Balanced SSFP imaging of the musculoskeletal system

Journal of Magnetic Resonance Imaging (Impact Factor: 2.79). 02/2007; 25(2):270 - 278. DOI: 10.1002/jmri.20819

ABSTRACT Magnetic resonance imaging (MRI), with its unique ability to image and characterize soft tissue noninvasively, has emerged as one of the most accurate imaging methods available to diagnose bone and joint pathology. Currently, most evaluation of musculoskeletal pathology is done with two-dimensional acquisition techniques such as fast spin echo (FSE) imaging. The development of three-dimensional fast imaging methods based on balanced steady-state free precession (SSFP) shows great promise to improve MRI of the musculoskeletal system. These methods may allow acquisition of fluid sensitive isotropic data that can be reformatted into arbitrary planes for improved detection and visualization of pathology. Sensitivity to fluid and fat suppression are important issues in these techniques to improve delineation of cartilage contours, for detection of marrow edema and derangement of other joint structures. J. Magn. Reson. Imaging 2007. © 2007 Wiley-Liss, Inc.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Osteoarthritis (OA) is the most common musculoskeletal degenerative disease, affecting millions of people. Although OA has been considered primarily a cartilage disorder associated with focal cartilage degeneration, it is accompanied by well-known changes in subchondral and trabecular bone, including sclerosis and osteophyte formation. The exact cause of OA initiation and progression remains under debate, but OA typically first affects weightbearing joints such as the knee. Magnetic resonance imaging (MRI) has been recognized as a potential tool for quantitative assessment of cartilage abnormalities due to its excellent soft tissue contrast. Over the last two decades, several new MR biochemical imaging methods have been developed to characterize the disease process and possibly predict the progression of knee OA. These new MR biochemical methods play an important role not only for diagnosis of disease at an early stage, but also for their potential use in monitoring outcome of various drug therapies (success or failure). Recent advances in multicoil radiofrequency technology and high field systems (3 T and above) significantly improve the sensitivity and specificity of imaging studies for the diagnosis of musculoskeletal disorders. The current state-of-the-art MR imaging methods are briefly reviewed for the quantitative biochemical and functional imaging assessment of musculoskeletal systems.
    Seminars in musculoskeletal radiology 10/2008; 12(3):266-80. DOI:10.1055/s-0028-1083109 · 0.95 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: High field magnetic resonance imaging at 3.0 T is rapidly gaining clinical acceptance as the preferred platform for magnetic resonance (MR) imaging. This is spurred in part because advances in the manufacture of magnet technology have brought the cost of 3.0-T magnets into the range of previous 1.5-T machines, as well as ongoing research demonstrating numerous advantages of 3.0 T over 1.5 T in neurological imaging. Many factors are responsible for improved imaging at higher field strength, including increased signal-to-noise and contrast-to-noise ratios. The impact of 3.0-T imaging of the musculoskeletal system has been less dramatic because its optimization is more complicated in the musculoskeletal system than in the brain. Many issues must be considered beyond what might be expected from simply doubling the field strength, including hardware design, protocol modifications because of changes in tissue characteristics at higher fields, artifact reduction, and safety. This article addresses many of these concerns, focusing on techniques to optimize high field MR imaging of the musculoskeletal system.
    Seminars in musculoskeletal radiology 10/2008; 12(3):185-95. DOI:10.1055/s-0028-1083103 · 0.95 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To compare a vastly undersampled isotropic projection steady-state free precession (VIPR-SSFP) sequence and routine magnetic resonance (MR) imaging for evaluating the cartilage, ligaments, menisci, and osseous structures of the knee in symptomatic patients. All subjects signed written informed consent prior to participation in this prospective, HIPAA-compliant, institutional review board-approved study. VIPR-SSFP was added to the routine 1.5-T MR imaging performed on 95 symptomatic patients (52 men, 43 women; average age, 41.6 years) who subsequently underwent arthroscopic knee surgery. All MR examinations were independently reviewed twice by two musculoskeletal radiologists to detect cartilage lesions, anterior and posterior cruciate ligament tears, meniscal tears, and bone marrow edema lesions, first by using routine MR and second by using VIPR-SSFP. By using arthroscopy as the reference standard, the sensitivity and specificity of both MR protocols were calculated. The z test was used to compare sensitivity and specificity values. VIPR-SSFP had significantly higher specificity (P < .01) for helping detect cartilage lesions (92.2% for VIPR-SSFP and 88.4% for routine MR), while routine MR had significantly higher sensitivity (P = .02) and accuracy (P = .05) for helping detect lateral meniscal tears (73.2% sensitivity and 88.4% accuracy for VIPR-SSFP and 87.5% specificity and 93.2% accuracy for routine MR). There was no significant difference (P = .14 to >.99) between VIPR-SSFP and routine MR in the remaining sensitivity and specificity values. VIPR-SSFP helped detect 69.3% of bone marrow edema lesions identified at routine MR. VIPR-SSFP can provide important clinical information regarding the cartilage, ligaments, menisci, and osseous structures of the knee, but is less sensitive than conventional MR imaging at helping detect lateral meniscal tears and bone marrow edema lesions.
    Radiology 02/2009; 251(1):185-94. DOI:10.1148/radiol.2511081133 · 6.21 Impact Factor
Show more