Magnetic resonance imaging of ankle tendon pathology: benefits of additional axial short-tau inversion recovery imaging to reduce magic angle effects

Abstract

Axial STIR sequences reduce magic angle effects and improve visualization of ankle tendon pathology.

Use of Fat-Suppressed T2-Weighted MRI Images to Reduce the Magic Angle Effect in Peroneal Tendons

“…This reduction in the MAE using T2FS images is comparable to results obtained using STIR images. 12 It is, however, important to appreciate that the use of T2-weighted imaging does not completely eliminate the MAE, as shown by our results. The inclusion of a T2-weighted or STIR sequence would, therefore, be useful in MRI scanning for tendons and ligaments to avoid potential artifact and misdiagnosis.…”

“…The STIR sequences demonstrated a significantly lower MAE, as well as a higher sensitivity in the diagnosis of tendon abnormalities compared with the standard sequences. 12 It is also recognized that T2-weighted sequences can be helpful in minimizing the MAE. 16 One study compared modified STIR sequences with T2FSs to assess the rotator cuff in 61 patients.…”

“…The peroneus brevis and peroneus longus tendons were assessed at 5 defined levels on PDFS and T2FS images, which have been defined in previous studies. 7,12 The levels are demonstrated in Figure 1. The MRI orientation is perpendicular to collagen fibers in the peroneal tendons in positions 1 and 2.…”

“…Studies have reported that axial short tau inversion recovery (STIR) sequences significantly reduce MAE in ankle tendons compared with axial PDFS sequences in 3T MRI of the ankle. 11,12 T2-weighted FS sequences (T2FSs), rather than STIR images, can also be used to avoid MAE. T2FSs have been favored over STIR images in this study because they provide better spatial resolution.…”

Relaxation anisotropy of quantitative MRI parameters in biological tissues

“…Thus it might not be the best option to detect subtle changes in tendon structure, or not applicable for any other tissues. To obtain orientation independent images or quantitative values, specific MRI methods have been explored in previous research, such as short-tau inversion recovery (STIR) (Srikhum et al, 2013), T 1ρ using adiabatic spin-lock pulse (Rautiainen et al, 2014;J. Zhang et al, 2016), ultrashort echo time magnetization transfer (UTE-MT) imaging (Ma et al, 2016), UTE-T * 2 bi-component fractions (Pauli et al, 2012;Shao et al, 2016), UTE-cones-MT (Zhu et al, 2018) and UTE-cones Adiabatic T 1 rho (Wu et al, 2020).…”