Dual Echo Steady State Research Articles

Diffusion tensor imaging combined with the dual-echo steady-state (DESS) protocol for the evaluation of the median nerve in the carpal tunnel: A preliminary study.

Carpal tunnel syndrome (CTS) is diagnosed based on neurological, electrophysiology, and radiological findings. Due to the technical development of magnetic resonance imaging (MRI), the median nerve is evaluated with several MRI protocols. However, diffusion tensor imaging (DTI) combined with a dual-echo steady-state (DESS) protocol is not frequently used to evaluate the median nerve of CTS. This study aimed to evaluate the median nerve in the carpal tunnel using DTI combined with a DESS protocol. Five healthy volunteers and seven patients with CTS were enrolled. The patients underwent MRI for CTS pre- and post-operatively. The median nerve was evaluated using a 3-T MRI scanner. The parameters of the DESS protocol were as follows: Repetition time (TR)/echo time (TE) = 10.83/3.32 ms, slice thickness = 0.45 mm, field of view (FoV) = 350 × 253 × 350 mm, and 3D voxel size = 0.5 × 0.5 ×0.4 mm. The parameters of the DTI sequence were as follows: TR/TE = 4000/86 ms, slice thickness = 3 mm, FoV = 160 × 993 × 90 mm, 3D voxel size = 1.2 × 1.2 ×3.0 mm, and b value = 0.1000 s/mm2. The apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values of the median nerve were statistically analyzed. Statistical significance was set at P< 0.05. The FA value of healthy volunteers was 0.576 ± 0.058, while those of the patients were 0.357 ± 0.094 and 0.395 ± 0.062 pre-and post-operatively, respectively. Statistically significant differences were identified between the FA values of healthy volunteers and pre-operative/post-operative patients. The ADC values of healthy volunteers and pre-operative patients were 0.931 ± 0.096 and 1.26 ± 0.282 (10-3 mm2/s), respectively (P< 0.05). This MRI protocol may be useful for evaluating the median nerve in the carpal tunnel.

7 T MRI of the Cervical Neuroforamen: Assessment of Nerve Root Compression and Dorsal Root Ganglia in Patients With Radiculopathy.

The aim of this study was to assess the diagnostic value of 3-dimensional dual-echo steady-state (DESS) magnetic resonance imaging (MRI) of the cervical spine at 7 T compared with 3 T in patients with cervical radiculopathy. Patients diagnosed with cervical radiculopathy were prospectively recruited between March 2020 and January 2023 before undergoing surgical decompression and received 3-dimensional DESS imaging at 3 T and 7 T MRI. Cervical nerve root compression and the dimensions of the dorsal root ganglia were assessed by 2 radiologists independently. Signal intensity, visibility of nerve anatomy, diagnostic confidence, and image artifacts were evaluated with Likert scales. The degree of neuroforaminal stenosis was assessed on standard clinical 3 T scans. Statistics included the analysis of the diagnostic accuracy and interreader reliability. The Wilcoxon signed rank test was used to assess differences between the groups. Forty-eight patients (mean age, 57 ± 12 years; 22 women) were included in the study with the highest prevalence of severe neuroforaminal stenosis observed at C6 (n = 68) followed by C7 (n = 43). Direct evaluation of nerve root compression showed significantly higher diagnostic confidence and visibility of cervical nerve rootlets, roots, and dorsal root ganglia on 7 T DESS than on 3 T DESS (diagnostic confidence: P = 0.01, visibility: P < 0.01). Assessment of nerve root compression using 7 T DESS allowed more sensitive grading than standard clinical MRI ( P < 0.01) and improved the performance in predicting sensory or motor dysfunction (area under the curve combined: 0.87). 7 T DESS imaging allows direct assessment of cervical nerve root compression in patients with radiculopathy, with a better prediction of sensory or motor dysfunction than standard clinical MRI. Diagnostic confidence and image quality of 7 T DESS were superior to 3 T DESS.

Quantitative MRI evaluation of articular cartilage in patients with meniscus tear.

PurposeThe aim of this study was to assess quantitatively articular cartilage volume, thickness, and T2 value alterations in meniscus tear patients.Materials and methodsThe study included 32 patients with meniscus tears (17 females, 15 males; mean age: 40.16 ± 11.85 years) and 24 healthy controls (12 females; 12 males; mean age: 36 ± 9.14 years). All subjects were examined by 3 T magnetic resonance imaging (MRI) with 3D dual-echo steady-state (DESS) and T2 mapping images. All patients underwent diagnostic arthroscopy and treatment. Cartilage thickness, cartilage volume and T2 values of 21 subregions of knee cartilage were measured using the prototype KneeCaP software (version 2.1; Siemens Healthcare, Erlangen, Germany). Mann-Whitney-U tests were utilized to determine if there were any significant differences among subregional articular cartilage volume, thickness and T2 value between patients with meniscus tear and the control group.ResultsThe articular cartilage T2 values in all subregions of the femur and tibia in the meniscus tear group were significantly higher (p< 0.05) than in the healthy control group. The cartilage thickness of the femoral condyle medial, femur trochlea, femur condyle lateral central, tibia plateau medial anterior and patella facet medial inferior in the meniscus tear group were slightly higher than in the control group (p< 0.05). In the femur trochlea medial, patella facet medial inferior, tibia plateau lateral posterior and tibia plateau lateral central, there were significant differences in relative cartilage volume percentage between the meniscus tear group and the healthy control group (p< 0.05). Nineteen patients had no cartilage abnormalities (Grade 0) in the meniscus tear group, as confirmed by arthroscopic surgery, and their T2 values in most subregions were significantly higher (p< 0.05) than those of the healthy control group.ConclusionThe difference in articular cartilage indexes between patients with meniscus tears and healthy people without such tears can be detected by using quantitative MRI. Quantitative T2 values enable early and sensitive detection of early cartilage lesions.

Paper 01: ACL Reconstructed Knees Had Significantly Higher MR T1ρ and T2 Values in Cartilage but not in Meniscus Compared to Contralateral Knees at 10 Years after ACL Reconstruction

Paper 01: ACL Reconstructed Knees Had Significantly Higher MR T1ρ and T2 Values in Cartilage but not in Meniscus Compared to Contralateral Knees at 10 Years after ACL Reconstruction

Impact of Sustained Synovitis on Knee Joint Structural Degeneration: 4-Year MRI Data from the Osteoarthritis Initiative.

Synovial inflammation is a risk factor for osteoarthritis (OA). But to date, there is limited information on how inflammation impacts progression of knee OA. To investigate how sustained synovitis, assessed with semi-quantitative magnetic resonance imaging (MRI) scores, impacts progression of knee degenerative changes over 4 years. Retrospective cohort study. In 249 participants (N= 132 women [53%]), from the Osteoarthritis Initiative (OAI) two definitions for synovitis were used resulting in two groups of participants with sustained synovitis at baseline, 2-year, and 4-year follow-up (N=80 and N=132), and two groups without synovitis at all three time points (N=81 and N=47). 3 T intermediate-weighted (IW) turbo spin-echo (TSE) sequence and three-dimensional (3D) dual-echo steady-state (DESS) sequence. Synovitis was scored semi-quantitatively using the Anterior Cruciate Ligament Osteoarthritis Score (ACLOAS), MRI Osteoarthritis Knee Score (MOAKS), and synovial proliferation score (SPS). Two MRI-based definitions of synovitis were used: (i) score ≥2 based on cumulative score of MOAKS and ACLOAS, and (ii) score ≥3 based on the cumulative score of ACLOAS, MOAKS, and SPS. Changes in structural abnormalities from baseline to year 4 measured using the whole-organ MRI score (WORMS) were defined as outcomes. Linear regression models were used to compare the differences in longitudinal changes in WORMS scores between participants with and without sustained synovitis for each definition of sustained synovitis. A P-value of <0.05 was considered statistically significant. Significantly higher rates of progression were found in participants with synovitis for patellar (Beta coeff.=0.29) and medial tibial cartilage abnormalities (Beta coeff.=0.29) for definition (i). For definition (ii), patellar (Beta coeff.=0.36) and medial femoral cartilage (Beta coeff.=0.30) abnormalities demonstrated significant differences. Greater progression of structural degenerative disease was observed in individuals with sustained synovitis compared to those without sustained synovitis, suggesting that sustained synovitis is associated with progressive OA. 3 TECHNICAL EFFICACY: Stage 2.

Predicting osteoarthritis onset and progression with 3D texture analysis of cartilage MRI DESS: 6-Year data from osteoarthritis initiative.

In this study, we developed a gray level co-occurrence matrix-based 3D texture analysis method for dual-echo steady-state (DESS) magnetic resonance (MR) images to be used for knee cartilage analysis in osteoarthritis (OA) studies and use it to study changes in articular cartilage between different subpopulations based on their rate of progression into radiographically confirmed OA. In total, 642 series of right knee DESS MR images at 3T were obtained from baseline, 36- and 72-month follow-ups from the OA Initiative database. At baseline, all 214 subjects included in the study had Kellgren-Lawrence (KL) grade <2. Three groups were defined, based on time of progression into radiographic OA (ROA) (KL grades ≥2): control (no progression), fast progressor (ROA at 36 months), and slow progressor (ROA at 72 months) groups. 3D texture analysis was used to extract textural features for femoral and tibial cartilages. All textural features, in both femur and tibia, showed significant longitudinal changes across all groups and tissue layers. Most of the longitudinal changes were observed in progressors, but significant changes were observed also in controls. Differences between groups were mostly seen at baseline and 72 months. The method is sensitive to cartilage changes before and after ROA. It was able to detect longitudinal changes in controls and progressors and to distinguish cartilage alterations due to OA and aging. Moreover, it was able to distinguish controls and different progressor groups before any radiographic signs of OA and during OA. Thus, texture analysis could be used as a marker for the onset and progression of OA.

3T MRI of wrist ligaments and TFCC using true plane oblique 3D T2 Dual Echo Steady State (DESS) - a study of diagnostic accuracy.

This study was designed to assess the accuracy of unenhanced 3T MRI supplemented with dedicated true plane reformats of 3D T2 Dual Echo Steady State (DESS), in assessing tears of scapholunate, lunotriquetral ligaments and triangular fibrocartilage complex, using arthroscopy as gold-standard. In a retrospective cohort review, patients who underwent wrist arthroscopy and MRI over 2 years (n=46) were identified. Dedicated axial and coronal reformats were obtained from 3D T2 DESS sequence for assessing intrinsic ligaments and triangular fibrocartilage (TFCC). At arthroscopy, tears were classified using Geissler's classification and compared to MRI findings. The sensitivity of unenhanced 3T MRI in detecting scapholunate ligament tears was 87%, specificity was 90% and negative predictive value of 93%. The lunate triquetral ligament was assessed with a high specificity (97%) and negative predictive value (93%), sensitivity was 63%. TFCC tears were assessed with a sensitivity of 100%. The overall diagnostic accuracy of unenhanced 3T MRI of wrist in detecting ligament tears was 91%. 3T wrist MRI with dedicated reformats from 3D T2 DESS has a high diagnostic accuracy in assessing acute intrinsic ligament and TFCC injuries. High strength 3T MRI with good technical quality isotropic 3D T2 DESS is critical for accurate wrist ligament assessment. Negative predictive values of 3T MRI of 95% can lead to reduced need for diagnostic arthroscopy of the wrist. This study assesses the diagnostic performance of unenhanced 3T MRI with 3D T2 DESS in assessing traumatic wrist ligament tears. The accuracy of T2 DESS in wrist imaging has not been previously reported.

Assessing the scapholunate and lunotriquetral interosseous ligament in MR arthrography: Diagnostic advantages of paraxial reformatting

PurposeThe scapholunate (SLIL) and lunotriquetral interosseous ligament (LTIL) function as the main stabilizers of the proximal carpal row. Even with MR arthrography, component assessability is often limited in orthogonal standard planes due to their horseshoe-like shape and resulting partial volume effects. This study aims to investigate the diagnostic value of reformatting isotropic 3D sequences with respect to the anatomical orientation of the intrinsic carpal ligaments. MethodIn 110 MR arthrograms of the wrist, we investigated the diagnostic accuracy of two radiologists (R1/R2) for SLIL and LTIL injuries in orthogonal standard planes vs. ancillary angulated reformatting of isotropic 3D dual echo steady state sequence. Component assessability and diagnostic confidence were compared between datasets. ResultsThe addition of paraxial reformations improved diagnostic accuracy for lesions of the palmar (R1: 0.87 vs. 0.93; R2: 0.86 vs. 0.93; all p < 0.05) and dorsal LTIL (R1: 0.85 vs. 0.93; R2: 0.82 vs. 0.90; all p < 0.05). No significant increase in accuracy could be ascertained for palmar (R1: 0.92 vs. 0.94, p = 0.50; R2: 0.86 vs. 0.92, p = 0.07) and dorsal (R1: 0.95 vs. 0.95, p = 1.00; R2: 0.90 vs. 0.94, p = 0.29) lesions of the SLIL. Interrater reliability was almost perfect with and without angulated planes for SLIL (κ = 0.88 vs. 0.82) and LTIL assessment (κ = 0.88 vs. 0.86). For the LTIL, observer confidence and component assessability were superior with anatomical reformations available (all p < 0.05). ConclusionsIn contrast to SLIL injuries, diagnosis of LTIL lesions benefits from ancillary paraxial reformations of 3D sequences in MR wrist arthrography.

Ultra-high resolution 3D MRI for chondrocalcinosis detection in the knee\u2014a prospective diagnostic accuracy study comparing 7-tesla and 3-tesla MRI with CT

ObjectivesTo test the diagnostic accuracy of a 3D dual-echo steady-state (DESS) sequence at 7-T MRI regarding the detection of chondral calcific deposits of the knee in comparison to 3-T MRI, using CT as cross-sectional imaging reference standard.MethodsCT and 7-T MRI (DESS) of knee joints in 42 patients with radiographically known chondrocalcinosis (13 of 42 bilateral) were prospectively acquired for all included patients (n = 55 knee joints). Additionally, 3-T MRI (DESS) was performed for 20 of these 55 knee joints. Two fellowship-trained musculoskeletal radiologists scored eight cartilage regions of each knee joint separately regarding presence of cartilage calcification, diagnostic confidence level, and sharpness of calcific deposits. In an explorative subanalysis, micro-CT of the menisci was evaluated after knee arthroplasty in one patient. Diagnostic performance metrics and nonparametric tests were used to compare between modalities. p values < 0.05 were considered to represent statistical significance.ResultsSensitivity for chondrocalcinosis detection was significantly higher for 7-T MRI (100%) compared to 3-T MRI (reader 1: 95.9%, p = 0.03; reader 2: 93.2%, p = 0.002). The diagnostic confidence was significantly higher for both readers at 7 T compared to both 3-T MRI (p < 0.001) and to CT (p = 0.03). The delineation of chondral calcifications was significantly sharper for 7-T compared to both 3-T MRI and CT (p < 0.001, both readers). Micro-CT in one patient suggested that 7-T MRI may potentially outperform standard CT in diagnosing chondral calcifications.Conclusion3D-DESS imaging at 7-T MRI offers a significantly higher sensitivity in detection of chondral calcific deposits compared to 3-T MRI.Key Points• 3D dual-echo steady-state (DESS) MRI at 7 T has a higher sensitivity in detection of chondral calcific deposits compared to 3-T MRI (p ≤ 0.03).• 3D DESS MRI at 7 T yields no false-negative cases regarding presence of chondral calcific deposits.• 3D DESS MRI at 7 T offers better delineation and higher diagnostic confidence in detection of chondral calcific deposits compared to 3-T MRI (p < 0.001).

High-resolution in vivo MR imaging of intraspinal cervical nerve rootlets at 3 and 7 Tesla.

No routine imaging technology allows reliable visualization of nerve rootlets inside the spinal canal with positive contrast. The stronger MR signal at 7 T, with optimized protocols, may offer a solution. The purpose was to evaluate the potential of 3D Dual-Echo Steady-State (DESS) MR imaging of the cervical spine at 3 and 7 T in assessing the micro-anatomy of the nerve rootlets. This prospective study was approved by the local ethics committee. Twenty-one patients, clinically referred to cervical-spine MRI, underwent additional MR exams at 3 T and 7 T, each of which consisted of a single 3D-DESS series with equal acquisition times. Artifacts, visualization quality, and number of identified rootlets (C2 to C8) were rated by two musculoskeletal radiologists. Results were compared by Wilcoxon tests. Interobserver reliability was assessed using weighted κ statistics and intraclass correlation coefficient (ICC). Intraspinal rootlets could successfully be visualized at both field strengths. Rating differences for artifacts and quality of rootlet depiction were not significant for the two field strengths. The mean number of identified rootlets was larger for 7-T than for 3-T MR for every assessed nerve; however, this difference was not statistically significant using the Bonferroni correction (p values ranging from 0.002 to 0.53). Interobserver agreement was substantial to almost perfect (weighted κ values of 0.69 and 0.82). The ICC for the number of identified rootlets was 0.80. Non-invasive 3D-DESS MR-imaging at 3 and 7 T has the potential to provide precise assessments of the micro-anatomy of intraspinal cervical nerve roots. • Cervical rootlets can be successfully visualized with positive contrast using 3D-DESS MR-imaging. • 3D-DESS MR-imaging at 3 and 7 T provides precise assessments of the micro-anatomy of cervical nerves. • The mean number of identified cervical rootlets using 3D-DESS was larger for 7 T than for 3 T MR; however, this difference was not statistically significant.

Novel observations of Pacinian corpuscle distribution in the hands and feet based on high-resolution 7-T MRI in healthy volunteers

Pacinian corpuscles represent special nerve endings that serve as mechanoreceptors sensitive to vibration and pressure and are crucial for proprioception. This work demonstrates that the complex network of Pacinian corpuscles in hands and feet can be examined with three-dimensional Dual Echo Steady State (DESS) MR imaging at 7 T, while previous dedicated MRI reports were either limited to two-dimensional images or focused on the hands. The high-resolution MR images show the detailed architecture of the complex receptor network and reveal a “chain-like” arrangement of Pacinian corpuscles, a predilection for clustering around metacarpophalangeal/metatarsophalangeal joints, proximal phalanges and fingertips, and specific sensor locations both in the superficial subcutaneous tissue and adjacent to deep soft tissue structures such as tendons and joint capsules.

Image quality of hip MR arthrography with intra-articular injection of hyaluronic acid versus gadolinium-based contrast agent in patients with femoroacetabular impingement.

To compare image quality of magnetic resonance arthrography (MRA) of the hip with intra-articular injection of high-viscosity hyaluronic acid (HA-MRA) versus Gd-based contrast agent (Gd-MRA) in patients with femoroacetabular impingement (FAI). Design: single-centre, observational, retrospective, inter-individual, and cross-sectional. FAI patients who underwent HA-MRA (3mL of high-viscosity HA plus 17mL of saline) were compared with 37 age- and sex-matched FAI patients who underwent Gd-MRA (20mL of 2mmol/L solution of gadopentetate dimeglumine). Two independent blinded radiologists assessed image quality for all sequences (two-dimensional proton density, non-fat-sat axial, fat-sat coronal and sagittal; three-dimensional dual-echo steady state), using a 5-point Likert scale considering separately labrum, cartilage, round ligament, transverse ligament, and capsule. Pearson χ2 and Cohen κ were used. The HA-MRA group was composed of 37 patients (23 males, 14 females; median age 38years), the Gd-MRA group of 37 patients (21 males, 16 females; median age 38years), without significant difference for age (p = 0.937) and sex (p = 0.636). Image quality did not differ between the two readers for any structure: labrum (p ≥ 0.340), cartilage (p ≥ 0.198), round ligament (p ≥ 0.255), transverse ligament (p ≥ 0.806), and capsule (p ≥ 0.314). Inter-reader agreement (κ) ranged from 0.785 to 1.000. HA-MRA provided an image quality not significantly different from that of Gd-MRA. This may open the possibility of combining MRA and viscosupplementation in one single procedure.

Longitudinal survey for high density mineralised protrusions identified by 3D dess MRI in patients of the osteoarthritis initiative

Purpose: The structural and physiological integrity of the bone-cartilage interface is essential to maintaining joint health. Phenomena that disrupt this boundary can compromise whole joint function and are a major factor in the development of osteoarthritis (OA), particularly in the knee. Early diagnosis of such maladies may offer a predictive biomarker of joint destruction. Microcracks in the subchondral bone plate including the articular calcified cartilage (ACC) are in some cases repaired with a high density mineralised infill material. This material may also extend from the mineralising front into hyaline articular cartilage (HAC) as a high density mineralised protrusion (HDMP). Such features are likely to impair biomechanical performance of surrounding tissues. Their formation can occur in the absence of symptomatic OA and they are potentially a primary cause of OA. Recent reports have confirmed the presence of HDMPs in human ex- and in-vivo knee joints and their detectability with clinical MRI. Here we present the first longitudinal MRI study prospecting for HDMPs in the human knee. Methods: Twenty-one patients were selected from the osteoarthritis initiative (OAI) progression cohort for whom bilateral knee MRI data were available at five consecutive annual visits. Sagitally-acquired dual echo steady state MRI images were assessed for the presence of HDMP-like features at baseline. Incidences were recorded and categorised to one of six regions according to bone and laterality: medial femoral condyle (MFC), lateral femoral condyle (LFC), intercondylar fossa of femur (ICF), medial tibial condyle (MTC), lateral tibial condyle (LTC) and intercondylar ridge of tibia (ICT). Imaging data from follow-up visits were used to monitor the development of features over time. Results: Seventeen patients were found to possess MRI features identified as HDMPs in at least one knee with incidence being unilateral in 5 and bilateral in 12 cases. A total of 58 features were found, ranging from 1 to 5 in a single joint. Features were found in all six regions of the knee joint but distribution between regions was inequitable with 73% being located somewhere on the femur (ICF = 36%; LFC = 25%; MFC = 12%) and only 27% on the tibia (LTC = 23%; MTC = 2%; ICT = 2%). Of those HDMPs identified at baseline, the percentage still present at each subsequent annual visit was 96, 90, 85 and 81, respectively. Morphology of those still visible varied greatly; some remained similar in appearance while others altered substantially, for example, changing in size and shape. Some appeared to have fragmented, forming clusters within HAC. Figure 1 shows an example of a HDMP located on the articular surface of the medial femoral condyle. The material extends from the subchondral bone surface initially. It can be seen breaking away and moving gradually through HAC over time. Conclusions: Observation of features in regions of high mechanical stress and noting their disappearance over time is suggestive of a role in arthropathy. Fine particles of fragmented HDMP may abrade HAC and damage surrounding tissue. The potential for mineral features to fragment may account for apparent clustering of features over time, or they may be discrete incidences. Longevity of features throughout the study duration suggests fragmentation is slow and not guaranteed. Disappearance may indicate destruction or may be caused by average effects. The lower proportion of HDMPs in tibiae may indicate the bone is less susceptible to HDMP formation, or they may be shorter lived. The appearances of HDMPs in clinical scans were consistent with reported ex-vivo studies. Clinical DESS yields high contrast between signal intensities of mineral (low yield) and HAC (high yield) and the features described should be considered a potential imaging biomarker for the prediction of joint destruction in some forms of OA.

Comparison of 3D MR imaging sequences in knee articular cartilage at 1.5 T

Purpose: To compare 3D high-resolution MRI sequences in term of contrast, Signal to Noise Ratio (SNR), artefacts and cartilage thickness in knee articular cartilage at 1.5 T. Materials and Methods: Fourteen healthy volunteers and seven patients underwent articular knee cartilage exam. The 3D sequences were VOLUME Imaging with Body Enhancement (VIBE), True Fast Imaging with Steady-state Precession (TRUEFISP), Dual Echo Steady State (DESS), Multi Echo Data Image Combination (MEDIC) and Sampling Perfection with Application optimized Contrasts using different flip angle Evolutions (SPACE). For all 3D sequences, we measured contrast ratio between cartilage-bone and cartilage-meniscus, SNR and cartilage thickness. In addition, we quantified magnetic susceptibility and flow artifacts. Statistical analyses were performed using the t-test and P<0.005 was considered statistically significant. Results: Statistical results were significantly different (p>0.05). MEDIC and VIBE sequences showed the best contrast ratio between cartilage-meniscus (0.40 ± 0.14, p=0.000) and cartilage-bone (0.75 ± 0.4, p=0.022), respectively. TRUEFISP sequence showed the highest SNR (28.04 ± 14.05, p=0.000) whereas DESS sequence showed the lowest SNR (11.62 ± 3.99, p=0.000). VIBE sequence provided the highest cartilage thickness measurement compared to the remaining 3D sequences (2.0 ± 0.4 cm, IRR=75.33%, ICC=0.96). The quantification of magnetic susceptibility and flow artifacts revealed that TRUEFISP (IRR=59%, ICC=0.92) and SPACE (IRR=59%, ICC=0.96) sequences presented the highest artifacts compared to the others sequences. Conclusion: 3D high-resolution sequences provide knee articular cartilage imaging with high image quality in relatively short acquisition time. MEDIC and VIBE sequences showed the best contrast and the lowest magnetic susceptibility and flow artifacts, TRUEFISP and SPACE sequence showed the highest SNR but they are more sensitive to artifacts, DESS sequence showed medium contrast and VIBE sequence provided the highest cartilage thickness.

An open 8-channel parallel transmission coil for static and dynamic 7T MRI of the knee and ankle joints at multiple postures.

We present the initial in vivo imaging results of an open architecture eight-channel parallel transmission (pTx) transceive radiofrequency (RF) coil array that was designed and constructed for static and dynamic 7T MRI of the knee and ankle joints. The pTx coil has a U-shaped dual-row configuration (200 mm overall length longitudinally) that allows static and dynamic imaging of the knee and ankle joints at various postures and during active movements. This coil structure, in combination with B1 shimming, allows flexible configuration of B1 transmit profiles, with good homogeneity over 120-mm regions of interest. This coil enabled high-resolution gradient echo (e.g., 3D dual-echo steady state [DESS] and 3D multiecho data image combination [MEDIC]) and turbo spin echo (TSE) imaging (e.g., with proton density weighting [PDw], PDw with fat saturation, and T1 and T2 weightings) with local RF energy absorption rates well below regulatory limits. High-resolution 2D and 3D image series (e.g., 0.3 mm in-plane resolution for TSE, 0.47 mm isotropic for DESS and MEDIC) were obtained from the knee and ankle joints with excellent tissue contrast. Dynamic imaging during continuous knee and ankle flexion-extension cycles were successfully acquired. The new open pTx coil array provides versatility for high-quality static and dynamic MRI of the knee and ankle joints at 7T. Magn Reson Med 79:1804-1816, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Hip MRI: Prevalence of articular cartilage defects and labral tears in asymptomatic volunteers. A comparison with a matched population of patients with femoroacetabular impingement.

To prospectively compare defects of the articular cartilage and labrum in asymptomatic volunteers and in patients with femoroacetabular impingement (FAI) matched for age and gender. This cross-sectional study was institutional review board approved. A total of 63 asymptomatic volunteers and 63 patients with symptomatic FAI between 20 and 50 years underwent 1.5 Tesla MRI (coronal T1-weighted, coronal intermediate-weighted fat saturated, transverse oblique true fast imaging with steady-state precession [FISP], sagittal dual echo steady state [DESS] sequence). Two radiologists independently assessed defects of the cartilage and labrum at six positions. Statistics included Mann-Whitney U-test and Spearman's rho. A defect of the articular cartilage and/or labrum was present on average in 57% of asymptomatic volunteers, compared with 80% of symptomatic patients (P ≤ 0.028). A total of 14% of volunteers had acetabular cartilage defects, and 6% had femoral cartilage defects, compared with 47% and 30% in symptomatic patients (P ≤ 0.001 and P ≤ 0.003), respectively. Labrum defects were seen in 44% of volunteers versus 61% of patients (P ≤ 0.12). Both cartilage and labral defects were more commonly encountered in male volunteers than in female volunteers, with the largest difference seen for the acetabular cartilage (P ≤ 0.02). In all groups, the majority of cartilage and labrum defects were encountered in the anterosuperior, superior, and posterosuperior position. A substantial number of asymptomatic volunteers had labral tears, defects of the acetabular cartilage, and to a lesser degree, defects of the femoral cartilage; our data demonstrate that not all cartilage and labral defects of the hip joint are symptomatic and that a similar predilection for location of defects is found in volunteers and FAI patients. 2 Technical Efficacy: Stage 3 J. MAGN. RESON. IMAGING 2017;46:440-451.

Optimizing MR Scan Design for Model-Based ${T}_{1}$ , ${T}_{2}$ Estimation From Steady-State Sequences.

Rapid, reliable quantification of MR relaxation parameters T1 and T2 is desirable for many clinical applications. Steady-state sequences such as Spoiled Gradient-Recalled Echo (SPGR) and Dual-Echo Steady-State (DESS) are fast and well-suited for relaxometry because the signals they produce are quite sensitive to T1 and T2 variation. However, T1, T2 estimation with these sequences typically requires multiple scans with varied sets of acquisition parameters. This paper describes a systematic framework for selecting scan types (e.g., combinations of SPGR and DESS scans) and optimizing their respective parameters (e.g., flip angles and repetition times). The method is based on a Cramér-Rao Bound (CRB)-inspired min-max optimization that finds scan parameter combinations that robustly enable precise object parameter estimation. We apply this technique to optimize combinations of SPGR and DESS scans for T1, T2 relaxometry in white matter (WM) and grey matter (GM) regions of the human brain at 3T field strength. Phantom accuracy experiments show that SPGR/DESS scan combinations are in excellent agreement with reference measurements. Phantom precision experiments show that trends in T1,T2 pooled sample standard deviations reflect CRB-based predictions. In vivo experiments show that in WM and GM, T1 and T2 estimates from a pair of optimized DESS scans exhibit precision (but not necessarily accuracy) comparable to that of optimized combinations of SPGR and DESS scans. To our knowledge, T1 maps from DESS acquisitions alone are new. This example application illustrates that scan optimization may help reveal new parameter mapping techniques from combinations of established pulse sequences.

Integration of accelerated MRI and post-processing software: a promising method for studies of knee osteoarthritis

Magnetic resonance imaging (MRI) is a widely used imaging modality for studies of knee osteoarthritis (OA). Compared to radiography, MRI offers exceptional soft tissue imaging and true three-dimensional (3D) visualization. However, MRI is expensive both due to the cost of acquisition and evaluation of the images. The goal of our study is to develop a new method to address the cost of MRI by combining innovative acquisition methods and automated post-processing software. Ten healthy volunteers were scanned with three different MRI protocols: A standard 3D dual-echo steady state (DESS) pulse sequence, an accelerated DESS (DESSAcc), acquired at approximately half the time compared to DESS, and a multi-echo time DESS (DESSMTE), which is capable of producing measurements of T2 relaxation time. A software tool was used to measure cartilage volume. Accuracy was quantified by comparing DESS to DESSAcc and DESSMTE and precision was measured using repeat readings and acquisitions. T2 precision was determined using duplicate DESSMTE acquisitions. Intra-class correlation coefficients (ICCs), root-mean square standard deviation (RMSSD), and the coefficient of variation (CoV) were used to quantify accuracy and precision. The accuracies of DESSAcc and DESSMTE were CoV=3.7% and CoV=6.6% respectively, while precision was 3.8%, 3.0%, and 3.1% for DESS, DESSAcc and DESSMTE. T2 repositioning precision was 5.8%. The results demonstrate that accurate and precise quantification of cartilage volume is possible using a combination of substantially faster MRI acquisition and post-processing software. Precise measurements of cartilage T2 and volume can be made using the same acquisition.

Rapid quantitative T2 mapping of the prostate using three-dimensional dual echo steady state MRI at 3T.

To develop and evaluate a rapid three-dimensional (3D) quantitative T2 mapping method for prostate cancer imaging using dual echo steady state (DESS) MRI at 3T. In simulations, DESS-T2 mapping in the presence of T1 and B1+ variations was evaluated. In a phantom and in healthy volunteers (n = 4), 3D DESS-T2 mapping was compared with a two-dimensional turbo spin echo (TSE) approach. In volunteers and a pilot patient study (n = 29), quantitative T2 in normal prostate anatomical zones and in suspected cancerous lesions was evaluated. The simulated bias for DESS-T2 was < 2% (5%) for typically observed T1 ( B1+) variations. In phantoms and in vivo, high correlation of DESS-T2 and TSE-T2 (r2 = 0.98 and 0.88, P < 0.001) was found. DESS-T2 in the normal peripheral zone and transition zone was 115 ± 26 ms and 64 ± 7 ms, respectively, in healthy volunteers and 129 ± 39 ms and 83 ± 12 ms, respectively, in patients. In suspected cancerous lesions, DESS-T2 was 72 ± 14 ms, which was significantly decreased from the normal peripheral zone (P < 0.001) but not from the transition zone. Rapid 3D T2 mapping in the entire prostate can be performed in 1 min using DESS MRI. Magn Reson Med 76:1720-1729, 2016. © 2016 International Society for Magnetic Resonance in Medicine.

Quantitative Biomedical Imaging: Techniques and Clinical Applications.

Quantitative Biomedical Imaging: Techniques and Clinical Applications.