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Prospective navigator-echo-based real-time triggering of fetal head movement for the reduction of artifacts

Bonel, H. ; Frei, K. ; Raio, L. ; Meyer-Wittkopf, M. ; Remonda, L. ; Wiest, R.

In: European Radiology, 2008, vol. 18, no. 4, p. 822-829

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    Title
    • Prospective navigator-echo-based real-time triggering of fetal head movement for the reduction of artifacts
    Author
    • Bonel, H.. Institute of Diagnostic, Interventional and Pediatric Radiology, University Hospital Berne-Inselspital, Freiburgstrasse, 3010, Bern, Switzerland
    • Frei, K.. Women‘s' Hospital, University of Berne, Bern, Switzerland
    • Raio, L.. Women‘s' Hospital, University of Berne, Bern, Switzerland
    • Meyer-Wittkopf, M.. Women‘s' Hospital, University of Berne, Bern, Switzerland
    • Remonda, L.. Institute of Diagnostic and Interventional Neuroradiology (DIN), Inselspital, University of Berne, Bern, Switzerland
    • Wiest, R.. Institute of Diagnostic and Interventional Neuroradiology (DIN), Inselspital, University of Berne, Bern, Switzerland
    Document Type
    • Postprint
    OAI-PMH Identifier
    • oai:doc.rero.ch:317541
    Summary
    The purpose of this study was to evaluate the neuroimaging quality and accuracy of prospective real-time navigator-echo acquisition correction versus untriggered intrauterine magnetic resonance imaging (MRI) techniques. Twenty women in whom fetal motion artifacts compromised the neuroimaging quality of fetal MRI taken during the 28.7 ± 4week of pregnancy below diagnostic levels were additionally investigated using a navigator-triggered half-Fourier acquired single-shot turbo-spin echo (HASTE) sequence. Imaging quality was evaluated by two blinded readers applying a rating scale from 1 (not diagnostic) to 5 (excellent). Diagnostic criteria included depiction of the germinal matrix, grey and white matter, CSF, brain stem and cerebellum. Signal-difference-to-noise ratios (SDNRs) in the white matter and germinal zone were quantitatively evaluated. Imaging quality improved in 18/20 patients using the navigator echo technique (2.4 ± 0.58 vs. 3.65 ± 0.73 SD, p < 0.01 for all evaluation criteria). In 2/20 patients fetal movement severely impaired image quality in conventional and navigated HASTE. Navigator-echo imaging revealed additional structural brain abnormalities and confirmed diagnosis in 8/20 patients. The accuracy improved from 50% to 90%. Average SDNR increased from 0.7 ± 7.27 to 19.83 ± 15.71 (p < 0.01). Navigator-echo-based real-time triggering of fetal head movement is a reliable technique that can deliver diagnostic fetal MR image quality despite vigorous fetal movement