Dynamic MRI for articulating joint evaluation on 1.5 T and 3.0 T scanners: setup, protocols, and real-time sequences

Abstract

Dynamic magnetic resonance imaging (MRI) is a non-invasive method that can be used to increase the understanding of the pathomechanics of joints. Various types of real-time gradient echo sequences used for dynamic MRI acquisition of joints include balanced steady-state free precession sequence, radiofrequency-spoiled sequence, and ultra-fast gradient echo sequence. Due to their short repetition time and echo time, these sequences provide high temporal resolution, a good signal-to-noise ratio and spatial resolution, and soft tissue contrast. The prerequisites of the evaluation of joints with dynamic MRI include suitable patient installation and optimal positioning of the joint in the coil to allow joint movement, sometimes with dedicated coil support. There are currently few recommendations in the literature regarding appropriate protocol, sequence standardizations, and diagnostic criteria for the use of real-time dynamic MRI to evaluate joints. This article summarizes the technical parameters of these sequences from various manufacturers on 1.5 T and 3.0 T MRI scanners. We have reviewed pertinent details of the patient and coil positioning for dynamic MRI of various joints. The indications and limitations of dynamic MRI of joints are discussed.

Development of Real-Time Kinematic Magnetic Resonance Imaging (kMRI) Techniques for Studying the Kinematics of the Spine and Joints in Dogs—Preliminary Study on Cadavers

“…Among the currently available diagnostic imaging techniques, MRI can provide the greatest range of information and the finest accuracy in detecting subtle abnormalities due to the highest soft tissue contrasts [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ]. Conventional MRI studies are conducted at functional rest, but some spinal or orthopedical diseases, characterized by articular instability and a dynamic component, can be underestimated when imaged in these conditions [ 10 ]. As a result, kMRI is performed, imaging patients in weight-bearing or stressed positions [ 9 , 10 ].…”

“…Conventional MRI studies are usually performed at functional rest. However, these static studies can potentially underestimate the disease entity and fail to characterize the dynamic physiology of joints [ 9 , 10 ]. As a result, kMRI is performed, imaging patients in weight-bearing or stressed positions [ 9 , 10 ].…”

“…However, these static studies can potentially underestimate the disease entity and fail to characterize the dynamic physiology of joints [ 9 , 10 ]. As a result, kMRI is performed, imaging patients in weight-bearing or stressed positions [ 9 , 10 ]. In human medicine, three kMRI methods exist: (1) incremental (quasi-static) acquisition, i.e., a static MRI study repeated after a change in the joint/spine position; (2) motion-triggered acquisition, i.e., cine-MRI and cine phase contrast techniques applied while cycles of joint movement occur; and (3) real-time acquisition, i.e., few seconds real-time MRI acquisition during a single joint movement [ 10 ].…”

“…One major drawback of this method is the considerable amount of time added to the standard MRI protocol when used in a clinical setting, consequently increasing the anesthetic time and risk for the patient, as well as the overall exam time and cost [ 12 , 14 ]. The real-time acquisition technique is a very fast kMRI modality allowing the study of joint and spine movements in a few seconds [ 10 , 18 , 19 ]. To the authors’ knowledge, this method has never been tested in veterinary medicine.…”

Editorial Commentary: Real-Time Dynamic Magnetic Resonance Imaging of the Patellofemoral Joint: Ready for Prime Time?

“…Real-time dynamic MRI techniques open the doors to diagnosing dynamic pathology such as joint instability or impingement syndromes by direct visualization, providing attractive alternatives to previous quasi-static MRI in which joint repositioning between static image acquisitions adds considerably to examination duration, nonuniformity, and patient discomfort. Growing demand for dynamic MRI has been supported by modified imaging sequences incorporating fast spin echo or gradient echo techniques, and others such as coherent (or balanced) steady-state free precession imaging sequences, 7 now readily available in most radiology departments through a range of vendors.…”