Impact of a fast free-breathing 3-T abdominal MRI protocol on improving scan time and image quality for pediatric patients with tuberous sclerosis complex

Background Magnetic resonance imaging (MRI) of the abdomen can be especially challenging in pediatric patients because of image quality degradation from respiratory motion. Abdominal MR protocols tailored for free-breathing children can potentially improve diagnostic image quality and reduce scan time. Objective To evaluate the performance of a free-breathing 3-T MRI protocol for renal evaluation in pediatric patients with tuberous sclerosis complex (TSC). Materials and methods A single institution, Institutional Review Board-approved, retrospective database query identified pediatric TSC patients who underwent a free-breathing 3-T MR abdominal protocol including radial and respiratory-triggered pulse sequences and who also had a prior abdominal MRI on the same scanner using a traditional MR protocol utilizing signal averaging and Cartesian k-space sampling. Scan times and use of sedation were recorded. MR image quality was compared between the two protocols using a semiquantitative score for overall image quality and sharpness. Results Forty abdominal MRI studies in 20 patients were evaluated. The mean scan time of the fast free-breathing protocol was significantly lower (mean: 42.5 +/- 9.8 min) compared with the traditional protocol (58.7 +/- 11.7 min; P=<0.001). Image sharpness was significantly improved for radial T2-weighted and T1-weighted triggered Dixon and radial T1-weighted fat-suppressed post-contrast images in the free-breathing protocol, while image quality was significantly higher on radial and Dixon T1-weighted sequences. Conclusion A free-breathing abdominal MR protocol in pediatric TSC patients decreases scan time and improves image quality and should be considered more widely for abdominal MRI in children.