title: Feasibility of three-dimensional ultrashort echo time magnetic resonance imaging at 1.5 T for the diagnosis of skull fractures.
abstract: OBJECTIVE
  To investigate the feasibility of ultrashort echo time (UTE) magnetic resonance imaging (MRI) for the diagnosis of skull fractures.
  
  
  METHODS
  The skull fracture models of ten Bama pigs and 364 patients with craniocerebral trauma were subjected to computed tomography (CT), UTE and conventional MRI sequences. The accuracy of UTE imaging in skull fracture diagnosis was analysed using receiver operating characteristic (ROC) curve analysis, McNemar's test and Kappa values. Differences among CT, UTE imaging and anatomical measurement (AM) values for linear fractures (LFs) and depressed fractures (DFs) were compared using one-way ANOVA and a paired-samples t-test.
  
  
  RESULTS
  UTE imaging clearly demonstrated skull structures and fractures. The accuracy, validity and reliability of UTE MRI were excellent, with no significant differences between expert readings (P > 0.05; Kappa, 0.899). The values obtained for 42 LFs and 13 DFs in the ten specimens were not significantly different among CT, UTE MRI and AMs, while those obtained for 55 LFs and ten DFs in 44 patients were not significantly different between CT and UTE MRI (P > 0.05).
  
  
  CONCLUSIONS
  UTE MRI sequences are feasible for the evaluation of skull structures and fractures, with no radiation exposure, particularly for paediatric and pregnant patients.
  
  
  CONCLUSIONS
  Despite ionising radiation, CT is standard for skull fracture assessment. Conventional MRI cannot depict skull structures. 3D-UTE sequences clearly demonstrate skull structures and fractures. UTE plus conventional MRI are superior to CT in craniocerebral trauma assessment. Paediatric and pregnant patients will benefit from this imaging modality.
authors.affiliation: Department of Radiology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, No. 1678, Dongfang Road, Shanghai, 200127, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Wu
authors.affiliation: Department of Radiology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, No. 1678, Dongfang Road, Shanghai, 200127, China. zyumin2002@gmail.com.
authors.forename: Yu-min
authors.initials: YM
authors.lastname: Zhong
authors.affiliation: Department of Neurosurgery Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, No. 1630, Dongfang Road, Shanghai, 200127, China. xy20096688@163.com.
authors.forename: Quan-min
authors.initials: QM
authors.lastname: Nie
authors.affiliation: Philips Healthcare, Shanghai, China.
authors.forename: Wei-bo
authors.initials: WB
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, No. 1630, Dongfang Road, Shanghai, 200127, China.
authors.forename: Lie-mei
authors.initials: LM
authors.lastname: Guo
authors.affiliation: Department of Neurosurgery Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, No. 1630, Dongfang Road, Shanghai, 200127, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Yang
authors.affiliation: Department of Radiology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, No. 1678, Dongfang Road, Shanghai, 200127, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Radiology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, No. 1678, Dongfang Road, Shanghai, 200127, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Lin
authors.affiliation: Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Jian-rong
authors.initials: JR
authors.lastname: Xu
authors.affiliation: Philips Healthcare, Shanghai, China.
authors.forename: Yong-ming
authors.initials: YM
authors.lastname: Dai
authors.affiliation: Department of Radiology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, No. 1678, Dongfang Road, Shanghai, 200127, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Zhu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D002648:Child; D002675:Child, Preschool; D004195:Disease Models, Animal; D017352:Echo-Planar Imaging / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results; D012887:Skull Fractures / Q000175:diagnosis*; D013552:Swine; D013556:Swine, Miniature; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Computed tomography; Magnetic resonance imaging; Radiation; Skull fracture; Ultrashort echo time