Objectives: To evaluate the feasibility and image quality of respiratory motion-resolved 4D zero echo time (ZTE) lung MRI compared with that of 3D ZTE.
Methods: Our institutional review board approved this study. Twenty-one patients underwent lung scans using 3D ZTE and 4D ZTE sequences via prospective and retrospective soft gating techniques, respectively. Image qualities of 3D ZTE and 4D ZTE at end-expiration were compared through objective and subjective assessments. The quality of end-expiratory images of 3D ZTE and 4D ZTE of the two groups with different lung functions was also compared.
Results: Images were successfully acquired in all patients without any adverse events. Signal-to-noise ratios (SNRs) of lung parenchyma and thoracic structures were significantly (all p < 0.001) higher in 4D ZTE. Contrast-to-noise ratios (CNRs) of peripheral bronchi, peripheral pulmonary vessels, and nodules or masses were significantly (all p < 0.001) higher in 4D ZTE. The subjective image quality assessed by two independent radiologists showed that intrapulmonary structures, noise and artifacts, and overall acceptability were superior in 4D ZTE (all p < 0.001). Image qualities of groups with normal and low lung functions differed significantly (all p < 0.05) in 3D ZTE, but not in 4D ZTE. The mean acquisition time was 136 s (127-143 s) in 3D ZTE and 325 s (308-352 s) in 4D ZTE.
Conclusions: Respiratory motion-resolved 4D ZTE lung imaging was feasible as part of routine chest MRI. The 4D ZTE provides motion-robust lung parenchymal images with better SNR and CNR than the 3D ZTE, regardless of patients' lung function.
Key Points: • ZTE MRI captures rapidly decaying transverse magnetization in the lung parenchyma. • 4D ZTE provides motion-robust lung parenchymal images with better SNR and CNR compared with 3D ZTE. • Compared with 3D ZTE, the image quality of 4D ZTE lung MRI was affected less by patients' lung function and respiratory performance.
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