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Diffusion-Weighted Imaging of the Appendicular Skeleton with a Non–Carr-Purcell-Meiboom-Gill Single-Shot Fast Spin-Echo Sequence

¹ Department of Radiology, Gazi University School of Medicine, Besevler, Ankara 06510, Turkey.
² GE Medical Systems, Istanbul, Turkey.

OBJECTIVE. The objective of our study was to prospectively evaluate the signal-to-noise ratio (SNR) improvement in diffusion-weighted imaging (DWI) of the appendicular skeleton with the use of a newly developed non–Carr-Purcell-Meiboom-Gill (non-CPMG) single-shot fast spin-echo (SSFSE) sequence and to evaluate its effect on apparent diffusion coefficient (ADC) measurements.

SUBJECTS AND METHODS. DWI of the bone was performed in 32 patients with an echo-planar imaging (EPI)–based sequence followed by a non-CPMG SSFSE technique. SNR and ADC values were measured over a lesion-free right femoral head. A score was assigned for each set of images to assess image quality. When a bone lesion was present, contrast-to-noise ratio (CNR) and ADC were also measured. Paired Student's t tests were used for statistical analysis.

RESULTS. The mean (± SD) SNR values were 9.89 ± 2.20 and 81.68 ± 4.87 for EPI and non-CPMG SSFSE DWI, respectively. SNR values associated with the non-CPMG SSFSE technique were found to be significantly higher than those measured with the EPI-based DWI technique (p < 0.01). Mean ADCs of the bone were 0.57 ± 0.20 and 0.29 ± 0.15 x 10^–3 mm²/s, respectively, for EPI and non-CPMG SSFSE DWI. Image quality scores were higher for the non-CPMG SSFSE DWI technique (p < 0.05) than for the EPI-based DWI technique. Overall lesion CNR was found to be higher in DWI performed with the non-CPMG SSFSE technique.

CONCLUSION. The non-CPMG SSFSE technique provides a significant improvement over the currently used EPI-based DWI technique and has the potential to be a powerful tool in imaging the appendicular skeleton.

Keywords: appendicular skeleton • avascular necrosis • bone lesions • diffusion-weighted imaging • echo-planar imaging • MR techniques • parallel imaging • perfusion imaging

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