Feasibility of using an inversion-recovery ultrashort echo time (UTE) sequence for quantification of glenoid bone loss

Abstract

Objective To utilize the 3D Inversion Recovery prepared Ultrashort-Echo-Time with Cones Readout (IR-UTE-Cones) MRI technique for direct imaging of lamellar bone with comparison to the gold standard of computed tomography (CT). Materials and Methods CT and MRI was performed on 11 shoulder specimens and 3 patients. Five specimens had imaging performed before and after glenoid fracture (osteotomy). 2D and 3D volume-rendered CT images were reconstructed and conventional T1-weighted and 3D IR-UTE-Cones MRI techniques were performed. Glenoid widths and defects were independently measured by two readers using the circle method. Measurements were compared with those made from 3D CT datasets. Paired-sample Student’s t tests and intraclass correlation coefficients were performed. In addition, 2D CT and 3D IR-UTE-Cones MRI datasets were linearly registered, digitally overlaid, and compared in consensus by these two readers. Results Compared with the reference standard (3D CT), glenoid bone diameter measurements made on 2D CT and 3D IR-UTE-Cones were not significantly different for either reader whereas T1-weighted images underestimated the diameter (mean difference of 0.18 cm, p=0.003 and 0.16 cm, p=0.022 for readers 1 and 2, respectively). However, mean margin of error for measuring glenoid bone loss was small for all modalities (range 1.46-3.92%). All measured ICCs were near perfect. Digitally registered 2D CT and 3D IR-UTE-Cones MRI datasets yielded essentially perfect congruity between the two modalities. Conclusion The 3D IR-UTE-Cones MRI technique selectively visualizes lamellar bone, produces similar contrast to 2D CT imaging, and compares favorably to measurements made using 2D and 3D CT.

T1 measurement of bound water in cortical bone using 3D adiabatic inversion recovery ultrashort echo time (3D IR‐UTE) Cones imaging

“…As a result, cortical bone appears as a signal void when imaged using conventional clinical sequences which have echo times (TEs) of a few milliseconds, and are typically longer than the s of cortical bone components. However, this limitation can largely be overcome by the use of ultrashort echo time (UTE) sequences, which provide direct imaging of cortical bone by using a nominal TE of 8~32 µs …”

All About Shoulder Arthroplasty: What Radiologists Should Know

“…27,28 When combined with fat and adjacent soft tissue suppression, UTE sequences result in an image with bone contrast that is more similar in quality to that provided by CT. 29 In a recent study, Chang et al compared glenoid bone measurements using 3D inversion recovery (IR)-UTE-Cones sequences, conventional T1-weighted sequences, and 3D CT images by overlaying the two MR sequences over CT images. They showed near perfect registration of the 3D IR-UTE-Cones sequences and 2D CT, whereas conventional T1weighted sequences underestimated the width of the intact glenoid 30 (►Fig. 4).…”

Magnetic resonance imaging of the shoulder

“…It has been shown that higher humeral bone loss compared to the glenoid bone loss may indicate the need for bone augmentation in addition to labroligamentous repair for a better postoperative outcome. Newer MRI techniques such as zero echo time (ZTE) or inversion-recovery (IR) UTE imaging can be used to generate high-contrast bone images [ 61 , 62 ]. ZTE provides an isotropic dataset, which facilitates the creation of 3D-volume rendered images, but IR-UTE provides better suppression of non-bone tissues ( Figure 16 ).…”