Echo Time Acquisition Research Articles

Influence of echo time on pulmonary ventilation and perfusion derived by phase-resolved functional lung (PREFUL) MRI using multi-echo ultrashort echo time acquisition.

Non-contrast enhanced 1H magnetic resonance imaging (MRI) is promising for ventilation/perfusion (V/Q) assessment of the lung but the influence of the echo time (TE) on V/Q parameters is lacking. Therefore, the purpose of this study was to investigate the influence of different TEs on pulmonary V/Q parameters derived by phase-resolved functional lung (PREFUL) MRI using a multi-echo ultrashort TE (UTE) acquisition. A 2D multi-echo UTE sequence with radial center out readout and tiny golden angle increment was developed. Forty-eight participants were enrolled in this study: 25 healthy subjects, six patients with asthma, and 17 patients with pulmonary fibrosis. Participants underwent two acquisitions of 2D multi-echo UTE MRI with three TEs per acquisition (TE1-6: 0.07, 0.82, 1.72, 2.47, 3.37, and 4.12 ms). Regional ventilation (RVent), flow-volume loop cross-correlation metric (FVL-CM), and normalized perfusion-weighted signal (QN) maps were calculated. V/Q defect percentages (VDP/QDP) were determined. To assess repeatability, the measurement was repeated in healthy subjects. Median and interquartile range of RVent, FVL-CM, QN, VDP, and QDP were calculated. To assess significant differences between parameters obtained at different TEs, Friedman's test and Dunnett's test were performed. Pearson correlation coefficients between RVent derived at TE1 and the difference in RVent between TE2,3 and TE1 were calculated. For repeatability assessment, coefficient of variation (CoV) and intraclass correlation coefficient (ICC) were determined. Significant differences were found comparing V/Q parameters obtained at TE3-6 compared to TE1. CoV increased with TE. For ICC, values between 0.35 (QDP at TE1) and 0.83 (VDPRVent at TE2) were obtained for T1,2. Statistically significant differences for ventilation and perfusion parameters derived by PREFUL were found for TE3-6 compared to TE1. All V/Q parameters were well repeatable for TE1-2. With increasing TE and respiratory volume, RVent shows a T2*-dependency leading to biased ventilation assessment compared to TE1.

Significant age-related differences between lower leg muscles of older and younger female subjects detected by ultrashort echo time magnetization transfer modeling.

Magnetization transfer (MT) magnetic resonance imaging (MRI) can be used to estimate the fraction of water and macromolecular proton pools in tissues. MT modeling paired with ultrashort echo time acquisition (UTE-MT modeling) has been proposed to improve the evaluation of the myotendinous junction and fibrosis in muscle tissues, which the latter increases with aging. This study aimed to determine if the UTE-MT modeling technique is sensitive to age-related changes in the skeletal muscles of the lower leg. Institutional review board approval was obtained, and all recruited subjects provided written informed consent. The legs of 31 healthy younger (28.1±6.1years old, BMI = 22.3±3.5) and 20 older (74.7±5.5years old, BMI = 26.7±5.9) female subjects were imaged using UTE sequences on a 3T MRI scanner. MT ratio (MTR), macromolecular fraction (MMF), macromolecular T2 (T2-MM), and water T2 (T2-W) were calculated using UTE-MT modeling for the anterior tibialis (ATM), posterior tibialis (PTM), soleus (SM), and combined lateral muscles. Results were compared between groups using the Wilcoxon rank sum test. Three independent observers selected regions of interest (ROIs) and processed UTE-MRI images separately, and the intraclass correlation coefficient (ICC) was calculated for a reproducibility study. Significantly lower mean MTR and MMF values were present in the older compared with the younger group in all studied lower leg muscles. T2-MM showed significantly lower values in the older group only for PTM and SM muscles. In contrast, T2-W showed significantly higher values in the older group. The age-related differences were more pronounced for MMF (-17 to -19%) and T2-W (+20 to 47%) measurements in all muscle groups compared with other investigated MR measures. ICCs were higher than 0.93, indicating excellent consistency between the ROI selection and MRI measurements of independent readers. As demonstrated by significant differences between younger and older groups, this research emphasizes the potential of UTE-MT MRI techniques in evaluating age-related skeletal muscle changes.

Magnetic Resonance Imaging Versus Computed Tomography for Three-Dimensional Bone Imaging of Musculoskeletal Pathologies: A Review.

Magnetic resonance imaging (MRI) is increasingly utilized as a radiation‐free alternative to computed tomography (CT) for the diagnosis and treatment planning of musculoskeletal pathologies. MR imaging of hard tissues such as cortical bone remains challenging due to their low proton density and short transverse relaxation times, rendering bone tissues as nonspecific low signal structures on MR images obtained from most sequences. Developments in MR image acquisition and post‐processing have opened the path for enhanced MR‐based bone visualization aiming to provide a CT‐like contrast and, as such, ease clinical interpretation. The purpose of this review is to provide an overview of studies comparing MR and CT imaging for diagnostic and treatment planning purposes in orthopedic care, with a special focus on selective bone visualization, bone segmentation, and three‐dimensional (3D) modeling. This review discusses conventional gradient‐echo derived techniques as well as dedicated short echo time acquisition techniques and post‐processing techniques, including the generation of synthetic CT, in the context of 3D and specific bone visualization. Based on the reviewed literature, it may be concluded that the recent developments in MRI‐based bone visualization are promising. MRI alone provides valuable information on both bone and soft tissues for a broad range of applications including diagnostics, 3D modeling, and treatment planning in multiple anatomical regions, including the skull, spine, shoulder, pelvis, and long bones.Level of Evidence3Technical EfficacyStage 3

MRI phase offset correction method impacts quantitative susceptibility mapping

Individual channel ultra-high field (7T) phase images have to be phase offset corrected prior to the mapping of magnetic susceptibility of tissue. Whilst numerous methods have been proposed for gradient recalled echo MRI phase offset correction, it remains unclear how they affect quantitative magnetic susceptibility values derived from phase images. Methods already proposed either employ a single or multiple echo time MRI data. In terms of the latter, offsets can be derived using an ultra-short echo time acquisition, or by estimating the offset based on two echo points with the assumption of linear phase evolution with echo time. Our evaluation involved 32 channel multi-echo time 7T GRE (Gradient Recalled Echo) and ultra-short echo time PETRA (Pointwise Encoding Time Reduction with Radial Acquisition) MRI data collected for a susceptibility phantom and three human brains. The combined phase images generated using four established offset correction methods (two single and two multiple echo time) were analysed, followed by an assessment of quantitative susceptibility values obtained for a phantom and human brains. The effectiveness of each method in removing the offsets was shown to reduce with increased echo time, decreased signal intensity and reduced overlap in coil sensitivity profiles. Quantitative susceptibility values and how they change with echo time were found to be method specific. Phase offset correction methods based on single echo time data have a tendency to produce more accurate and less noisy quantitative susceptibility maps in comparison with methods employing multiple echo time data.

Measuring tissue sodium concentration: Cross-vendor repeatability and reproducibility of 23 Na-MRI across two sites.

BackgroundSodium MRI (23Na‐MRI)‐derived biomarkers such as total sodium concentration (TSC) have the potential to provide information on tumor cellularity and the changes in tumor microstructure that occur following therapy.PurposeTo evaluate the repeatability and reproducibility of TSC measurements in the brains of healthy volunteers, providing evidence for the technical validation of 23Na‐MRI‐derived biomarkers.Study TypeProspective multicenter study.SubjectsEleven volunteers (32 ± 6 years; eight males, three females) were scanned twice at each of two sites.Field Strength/SequenceComparable 3D‐cones 23Na‐MRI ultrashort echo time acquisitions at 3T.AssessmentTSC values, quantified from calibration phantoms placed in the field of view, were obtained from white matter (WM), gray matter (GM), and cerebrospinal fluid (CSF), based on automated segmentation of coregistered 1H T1‐weighted images and hand‐drawn regions of interest by two readers.Statistical TestsCoefficients of variation (CoVs) from mean TSC values were used to assess intrasite repeatability and intersite reproducibility.ResultsMean GM TSC concentrations (52.1 ± 7.1 mM) were ∼20% higher than for WM (41.8 ± 6.7 mM). Measurements were highly repeatable at both sites with mean scan–rescan CoVs between volunteers and regions of 2% and 4%, respectively. Mean intersite reproducibility CoVs were 3%, 3%, and 6% for WM, GM, and CSF, respectively.Data ConclusionThese results demonstrate technical validation of sodium MRI‐derived biomarkers in healthy volunteers. We also show that comparable 23Na imaging of the brain can be implemented across different sites and scanners with excellent repeatability and reproducibility. Level of Evidence: 1 Technical Efficacy: Stage 2J. Magn. Reson. Imaging 2019;50:1278–1284.

A diffusion-based method for long-T2 suppression in steady state sequences: Validation and application for 3D-UTE imaging.

To introduce a novel method for long-T2 signal physical suppression in steady-state based on configuration states combination and modulation using diffusion weighting. Its efficiency in yielding a high contrast in short-T2 structures using an ultrashort echo time acquisition module (Diff-UTE) is compared to the adiabatically prepared Inversion-Recovery-UTE sequence (IR-UTE). Using a rectangular-pulse prepared 3D-UTE sequence, the possibility of long-T2 component signal cancellation through diffusion effects is addressed, and the condition met for sets of sequence parameters. Simultaneously, the short-T2 component signal is maximized using a Bloch equation-based optimization process. The method is evaluated from simulations, and experiments are conducted on a phantom composed of short and long-T2 components, as well as on an ex vivo mouse head. Within equal scan times, the proposed method allowed for an efficient long-T2 signal suppression, and expectedly yielded a higher signal to noise ratio in short-T2 structures compared to the IR-UTE technique, although an intrinsic short-T2 signal loss is expected through the preparation module. The Diff-UTE method represents an interesting alternative to the IR-UTE technique. Diffusion weighting allowing for a long-T2 suppression results in a less penalizing method to generate a high and selective contrast in short-T2 components. Magn Reson Med 80:548-559, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Free-breathing pediatric chest MRI: Performance of self-navigated golden-angle ordered conical ultrashort echo time acquisition.

To assess the feasibility and performance of conical k-space trajectory free-breathing ultrashort echo time (UTE) chest magnetic resonance imaging (MRI) versus four-dimensional (4D) flow and effects of 50% data subsampling and soft-gated motion correction. Thirty-two consecutive children who underwent both 4D flow and UTE ferumoxytol-enhanced chest MR (mean age: 5.4 years, range: 6 days to 15.7 years) in one 3T exam were recruited. From UTE k-space data, three image sets were reconstructed: 1) one with all data, 2) one using the first 50% of data, and 3) a final set with soft-gating motion correction, leveraging the signal magnitude immediately after each excitation. Two radiologists in blinded fashion independently scored image quality of anatomical landmarks on a 5-point scale. Ratings were compared using Wilcoxon rank-sum, Wilcoxon signed-ranks, and Kruskal-Wallis tests. Interobserver agreement was assessed with the intraclass correlation coefficient (ICC). For fully sampled UTE, mean scores for all structures were ≥4 (good-excellent). Full UTE surpassed 4D flow for lungs and airways (P < 0.001), with similar pulmonary artery (PA) quality (P = 0.62). 50% subsampling only slightly degraded all landmarks (P < 0.001), as did motion correction. Subsegmental PA visualization was possible in >93% scans for all techniques (P = 0.27). Interobserver agreement was excellent for combined scores (ICC = 0.83). High-quality free-breathing conical UTE chest MR is feasible, surpassing 4D flow for lungs and airways, with equivalent PA visualization. Data subsampling only mildly degraded images, favoring lesser scan times. Soft-gating motion correction overall did not improve image quality. 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:200-209.

Validation of quantitative bound‐ and pore‐water imaging in cortical bone

To implement and validate a previously proposed ultra-short echo time method for measuring collagen-bound- and pore-water concentrations in bone based on their T2 differences. Clinically compatible ultra-short echo time image sequences for quantitative T2 -based bound and pore-water imaging in bone were implemented and validated on a 3T human scanner and a 4.7T small bore system. Bound- and pore-water images were generating using T2 -selective adiabatic pulses. In both cases, the magnetization preparation was integrated into a three-dimensional ultra-short echo time acquisition, with 16 radial spokes acquired per preparation. Images were acquired from human cadaveric femoral mid-shafts from which isolated bone samples were subsequently extracted for nonimaging analysis using T2 spectroscopic measurements. A strong correlation was found between imaging-derived concentrations of bound and pore water and those determined from the isolated bone samples. These studies demonstrate the translation of the previously developed approaches for distinguishing bound and pore water from human cortical bone using practical human MRI constraints of gradient performance and radiofrequency power deposition.

Noninvasive monitoring of lactate dynamics in human forearm muscle after exhaustive exercise by1H-magnetic resonance spectroscopy at 7 tesla

Despite its importance in energy metabolism, lactate in human skeletal muscle has been difficult to detect by noninvasive (1)H-magnetic resonance spectroscopy mainly due to interference from large water and lipid signals. Long echo-time acquisitions at 7 T effectively attenuates the water and lipid signals in forearm muscle allowing direct observation of both lactate resonances, the methine at 4.09 ppm and the methyl at 1.31 ppm. Using this approach, we were able to monitor lactate dynamics at a temporal resolution of 32 s. While lactate was not detectable at rest, immediately after an acute period of exercise to fatigue the forearm muscle, lactate rose to a level comparable to that of creatine (∼30 mmol/kg wet weight). In a typical (1)H-magnetic resonance spectrum collected using a echo-time of 140 ms, the lactate methine and methyl resonances both appear as doublets with an unusually large splitting of ∼20 Hz due to residual dipolar coupling. During muscle recovery following exercise, the lactate signals decay rapidly with a time constant of t½ = 2.0 ± 0.6 min (n = 12 subjects). This fast and simple lactate detection method may prove valuable for monitoring lactate metabolism in cancer and in sports medicine applications.

Multicomponent T2* mapping of knee cartilage: Technical feasibility ex vivo

Disorganization of collagen fibers is a sign of early-stage cartilage degeneration in osteoarthritic knees. Water molecules trapped within well-organized collagen fibrils would be sensitive to collagen alterations. Multicomponent effective transverse relaxation (T2*) mapping with ultrashort echo time acquisitions is here proposed to probe short T(2) relaxations in those trapped water molecules. Six human tibial plateau explants were scanned on a 3T MRI scanner using a home-developed ultrashort echo time sequence with echo times optimized via Monte Carlo simulations. Time constants and component intensities of T2* decays were calculated at individual pixels, using the nonnegative least squares algorithm. Four T2*-decay types were found: 99% of cartilage pixels having mono-, bi-, or nonexponential decay, and 1% showing triexponential decay. Short T2* was mainly in 1-6 ms, while long T2* was ∼ 22 ms. A map of decay types presented spatial distribution of these T2* decays. These results showed the technical feasibility of multicomponent T2* mapping on human knee cartilage explants.

Highly localized positive contrast of small paramagnetic objects using 3D center‐out radial sampling with off‐resonance reception

In this article, we present a 3D imaging technique, applying center-out RAdial Sampling with Off-Resonance reception, to accurately depict and localize small paramagnetic objects with high positive contrast while suppressing long T(2) (*) components. The center-out RAdial Sampling with Off-Resonance reception imaging technique is a fully frequency-encoded 3D ultrashort echo time acquisition method, which uses a large excitation bandwidth and off-resonance reception. By manually introducing an offset, Δf(0), to the central reception frequency (f(0)), the typical radial signal pileup observed in 3D center-out sampling caused by a dipolar magnetic field disturbance can be shifted toward the source of the field disturbance, resulting in a hyperintense signal at the magnetic center of the small paramagnetic object. This was demonstrated both theoretically and using 1D time domain simulations. Experimental verification was done in a gel phantom and in inhomogeneous porcine tissue containing various objects with very different geometry and susceptibility, namely, subvoxel stainless steel spheres, a puncture needle, and paramagnetic brachytherapy seeds. In all cases, center-out RAdial Sampling with Off-Resonance reception was shown to generate high positive contrast exactly at the location of the paramagnetic object, as was confirmed by X-ray computed tomography.

Comparison of 3.0 T proton magnetic resonance spectroscopy short and long echo‐time measures of intramyocellular lipids in obese and normal‐weight women

To compare correlations of intramyocellular lipids (IMCL) measured by short and long echo-time proton magnetic resonance spectroscopy (1H-MRS) with indices of body composition and insulin resistance in obese and normal-weight women. We quantified IMCL of tibialis anterior (TA) and soleus (SOL) muscles in 52 premenopausal women (37 obese and 15 normal weight) using single-voxel 1H-MRS PRESS at 3.0 T with short (30 msec) and long (144 msec) echo times. Statistical analyses were performed to determine correlations of IMCL with body composition as determined by computed tomography (CT) and insulin resistance indices and to compare correlation coefficients from short and long echo-time data. Signal-to-noise ratio (SNR), linewidth, and coefficients of variation (CV) of short and long echo-time spectra were calculated. Short and long echo-time IMCL from TA and SOL significantly correlated with body mass index (BMI) and abdominal fat depots (r = 0.32 to 0.70, P = <0.05), liver density (r = -0.39 to -0.50, P < 0.05), and glucose area under the curve as a measure of insulin resistance (r = 0.47 to 0.49, P < 0.05). There was no significant difference between correlation coefficients of short and long echo-time spectra (P > 0.5). Short echo-time IMCL in both muscles showed significantly higher SNR (P < 0.0001) and lower CVs when compared to long echo-time acquisitions. Linewidth measures were not significantly different between groups. IMCL quantification using short and long echo-time 1H-MRS at 3.0 T is useful to detect differences in muscle lipid content in obese and normal-weight subjects. In addition, IMCL correlates with body composition and markers of insulin resistance in this population with no significant difference in correlations between short and long echo-times. Short echo-time IMCL quantification of TA and SOL muscles at 3.0 T was superior to long echo-time due to better SNR and better reproducibility.

High-resolution spiral imaging on a whole-body 7T scanner with minimized image blurring.

High-resolution (approximately 0.22 mm) images are preferably acquired on whole-body 7T scanners to visualize minianatomic structures in human brain. They usually need long acquisition time ( approximately 12 min) in three-dimensional scans, even with both parallel imaging and partial Fourier samplings. The combined use of both fast imaging techniques, however, leads to occasionally visible undersampling artifacts. Spiral imaging has an advantage in acquisition efficiency over rectangular sampling, but its implementations are limited due to image blurring caused by a strong off-resonance effect at 7T. This study proposes a solution for minimizing image blurring while keeping spiral efficient. Image blurring at 7T was, first, quantitatively investigated using computer simulations and point-spread functions. A combined use of multishot spirals and ultrashort echo time acquisitions was then employed to minimize off-resonance-induced image blurring. Experiments on phantoms and healthy subjects were performed on a whole-body 7T scanner to show the performance of the proposed method. The three-dimensional brain images of human subjects were obtained at echo time = 1.18 ms, resolution = 0.22 mm (field of view = 220 mm, matrix size = 1024), and in-plane spiral shots = 128, using a home-developed ultrashort echo time sequence (acquisition-weighted stack of spirals). The total acquisition time for 60 partitions at pulse repetition time = 100 ms was 12.8 min without use of parallel imaging and partial Fourier sampling. The blurring in these spiral images was minimized to a level comparable to that in gradient-echo images with rectangular acquisitions, while the spiral acquisition efficiency was maintained at eight. These images showed that spiral imaging at 7T was feasible.

SU‐GG‐BRC‐10: Shape Matters: Utilization of a Conformal Voxel Technique to Acquire Robust in Vivo Prostate MRSI at Short Echo Times

Purpose: We seek to improve the quality of in vivo prostate MRSI data acquisition by utilizing an optimized conformal voxel technique coupled with a spatial‐spectral excitation PRESS pulse sequence for short echo time acquisitions. Method and Materials: All subjects were scanned on a GE 1.5T Signa MR scanner equipped with Echospeed gradients. A standard endorectal coil in combination with a torso phased‐array coil was used. The PRESS pulse sequence was modified to include the optimized conformal voxel MR spectroscopic imaging technique (CV‐MRS). This method uses up to twenty Very Selective Saturation (VSS) pulses, automatically positioned in three dimensions, to “conform” the excitation volume to the shape of the prostate, effectively nulling signal from periprostatic lipids. Subjects were scanned using both the standard PRESS and the optimized CV‐MRS techniques at long and short echo times (TE). In vivo prostate spectra were collected and processed using a modified version of LCModel. Results: We observed an average lipid reduction of 60±18% for 17 subjects over the entire prostate when using the optimized CV‐MRS technique as compared to standard MRSI techniques. In specific regions along the peripheral zone, we observed lipid reduction greater than 95%. The effect of reducing the lipid contamination has resulted in a ∼70% improvement in peak identification of key prostate metabolites, based on goodness‐of‐fit parameters. Furthermore, short TE acquisitions have resulted in a substantial increase in the citrate signal, full visualization of the citrate multiplet and other metabolites not seen at long echo times. Conclusion: In vivo implementation of this optimized MRSI technique has confirmed the reduction in peripheral lipid contamination, and improved the quality of spectra throughout the prostate. Furthermore, this is the first demonstration of short TE in vivo prostate MRSI acquisitions, which provides significant signal increase and reveal short TE metabolites to potentially improve prostate cancer detection.

An independent multichannel imaging research system for ultrashort echo time imaging on clinical MR systems

AbstractMost clinical magnetic resonance systems do not have access to ultrashort echo time (UTE) imaging. The aim of this project was to develop a fully independent imaging insert for clinical MR systems to provide this new research application without disturbing routine operation. The initial clinical target for the system was improved orthopedic upper limb imaging using ultrashort repeat and echo time acquisitions. Echo times as short as TE = 80 μs were attained for standard 2DFT gradient echo sequences and TE = 25 μs for asymmetrically sampled radial acquisitions using the 160 mm inside diameter symmetrical cylindrical insert gradient set. The spectrometer was able to acquire 32 channels simultaneously with 14 bit resolution at up to 2.5 MS/s and had broadband operation from 250 kHz up to 200 MHz. Only eight active RF channels were constructed and used for this study. Acoustic noise with the insert coil was up to 30 dbA quieter than a whole body gradient system operating at the same gradient strength. The insert provides a useful method of performing UTE imaging using a standard clinical MRI system with no disturbance to normal operation. © 2009 Wiley Periodicals, Inc. Concepts Magn Reson Part B (Magn Reson Engineering) 35B: 80–88, 2009

Functional MRI with variable echo time acquisition

A new functional MRI protocol that integrates variable echo time (TE) acquisition and a block-design paradigm is proposed and evaluated with finger-tapping motor task. Simulations and experimental data show that the blood oxygenation level-dependent (BOLD) sensitivity achieved with this approach is comparable to that achieved using a conventional constant-TE protocol. The proposed variable-TE fMRI protocol provides valuable information that cannot be obtained with the constant-TE protocol. First, a field inhomogeneity map can be derived from the multi-TE data and used to correct EPI geometric distortions. Second, changes of T2* values due to the BOLD effect can be quantified. Third, for brain regions with pronounced susceptibility field gradients, the reduced BOLD sensitivity may be compensated for when the acquired multi-TE data are processed appropriately (e.g., with weighted summation). Fourth, large venules and veins may possibly be identified (depending on the vessel orientation and volume fraction) by evaluating the phase values of the multi-TE data. Finally, magnetic field drift over time can be measured from dynamic field maps available with this protocol.

Proton MR spectroscopy in children with acute brain injury: Comparison of short and long echo time acquisitions

The aim of this study was to evaluate comparatively the information given by proton magnetic resonance spectroscopy (MRS) with short echo time (TE 20 msec) stimulated echo acquisition mode and long TE (270 msec) point-resolved spectroscopy in predicting long-term outcome in children suffering from acute brain injury. At 1.5 T, we performed single-voxel proton MRS with both methods in occipital gray matter of 70 children. A linear discriminant analysis used to predict outcomes based on MRS variables was compared with actual neurologic outcome assigned at least 6 months after injury by a pediatric neurologist. Using peak area metabolite ratios and lactate presence, the short and long TE methods were equally predictive in children over 1 month of age. In neonates less than 1 month of age, the long TE method produced a higher percentage of correct outcome predictions (91%) than the short TE method (79%). The long TE method detected lactate more often in all age groups. J. Magn. Reson. Imaging 2000;11:9–19. © 2000 Wiley-Liss, Inc.

Proton MR spectroscopy in children with acute brain injury: comparison of short and long echo time acquisitions.

The aim of this study was to evaluate comparatively the information given by proton magnetic resonance spectroscopy (MRS) with short echo time (TE 20 msec) stimulated echo acquisition mode and long TE (270 msec) point-resolved spectroscopy in predicting long-term outcome in children suffering from acute brain injury. At 1.5 T, we performed single-voxel proton MRS with both methods in occipital gray matter of 70 children. A linear discriminant analysis used to predict outcomes based on MRS variables was compared with actual neurologic outcome assigned at least 6 months after injury by a pediatric neurologist. Using peak area metabolite ratios and lactate presence, the short and long TE methods were equally predictive in children over 1 month of age. In neonates less than 1 month of age, the long TE method produced a higher percentage of correct outcome predictions (91%) than the short TE method (79%). The long TE method detected lactate more often in all age groups.