title: Snapshot inversion recovery: an optimized single-shot T1-weighted inversion-recovery sequence for improved fetal brain anatomic delineation.
abstract: OBJECTIVE
  To prospectively evaluate the clinical effectiveness of snapshot inversion recovery (SNAPIR), which is a dedicated optimized inversion-recovery-prepared single-shot fast spin-echo T1-weighted sequence, in the delineation of normal fetal brain anatomy compared with that of the currently used T1-weighted gradient-echo protocol, which often yields images of poor quality due to motion artifacts and inadequate contrast.
  
  
  METHODS
  This study was approved by the hospital research ethics committee, and informed written consent was obtained from all patients. Forty-one fetuses were examined at 19-37 weeks gestation (mean, 29 weeks gestation) by using both the standard T1-weighted protocol and the optimized T1-weighted SNAPIR protocol with a 1.5-T imager. Two independent blinded observers performed qualitative analysis, evaluating overall diagnostic quality, detailed anatomic delineation, and severity of motion artifacts. Quantitative analysis comprised calculation of contrast ratios (CRs) for the cortical gray matter, subplate, white matter, and cerebrospinal fluid. The Wilcoxon signed rank test was used to compare image rating scores, the paired t test was used to compare CRs, and κ statistics were used to test interobserver agreement.
  
  
  RESULTS
  Both overall diagnostic quality (P < .001) and detailed anatomic delineation (P < .001) were enhanced with SNAPIR compared with the standard T1-weighted acquisition. Also, motion artifacts were less severe (P = .008) and less extensive (P < .001) with SNAPIR. Corresponding CRs were increased with SNAPIR in seven of eight examined regions.
  
  
  CONCLUSIONS
  SNAPIR is a promising robust alternative to the current T1-weighted acquisitions; its role in the detection of disease requires further study.
authors.affiliation: Robert Steiner MRI Unit, Imaging Sciences Department, Clinical Sciences Centre, Hammersmith Hospital Campus, Imperial College, DuCane Rd, London W12 0HS, England. cm1@imperial.ac.uk
authors.forename: Christina
authors.initials: C
authors.lastname: Malamateniou
authors.forename: Amy K
authors.initials: AK
authors.lastname: McGuinness
authors.forename: Joanna M
authors.initials: JM
authors.lastname: Allsop
authors.forename: Declan P
authors.initials: DP
authors.lastname: O'Regan
authors.forename: Mary A
authors.initials: MA
authors.lastname: Rutherford
authors.forename: Joseph V
authors.initials: JV
authors.lastname: Hajnal
mesh_terms: D016477:Artifacts; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis*; D005865:Gestational Age; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D011446:Prospective Studies; D018709:Statistics, Nonparametric