Evaluation of simultaneous multi-slice echo planar imaging in the diagnosis of brain lesions in pediatric patients: a quantitative and qualitative study

Neurological disorders often result in significant morbidity and mortality, highlighting the need for timely and accurate diagnosis. Magnetic Resonance Imaging (MRI) is a crucial clinical tool for obtaining accurate and timely diagnoses. Reducing scan times during MRI procedures is essential for minimizing the need for sedation and reducing motion artifacts. Single-shot echo-planar imaging (SS-EPI) is a commonly used technology for pediatric MRI. To evaluate the feasibility of using simultaneous multi-slice echo-planar imaging (SMS-EPI) as a clinical alternative to SS-EPI in pediatric patients. Both SS-EPI and SMS-EPI images were acquired from 58 pediatric patients aged 5 to 12 years using a 20-channel head-neck coil on either a 3T or 1.5T MRI scanner, with consistent voxel size and coverage. Two radiologists qualitatively assessed the structural anatomic clarity, overall image quality, degree of lesion display, degree of artifacts, and diagnostic confidence of the SS-EPI and SMS-EPI images. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were quantitatively compared. SMS-EPI exhibited shorter scanning times compared to SS-EPI. Although SNR and CNR favored SMS sequences over SS-EPI sequences for both 3T and 1.5T scanners, the differences did not reach statistical significance (all p > 0.05). Qualitative assessment revealed that SMS-EPI received significantly higher median scores in terms of structural anatomic clarity, overall image quality, lesion display, artifacts, and diagnostic confidence (all P < 0.001). The adjacent agreement rate indicated a high level of clinical consensus among the readers. SMS-EPI significantly shortens scanning times while providing equivalent or better reliability and consistency compared with SS-EPI. SMS-EPI shows significant potential for clinical diagnostic imaging applications in pediatric patients.