Clinical feasibility of 1-min ultrafast brain MRI compared with routine brain MRI using synthetic MRI: a single center pilot study

Background: Ultrafast brain MRI is required for uncooperative patients and time-critical diseases such as stroke because it reduces scan times and motion artifacts. This study investigated the clinical feasibility of a 1-min ultrafast brain MRI protocol for detecting intracranial abnormalities in restless and uncooperative patients. Methods: We retrospectively reviewed the records of 25 patients who underwent a 1-min ultrafast MRI protocol using T1-weighted image, T2-weighted image, echo-planar fluid-attenuated inversion recovery, diffusion-weighted image, and T2*-weighted image between March 2017 and May 2017. Simple methods were applied for ultrafast MRI protocol to reduce scan time as follows: parallel imaging techniques, multiband technique on diffusion sequence, and echo-planar fluid-attenuated inversion recovery. The images were compared with the routine brain MRI protocol using synthetic MRI, and quality was assessed by two independent readers. The Wilcoxon signed-rank test was used to compare the readers’ ratings of the routine MRI protocol and ultrafast MRI protocol images. Results: Using a four-point assessment scale, overall image quality and anatomical delineation of ultrafast brain MRI images were lower than those of routine brain MRI images. However, the ultrafast protocol demonstrated sufficient overall image quality and anatomical delineation with an assessment rating greater than two points. The ultrafast protocol had fewer artifacts than the routine protocol using synthetic MRI. Conclusions: Although the overall image quality and anatomical delineation of the 1-min ultrafast MRI were inferior to those of the routine brain MRI protocol, the ultrafast protocol showed at least sufficient image quality. Therefore, this protocol may be an option in specific clinical situations involving non-cooperative, restless, or pediatric patients, or patients with time-critical disease such as stroke. Further study is required to validate our findings.