Comparison between synthetic and conventional magnetic resonance imaging in patients with multiple sclerosis and controls

Synthetic magnetic resonance imaging (SyMRI) allows to obtain different weighted-images using the multiple-dynamic multiple-echo sequence lasting 6 min. The aim is to compare quantitatively and qualitatively synthetic- and conventional MRI in patients with multiple sclerosis (MS) and controls assessing the contrast (C), the signal to noise ratio (SNR), and the contrast to noise ratio (CNR). We evaluated the lesion count and lesion-to-white matter contrast ( $${\text{C}}_{{\text{l } - \text{ WM}}} {)}$$ in the MS patients. 51 patients underwent synthetic- and conventional MRI. Qualitative analysis was evaluated by assigning scores to all synthetic- and conventional MRI sequences by two neuroradiologists. Lesions were counted in MS patients both in the conventional- and synthetic T2-FLAIR. Regions of interest were placed in the cerebrospinal fluid, in the white- and grey matter. For the sequences were evaluated: C, CNR, and SNR. Synthetic T2-FLAIR images are qualitatively inferior. C and CNR were significantly higher in synthetic T1W and T2W images compared to conventional images, but not for T2-FLAIR. The SNR value was always lower in synthetic images than in conventional ones. SyMRI can be used in clinical practice because it has a similar diagnostic accuracy which reduces the scanning time compared to the conventional one. However, synthetic T2-FLAIR images need to be improved.