Temporal AI-assisted compressed sensing for high-resolution, motion-robust small-bowel MR enterography without antiperistaltic agents: a feasibility study.

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Abstract

To evaluate whether temporal AI-assisted compressed sensing (tACS) enables high-resolution, motion-robust magnetic resonance enterography (MRE) without antiperistaltic agents and improves acquisition efficiency and motility visualization. This prospective single-center study enrolled consecutive patients who underwent both routine and tACS MRE on a 3.0-T scanner between October 2024 and June 2025, without antiperistaltic agents. The tACS protocol acquired axial and coronal T2-weighted images (T2WI); the routine protocol included a coronal Cine sequence. Acquisition time and total temporal frames for non-fat-saturated T2WI (routine and tACS) and Cine were recorded to calculate imaging efficiency (frames/min). Primary outcomes included total temporal frames, scan time, efficiency, subjective image-quality scores, apparent signal-to-noise ratio (aSNR), contrast-to-noise ratio (aCNR), maximum local variation sharpness, peri-enteric fat-plane clarity, and ileocecal-valve (ICV) motility. Paired statistical tests compared within-subject differences; Kendall's W assessed inter-reader agreement. Thirty patients completed both protocols. tACS acquired 504 frames in 287 s vs 107 frames in 241 s for the routine protocol, improving efficiency 4.0-fold (105.4 vs 26.6 frames/min; p < 0.001). Subjective image quality favored tACS (median 5.0 vs ≤ 4.0; p < 0.01) with perfect agreement (W = 1.00). Quantitative analysis demonstrated significantly improved sharpness (all p < 0.001) and increased aSNR/aCNR. Fat-plane clarity reached perfect scores in 93% (28/30) with tACS, and ICV motility scoring was superior to Cine (median 3.0 vs 2.0; p < 0.001). tACS enhances temporal resolution and image quality for MRE without antiperistaltic agents, with minimal extra scan time and potential to simplify clinical workflows. Question Can tACS provide high-resolution, motion-robust MRE images without the need for antiperistaltic agents? Findings tACS improved imaging efficiency four-fold while significantly enhancing subjective image quality, sharpness, and motility visualization compared to routine protocols. Clinical relevance tACS enables high-quality MRE without antiperistaltic medication, with the potential to simplify clinical workflows, improve patient comfort, and support reliable visualization of bowel motility.

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