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PT  - JOURNAL ARTICLE
AU  - Schmidbauer, V.U.
AU  - Yildirim, M.S.
AU  - Dovjak, G.O.
AU  - Weber, M.
AU  - Diogo, M.C.
AU  - Milos, R.-I.
AU  - Giordano, V.
AU  - Prayer, F.
AU  - Stuempflen, M.
AU  - Goeral, K.
AU  - Buchmayer, J.
AU  - Klebermass-Schrehof, K.
AU  - Berger, A.
AU  - Prayer, D.
AU  - Kasprian, G.
TI  - Synthetic MR Imaging–Based WM Signal Suppression Identifies Neonatal Brainstem Pathways in Vivo
AID  - 10.3174/ajnr.A7710
DP  - 2022 Nov 17
TA  - American Journal of Neuroradiology
4099  - http://www.ajnr.org/content/early/2022/11/17/ajnr.A7710.short
4100  - http://www.ajnr.org/content/early/2022/11/17/ajnr.A7710.full
AB  - BACKGROUND AND PURPOSE: Multidynamic multiecho sequence–based imaging enables investigators to reconstruct multiple MR imaging contrasts on the basis of a single scan. This study investigated the feasibility of synthetic MRI-based WM signal suppression (syWMSS), a synthetic inversion recovery approach in which a short TI suppresses myelin-related signals, for the identification of early myelinating brainstem pathways.MATERIALS AND METHODS: Thirty-one cases of neonatal MR imaging, which included multidynamic multiecho data and conventionally acquired T1- and T2-weighted sequences, were analyzed. The multidynamic multiecho postprocessing software SyMRI was used to generate syWMSS data (TR/TE/TI = 3000/5/410 ms). Two raters discriminated early myelinating brainstem pathways (decussation of the superior cerebellar peduncle, medial lemniscus, central tegmental tract, and medial longitudinal fascicle [the latter 3 assessed at the level of the pons]) on syWMSS data and reference standard contrasts.RESULTS: On the basis of syWMSS data, the decussation of the superior cerebellar peduncle (31/31); left/right medial lemniscus (31/31; 30/31); left/right central tegmental tract (19/31; 20/31); and left/right medial longitudinal fascicle (30/31) were reliably identified by both raters. On the basis of T1-weighted contrasts, the decussation of the superior cerebellar peduncle (14/31); left/right medial lemniscus (22/31; 16/31); left/right central tegmental tract (1/31); and left/right medial longitudinal fascicle (9/31; 8/31) were reliably identified by both raters. On the basis of T2-weighted contrasts, the decussation of the superior cerebellar peduncle (28/31); left/right medial lemniscus (16/31; 12/31); left/right central tegmental tract (23/31; 18/31); and left/right medial longitudinal fascicle (15/31; 14/31) were reliably identified by both raters.CONCLUSIONS: syWMSS data provide a feasible imaging technique with which to study early myelinating brainstem pathways. MR imaging approaches that use myelin signal suppression contribute to a more sensitive assessment of myelination patterns at early stages of cerebral development.CTTcentral tegmental tractDSCPdecussation of superior cerebellar peduncleFGATIRfast gray matter acquisition T1 inversion recoveryGAgestational ageICCintraclass correlation coefficientMDMEmultidynamic multiechoMLmedial lemniscusMLFmedial longitudinal fasciclesyWMSSsynthetic MRI-based WM signal suppression