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Feasibility of three-dimensional ultrashort echo time magnetic resonance imaging at 1.5 T for the diagnosis of skull fractures

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To investigate the feasibility of ultrashort echo time (UTE) magnetic resonance imaging (MRI) for the diagnosis of skull fractures.

Methods

The skull fracture models of ten Bama pigs and 364 patients with craniocerebral trauma were subjected to computed tomography (CT), UTE and conventional MRI sequences. The accuracy of UTE imaging in skull fracture diagnosis was analysed using receiver operating characteristic (ROC) curve analysis, McNemar’s test and Kappa values. Differences among CT, UTE imaging and anatomical measurement (AM) values for linear fractures (LFs) and depressed fractures (DFs) were compared using one-way ANOVA and a paired-samples t-test.

Results

UTE imaging clearly demonstrated skull structures and fractures. The accuracy, validity and reliability of UTE MRI were excellent, with no significant differences between expert readings (P > 0.05; Kappa, 0.899). The values obtained for 42 LFs and 13 DFs in the ten specimens were not significantly different among CT, UTE MRI and AMs, while those obtained for 55 LFs and ten DFs in 44 patients were not significantly different between CT and UTE MRI (P > 0.05).

Conclusions

UTE MRI sequences are feasible for the evaluation of skull structures and fractures, with no radiation exposure, particularly for paediatric and pregnant patients.

Key Points

• Despite ionising radiation, CT is standard for skull fracture assessment.

• Conventional MRI cannot depict skull structures.

• 3D-UTE sequences clearly demonstrate skull structures and fractures.

• UTE plus conventional MRI are superior to CT in craniocerebral trauma assessment.

• Paediatric and pregnant patients will benefit from this imaging modality.

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Abbreviations

AM:

Anatomical measurement

AUC:

Area under the curve

CF:

Comminuted fracture

CT:

Computed tomography

CPR:

Curved planar reconstruction

DF:

Depressed fracture

ET:

Echo time

LF:

Linear fracture

MRI:

Magnetic resonance imaging

OML:

Orbitomeatal line

ROC:

Receiver operating characteristic

SNR:

Signal/noise ratio

3D-SSD:

Three-dimensional surface shaded display

3D-UTE:

Three-dimensional ultrashort echo time

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Acknowledgments

The authors thank Prof. Ming Zhu as the scientific guarantor, and Dr. Huihong Pan, Dr. Jinglei Wang and Dr. Hongliang Zhang for their technical support, Dr. Jin Lan for his thoughtful comments, and Dr. Baisong Wang and Xiaoling Zhang for their statistical advice. We also thank Prof. Yongming Qiu, Dr. Jianwei Ge, Dr. Yunhai Song and Dr. Bo Yang for their help in collecting clinical materials. The authors state that this work has not received any funding.

No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Approval from the institutional animal care committee was obtained. Methodology: prospective, case-control study/diagnostic study, multicentre study.

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Authors and Affiliations

  1. Department of Radiology, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, No. 1678, Dongfang Road, Shanghai, 200127, China

    Hao Wu, Yu-min Zhong, Hong Zhang, Yi Lin & Ming Zhu

  2. Department of Neurosurgery Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, No. 1630, Dongfang Road, Shanghai, 200127, China

    Quan-min Nie, Lie-mei Guo & Xi Yang

  3. Philips Healthcare, Shanghai, China

    Wei-bo Chen & Yong-ming Dai

  4. Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Jian-rong Xu

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  1. Hao Wu
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  2. Yu-min Zhong
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Corresponding authors

Correspondence to Yu-min Zhong or Quan-min Nie.

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Wu, H., Zhong, Ym., Nie, Qm. et al. Feasibility of three-dimensional ultrashort echo time magnetic resonance imaging at 1.5 T for the diagnosis of skull fractures. Eur Radiol 26, 138–146 (2016). https://doi.org/10.1007/s00330-015-3804-2

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  • DOI: https://doi.org/10.1007/s00330-015-3804-2

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