Evaluation of ultrashort echo-time (UTE) and fast-field-echo (FRACTURE) sequences for skull bone visualization and fracture detection – A postmortem study

• Published in: Journal of neuroradiology Vol. 49; no. 3; pp. 237 - 243
• Main Authors: Deininger-Czermak, Eva, Euler, Andre, Franckenberg, Sabine, Finkenstaedt, Tim, Villefort, Christina, Gascho, Dominic, Guggenberger, Roman
• Format: Journal Article
• Language: English
• Published: France Elsevier Masson SAS 01.05.2022
• Subjects: Computed tomography; Magnetic resonance imaging; Optimized gradient echo sequence; Radiology; Ultrashort echo time; Magnetic resonance imaging; Computed tomography; Optimized gradient echo sequence; Ultrashort echo time
• ISSN: 0150-9861
• DOI: 10.1016/j.neurad.2021.11.001

CT 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. Twenty 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). FRACTURE 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. Both 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. [Display omitted] •Ultrashort echo time (UTE) or fast-field echo (FRACTURE) sequences delineate bone.•FRACTURE MRI and UTE MRI may provide an alternative to CT for follow up exams.•FRACTURE MRI provides more detail on bone structure than UTE MRI.•UTE MRI was more appropriate for the detection of fractures than FRACTURE MRI.