OBJECTIVES: Fetal "black bone" MRI could be useful in the diagnosis of various skeletal conditions during pregnancy without exposure to ionizing radiation. Previously suggested susceptibility-weighted imaging (SWI) is not available in the suggested form on all scanners leading to long imaging times that are susceptible to motion artefacts. We aimed to assess if an optimized T2*-weighted GRE sequence can provide viable "black bone" contrast and compared it to other sequences in the literature. METHODS: A retrospective study was conducted on 17 patients who underwent fetal MRI. Patients were imaged with an optimized T2*-weighted GRE sequence, as well as at least one other "black-bone" sequence. Image quality was scored by four blinded observers on a five-point scale. RESULTS: The T2*-weighted GRE sequence offered adequate to excellent image quality in 63% of cases and scored consistently higher than the three other comparison sequences when comparing images from the same patient. Image quality was found to be dependent on gestational age with good image quality achieved on almost all patients after 26 weeks. CONCLUSIONS: T2*-weighted GRE imaging can provide adequate fetal "black bone" contrast and performs at least as well as other sequences in the literature due to good bone to soft tissue contrast and minimal motion artefacts. ADVANCES IN KNOWLEDGE: T2*-weighted fetal "black-bone" imaging can provide excellent bone to soft tissue contrast without using ionizing radiation. It is as good as other "black bone" sequences and may be simpler and more widely implemented, with less motion artefacts.
OBJECTIVES: Fetal "black bone" MRI could be useful in the diagnosis of various skeletal conditions during pregnancy without exposure to ionizing radiation. Previously suggested susceptibility-weighted imaging (SWI) is not available in the suggested form on all scanners leading to long imaging times that are susceptible to motion artefacts. We aimed to assess if an optimized T2*-weighted GRE sequence can provide viable "black bone" contrast and compared it to other sequences in the literature. METHODS: A retrospective study was conducted on 17 patients who underwent fetal MRI. Patients were imaged with an optimized T2*-weighted GRE sequence, as well as at least one other "black-bone" sequence. Image quality was scored by four blinded observers on a five-point scale. RESULTS: The T2*-weighted GRE sequence offered adequate to excellent image quality in 63% of cases and scored consistently higher than the three other comparison sequences when comparing images from the same patient. Image quality was found to be dependent on gestational age with good image quality achieved on almost all patients after 26 weeks. CONCLUSIONS: T2*-weighted GRE imaging can provide adequate fetal "black bone" contrast and performs at least as well as other sequences in the literature due to good bone to soft tissue contrast and minimal motion artefacts. ADVANCES IN KNOWLEDGE: T2*-weighted fetal "black-bone" imaging can provide excellent bone to soft tissue contrast without using ionizing radiation. It is as good as other "black bone" sequences and may be simpler and more widely implemented, with less motion artefacts.