Clinical Evaluation of Silent T1-Weighted MRI and Silent MR Angiography of the Brain

AJR Am J Roentgenol. 2018 Feb;210(2):404-411. doi: 10.2214/AJR.17.18247. Epub 2017 Nov 7.


Objective: New MRI sequences based on rapid radial acquisition have reduced gradient noise. The purpose of this study was to compare Silent T1-weighted and unenhanced MR angiography (MRA) against conventional sequences in a clinical population.

Materials and methods: The study cohort consisted of 40 patients with suspected brain metastases (median age, 60 years; range, 23-91 years) who underwent T1-weighted contrast-enhanced MRI and 51 patients with suspected vascular lesions or cerebral ischemia (median age, 60 years; range, 16-94 years) who underwent unenhanced intracranial MRA. Three neuroradiologists reviewed the images blindly and rated several measures of image quality on a 5-point Likert scale. Reviewers recorded the number of enhancing lesions and whether Silent images were better than, worse than, or equivalent to conventional images.

Results: For T1-weighted MR images, ratings were slightly lower for Silent versus conventional images, except for diagnostic confidence. Although more lesions were detected on conventional images, this difference was not statistically significant; agreement was seen in 88% of cases. In 48% of cases, T1-weighted scans were deemed equivalent, but when a preference existed, it was usually for conventional images (38% vs 14%). Conventional MRA images were rated higher on all image quality metrics and were strongly preferred (reviewers preferred conventional images in 69% of cases, rated the images as equivalent in 27% of cases, and preferred Silent images in 4% of cases). In some cases, artifacts on Silent images caused reduced vessel caliber, vessel irregularities, and even absent vessels.

Conclusion: Although conventional T1-weighted images were preferred overall, most Silent T1-weighted images were rated as equivalent to or better than conventional images and represent a potential alternative for imaging of noise-averse patients. Silent MRA scored significantly worse and could not be recommended at this time, suggesting that it requires additional refinement before routine clinical use.

Keywords: MR angiography; Silent T1-weighted MRI; brain.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Neoplasms / diagnostic imaging*
  • Contrast Media
  • Diagnosis, Differential
  • Female
  • Humans
  • Image Enhancement / methods
  • Magnetic Resonance Angiography / methods*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Meglumine / analogs & derivatives
  • Middle Aged
  • Organometallic Compounds


  • Contrast Media
  • Organometallic Compounds
  • gadobenic acid
  • Meglumine