sequences for the skull vault, was highest compared to other subregions. ConclusionsBoth MRI sequences may provide an alternative e.g. for surgical planning or follow up exams of the osseous neurocranium; although, at the skull base and viscerocranium bone visualization with MRI bone imaging sequences perform inferior to CT standard imaging.
Highlights
For the assessment of skull bones CT is recommended as first-line imaging modality.[1]
CT imaging was considered as a reference standard for all skull regions and obtained the maximum value of 3 for the visual
On the ultrashort echo time (UTE) sequence bone delineation was rated with 1.48 § 0.03 and on FRACTURE with 1.33 § 0.33, which did not show any statistically significant difference between the two MRI sequences
Summary
Both MRI sequences may provide an alternative e.g. for surgical planning or follow up exams of the osseous neurocranium; at the skull base and viscerocranium bone visualization with MRI bone imaging sequences perform inferior to CT standard imaging. Published at: Deininger-Czermak, Eva; Euler, Andre; Franckenberg, Sabine; Finkenstaedt, Tim; Villefort, Christina; Gascho, Dominic; Guggenberger, Roman (2021). Evaluation of ultrashort echo-time (UTE) and fastfield-echo (FRACTURE) sequences for skull bone visualization and fracture detection - A postmortem study. Eva Deininger-Czermaka,b, Andre Eulerb, Sabine Franckenberga,b, Tim Finkenstaedtb, Christina Villefortc, Dominic Gaschoa,1,*, Roman Guggenbergerb,[1] a Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland b Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland c Orthopedic Surgery, Balgrist University Hospital, Zurich, Switzerland
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