Five-Minute Five-Sequence Knee MRI Using Combined Simultaneous Multislice and Parallel Imaging Acceleration: Comparison with 10-Minute Parallel Imaging Knee MRI

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In the last few years, major developments have been observed in the field of magnetic resonance imaging (MRI). Advances in both scanner hardware and software technologies have witnessed great leaps, enhancing the diagnostic quality and, therefore, the value of MRI. In musculoskeletal radiology, three-dimensional (3D) MRI has become an integral component of the diagnostic pathway at our institutions. This technique is particularly relevant in patients with hand and wrist symptoms, due to the intricate nature of the anatomical structures and the wide range of differential diagnoses for most presentations. We review the benefits of 3D MRI of the hand and wrist, commonly used pulse sequences, clinical applications, limitations, and future directions. We offer guidance for enhancing the image quality and tips for image interpretation of 3D MRI of the hand and wrist.

Section: Motion Artifactsmentioning

confidence: 99%

3D MRI of the Hand and Wrist: Technical Considerations and Clinical Applications

Dalili

Fritz

Isaac

2021

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“…10 However, with the recent introduction of innovative acceleration strategies applied to 2D TSE images, such as simultaneous multislice techniques, the challenge to develop competitive, fast isotropic high-resolution 3D sequences has increased. [34][35][36][37] The main challenges for introducing isotropic high-resolution 3D FSE protocols for whole-joint assessment in clinical practice used to be long acquisition times of up to 10 minutes for a single image series. 38 However, in the last decade, the implementation of more advanced acceleration strategies, such as bidirectional (controlled aliasing in parallel imaging results in higher acceleration [CAIPIRINHA]) 27,33,[39][40][41][42] and random undersampling (compressed sensing) 43,44 strategies associated with 3D TSE sequences, shortening examination times, has increased the interest in their clinical potential.…”

Section: Practical Integration Of 3d Sequencesmentioning

confidence: 99%

3D MRI: Technical Considerations and Practical Integration

Grande

Hinterholzer

Nanz

2021

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One of the main advantages of three-dimensional (3D) magnetic resonance imaging (MRI) is the possibility of isotropic voxels and reconstructed planar cuts through the volumetric data set in any orientation with multiplanar reformation software through real-time evaluation. For example, reformats by the radiologist during reporting allows exploitation of the full potential of isotropic 3D volumetric acquisition or through standardized retrospective reformats of thicker predefined slices of an isotropic volumetric data set by technologists. The main challenges for integrating 3D fast spin echo (FSE) and turbo spin-echo (TSE) MRI in clinical practice are a long acquisition time and some artifacts, whereas for integrating 3D gradient-recalled echo protocols, the main challenges are lower signal-to-noise ratios (SNRs) and the inability to produce intermediate, and T2-weighted contrast. The implementation of bidirectional parallel imaging acquisition and random undersampling acceleration strategies of 3D TSE pulse sequences substantially shortens the examination time with only minor SNR reductions. This article provides an overview of general technical considerations of 3D FSE and TSE sequences in musculoskeletal MRI. It also describes how these sequences achieve efficient data acquisition and reviews the main advantages and challenges for their introduction to clinical practice.

“…5,6,[8][9][10][11] Because modern acceleration techniques allow the acquisition of clinically available high-quality 3D FSE/TSE sequences of the ankle in 5 minutes, time savings of up to 50% are possible if two of three standard 2D FSE/TSE sequences with an acquisition time of $ 3 minutes each are substituted. However, novel acceleration techniques have also been developed for 2D TSE pulse sequences, such as combined simultaneous multislice and parallel imaging, [12][13][14][15] that substantially accelerate 2D TSE MRI of the ankle. The true time-saving potential of 3D MRI in comparison with 2D FSE/TSE protocols may change over time as pulse sequence, scanner, and coil technologies evolve and should be assessed individually.…”

Section: Practical Considerations For Clinical Implementationmentioning

confidence: 99%

“…Although recent advances in 3D acceleration techniques now enable clinical fourfold and sixfold-accelerated highresolution 3D FSE/TSE MRI and with pulse sequence acquisition times 5 minutes, [5][6][7]17,18 recent advances in 2D TSE acquisition, including combined parallel imaging and simultaneous multislice acceleration, 12,14,15 similarly enabled fourfold-and sixfold-accelerated 2D TSE sequences and potentially triplanar, multicontrast five-sequence high-resolution 2D ankle MRI examinations in 5 minutes. 13 Therefore, the clinical time-saving potential of 3D sequences in comparison with 2D sequences should be assessed individually, considering the available MR scanner type and software and license packages at each institution.…”

Section: Voxelsmentioning

confidence: 99%

3D MRI of the Ankle: A Concise State-of-the-Art Review

Fritz

Sutter

2021

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Magnetic resonance imaging (MRI) is a powerful imaging modality for visualizing a wide range of ankle disorders that affect ligaments, tendons, and articular cartilage. Standard two-dimensional (2D) fast spin-echo (FSE) and turbo spin-echo (TSE) pulse sequences offer high signal-to-noise and contrast-to-noise ratios, but slice thickness limitations create partial volume effects. Modern three-dimensional (3D) FSE/TSE pulse sequences with isotropic voxel dimensions can achieve higher spatial resolution and similar contrast resolutions in ≤ 5 minutes of acquisition time. Advanced acceleration schemes have reduced the blurring effects of 3D FSE/TSE pulse sequences by affording shorter echo train lengths. The ability for thin-slice partitions and multiplanar reformation capabilities eliminate relevant partial volume effects and render modern 3D FSE/TSE pulse sequences excellently suited for MRI visualization of several oblique and curved structures around the ankle. Clinical efficiency gains can be achieved by replacing two or three 2D FSE/TSE sequences within an ankle protocol with a single isotropic 3D FSE/TSE pulse sequence. In this article, we review technical pulse sequence properties for 3D MRI of the ankle, discuss practical considerations for clinical implementation and achieving the highest image quality, compare diagnostic performance metrics of 2D and 3D MRI for major ankle structures, and illustrate a broad spectrum of ankle abnormalities.