Application of T1-weighted and augmented T1-weighted images of multi-parametric MR sequence in detecting neonatal punctate white matter lesions.

Background And Purpose: Punctate White Matter Lesion (PWML) is common in neonates. Multi-parametric MR imaging with flexible design (MULTIPLEX, MTP) generates multiple requires only about 6 min for full-head coverage. This study aimed to evaluate the value of T1WI and aT1WI contrasts of MTP in detecting neonatal punctate white matter lesions.

Materials And Methods: Twenty-one neonates with punctate white matter damage underwent multi-parametric MR imaging between November 2022 to July 2024. For subjective image quality, two pediatric neuroradiologists assessed overall image quality, and visualization of structures using a 4-point assessment scale. To analyze objective image quality, the signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), contrast, number and sharpness of lesions were quantified.

Results: With regard to sharpness of the lesion, MTP T1WI and aT1WI are comparable to conventional T1W. For subjective assessment, MTP-T1WI exhibited superior overall image quality and anatomical structure display compared to conventional T1WI (P < 0.01). Regarding objective assessment, MTP-T1WI had significantly higher SNR values for gray matter, white matter and lesions than the other two groups. The CNR values of MTP-T1WI and MTP-aT1WI of the white matter to lesion (WM-Lesion) were higher than conventional T1WI. The contrast of aT1WI surpassed that of the other two groups in WM-Lesion contrast. MTP-aT1W can detect more white matter lesions than conventional T1WI (conventional T1WI vs MTP-T1WI vs MTP-aT1WI,123 vs 165 vs 161).

Conclusions: The MTP-T1W and aT1W images can enhance lesion contrast and precisely delineate the extent and boundaries of the lesions, and could be more sensitive to PWML than conventional T1WI.