• So Mi Lee, Young Hun Choi, Jung-Eun Cheon, In-One Kim, Seung Hyun Cho, Won Hwa Kim, Hye Jung Kim, Hyun-Hae Cho, Sun-Kyoung You, Sook-Hyun Park, and Moon Jung Hwang.
• Department of Radiology, Kyungpook National University Hospital, Daegu, South Korea.
• Pediatr Radiol. 2017 Nov 1; 47 (12): 1638-1647.

BackgroundThe clinical application of the multi-echo, multi-delay technique of synthetic magnetic resonance imaging (MRI) generates multiple sequences in a single acquisition but has mainly been used in adults.ObjectiveTo evaluate the image quality of synthetic brain MR in children compared with that of conventional images.Materials And MethodsTwenty-nine children (median age: 6 years, range: 0-16 years) underwent synthetic and conventional imaging. Synthetic (T2-weighted, T1-weighted and fluid-attenuated inversion recovery [FLAIR]) images with settings matching those of the conventional images were generated. The overall image quality, gray/white matter differentiation, lesion conspicuity and image degradations were rated on a 5-point scale. The relative contrasts were assessed quantitatively and acquisition times for the two imaging techniques were compared.ResultsSynthetic images were inferior due to more pronounced image degradations; however, there were no significant differences for T1- and T2-weighted images in children <2 years old. The quality of T1- and T2-weighted images were within the diagnostically acceptable range. FLAIR images showed greatly reduced quality. Gray/white matter differentiation was comparable or better in synthetic T1- and T2-weighted images, but poorer in FLAIR images. There was no effect on lesion conspicuity. Synthetic images had equal or greater relative contrast. Acquisition time was approximately two-thirds of that for conventional sequences.ConclusionSynthetic T1- and T2-weighted images were diagnostically acceptable, but synthetic FLAIR images were not. Lesion conspicuity and gray/white matter differentiation were comparable to conventional MRI.

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