Comparison of DWI Methods in the Pediatric Brain: PROPELLER Turbo Spin-Echo Imaging Versus Readout-Segmented Echo-Planar Imaging Versus Single-Shot Echo-Planar Imaging

The purpose of this study is to compare DWI for pediatric brain evaluation using single-shot echo-planar imaging (EPI), periodically rotated overlapping parallel lines with enhanced reconstruction (Blade), and readout-segmented EPI (Resolve). Blade, Resolve, and single-shot EPI were performed for 27 pediatric patients (median age, 9 years), and three datasets were independently reviewed by two radiologists. Qualitative analyses were performed for perceptive coarseness, image distortion, susceptibility-related changes, motion artifacts, and lesion conspicuity using a 5-point Likert scale. Quantitative analyses were conducted for spatial distortion and signal uniformity of each sequence. Mean scores were 2.13, 3.17, and 3.76 for perceptive coarseness; 4.85, 3.96, and 2.19 for image distortion; 4.76, 3.96, and 2.30 for susceptibility-related change; 4.96, 3.83, and 4.69 for motion artifacts; and 2.71, 3.75, and 1.92 for lesion conspicuity, for Blade, Resolve, and single-shot EPI, respectively. Blade and Resolve showed better quality than did single-shot EPI for image distortion, susceptibility-related changes, and lesion conspicuity. Blade showed less image distortion, fewer susceptibility-related changes, and fewer motion artifacts than did Resolve, whereas lesion conspicuity was better with Resolve. Blade showed increased signal variation compared with Resolve and single-shot EPI (coefficients of variation were 0.10, 0.08, and 0.05 for lateral ventricle; 0.13, 0.09, and 0.05 for centrum semiovale; and 0.16, 0.09, and 0.06 for pons in Blade, Resolve, and single-shot EPI, respectively). DWI with Resolve or Blade yields better quality regarding distortion, susceptibility-related changes, and lesion conspicuity, compared with single-shot EPI. Blade is less susceptible to motion artifacts than is Resolve, whereas Resolve yields less noise and better lesion conspicuity than does Blade.