INTRODUCTION: Imaging extremities in MR is an invaluable, non-invasive method widely used in orthopedic, hand surgery, post-transplant evaluation, variety of pathologic hand conditions.1 In order to address soft-tissue related challenges, UHF-MR imaging is the precise imaging tool which provides high signal/contrast-to-noise ratio (S/CNR), higher anatomic resolution, and reduced scan time.2 Due to the small electrical size (filling-factor) of the arm/hand, we use a TEM resonator in conjunction with eight channels receive (Rx)-only-insert array rather than the multi-channel transmit or transceiver approach at 7T. METHODS: A shielded design of an actively detuned TEM resonator has two ports driven by quadrature hybrid instead a T/R switch. It contains eight inductively decoupled surface loops (each 18x8 cm2 in size).3 A detailed method mentioned in Ibrahim et al4 was followed to simulate the TEM coil and human hand as a single system using FDTD in order to estimate RF power absorption for RF safety. All the MR experiments were conducted at 7T Siemens Magnetom scanner by recruiting volunteer under university approved IRB. RESULTS: For TEMcoil: S11:-21dB, S12:-16dB(<3%), Rxcoil: S11:-15dB, S12:-14dB(<3%). The mean/SD: 743/126(coverage area: 120sq.cm). The SNR:44, and CNR:33 for in-vivo coronal images (almost double compared to 3T throughout the volume measured and verified). At 7T, experimental B1+maps show a good agreement with the simulated B1+field distribution and average SAR/10g of tissue is 2.02W, and peak SAR/10g of tissue is 8.98W. T1VIBE shows exquisite anatomical detail identifying various nerve branches, cartilage delineation, brachial branches, nerve fascicles and vessel-wall imaging in forearm(and elbow); and palmer arch(PA), and proper digita palmer (PPD) arteries in hand. T2WDESS represents cartilage and ulnar nerve with high intensity signal delineation, synovial fluid (bright signal) in between very fine cartilage. SWI demonstrates forearm micro-vasculature; ToF depicts PA and PDP arteries; DTI shows FA (median:0.83, radian: 0.48) and Color-coded maps; vessel segmentation of brachial branches and venous vasculature. CONCLUSION: The actively detuned TEM coil now makes independent transmit-receive coil operation possible at 7T for extremities which surpasses the work of current 7T applications and it goes beyond head and body (torso) applications. Our ongoing work involves optimizing the coil design, musculoskeletal pulse sequence development, and in addition nerve and smaller vessel imaging for neuropathy and transplant patient populations.
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