Performance of PROPELLER FSE T2WI in reducing metal artifacts of material porcelain fused to metal crown: a clinical preliminary study

Abstract

This study aimed to compare MRI quality between conventional fast spin echo T₂ weighted imaging (FSE T₂WI) with periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) FSE T₂WI for patients with various porcelain fused to metal (PFM) crown and analyze the value of PROPELLER technique in reducing metal artifacts. Conventional FSE T₂WI and PROPELLER FSE T₂WI sequences for axial imaging of head were applied in participants with different PFM crowns: cobalt-chromium (Co-Cr) alloy, pure titanium (Ti), gold-palladium (Au-Pd) alloy. Two radiologists evaluated overall image quality of section in PFM using a 5-point scale qualitatively and measured the maximum artifact area and artifact signal-to-noise ratio (SNR) quantitatively. Fifty-nine participants were evaluated. The metal crown with the least artifacts and the optimum image quality shown in conventional FSE T₂WI and PROPELLER FSE T₂WI were in Au-Pd alloy, Ti, and Co-Cr alloy order. PROPELLER FSE T₂WI was superior to conventional FSE T₂WI in improving image quality and reducing artifact area for Co-Cr alloy (17.0 ± 0.2% smaller artifact area, p < 0.001) and Ti (11.6 ± 0.7% smaller artifact area, p = 0.005), but had similar performance compared to FSE T₂WI for Au-Pd alloy. The SNRs of the tongue and masseter muscle were significantly higher on PROPELLER FSE T₂WI compared with conventional FSE T₂WI (tongue: 29.76 ± 8.45 vs. 21.54 ± 9.31, p = 0.007; masseter muscle: 19.11 ± 8.24 vs. 15.26 ± 6.08, p = 0.016). Therefore, the different PFM crown generate varying degrees of metal artifacts in MRI, and the PROPELLER can effectively reduce metal artifacts especially in the PFM crown of Co-Cr alloy.

Figure 1

Images of conventional FSE T₂WI (a–c) and PROPELLER FSE T₂WI (d–f) in different participants. Images of the metal crown of Co-Cr alloy in participant 1 (a,d); Images of the metal crown of pure Ti in participant 2 (b,e); Images of the metal crown of Au–Pd alloy in participant 3 (c,f).

Figure 2

Comparison of artifact areas of conventional FSE T₂WI and PROPELLER FSE T₂WI sequences caused by the different PFM crowns. n.s, not significant; **, P < 0.01; ***, P < 0.001.