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Isotropic 3D Fast Spin-Echo with Proton-Density-Like Contrast: A Comprehensive Approach to Musculoskeletal MRI

Lawrence Yao1, John T. Pitts2 and David Thomasson1

1 Diagnostic Radiology Department, Clinical Center, National Institutes of Health, 10 Center Dr., Rm. 1C360, Bethesda, MD 20892.
2 InVivo Corporation, Orlando, FL.


Figure 1
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  		Fig. 1A —Several anatomic structures in ankle and hindfoot of healthy 43-year-old male volunteer. Parameters for axial 2D turbo spin-echo (TSE) image, A, were TR/TE, 2,800/30 and echo-train length, 7. Parameters for various optimized, view planes reformatted from single 3D Fourier transform TSE acquisitions, B-F, were 720/40 and echo-train length, 11. Axial 2D TSE image shows calcaneofibular ligament (arrowhead) and portion of anterior talofibular ligament (arrow). Synovial fluid in anterolateral gutter is nearly isointense to cartilage and inconspicuous.

 

Figure 2
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  		Fig. 1B —Several anatomic structures in ankle and hindfoot of healthy 43-year-old male volunteer. Parameters for axial 2D turbo spin-echo (TSE) image, A, were TR/TE, 2,800/30 and echo-train length, 7. Parameters for various optimized, view planes reformatted from single 3D Fourier transform TSE acquisitions, B-F, were 720/40 and echo-train length, 11. Axial oblique 3D TSE image reformatted to show anterior talofibular ligament (arrow) to advantage. Joint fluid deep in relation to this ligament is relatively bright because of driven equilibrium technique, creating useful positive contrast relative to cartilage.

 

Figure 3
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  		Fig. 1C —Several anatomic structures in ankle and hindfoot of healthy 43-year-old male volunteer. Parameters for axial 2D turbo spin-echo (TSE) image, A, were TR/TE, 2,800/30 and echo-train length, 7. Parameters for various optimized, view planes reformatted from single 3D Fourier transform TSE acquisitions, B-F, were 720/40 and echo-train length, 11. Second axial oblique 3D TSE image is reformatted to show calcaneofibular ligament (arrow) to advantage. This ligament is typically not well seen on axial images oriented for best depiction of anterior talofibular ligament.

 

Figure 4
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  		Fig. 1D —Several anatomic structures in ankle and hindfoot of healthy 43-year-old male volunteer. Parameters for axial 2D turbo spin-echo (TSE) image, A, were TR/TE, 2,800/30 and echo-train length, 7. Parameters for various optimized, view planes reformatted from single 3D Fourier transform TSE acquisitions, B-F, were 720/40 and echo-train length, 11. Sagittal oblique 3D TSE image reformatted to course of flexor hallucis longus tendon (arrowheads) as it traverses tarsal tunnel.

 

Figure 5
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  		Fig. 1E —Several anatomic structures in ankle and hindfoot of healthy 43-year-old male volunteer. Parameters for axial 2D turbo spin-echo (TSE) image, A, were TR/TE, 2,800/30 and echo-train length, 7. Parameters for various optimized, view planes reformatted from single 3D Fourier transform TSE acquisitions, B-F, were 720/40 and echo-train length, 11. Axial oblique 3D TSE image reformatted to show both inferoplantar, longitudinal (arrowhead), and medioplantar oblique (arrow) portions of spring ligament. These structures are not consistently visualized on routine axial or sagittal 2D image acquisitions.

 

Figure 6
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  		Fig. 1F —Several anatomic structures in ankle and hindfoot of healthy 43-year-old male volunteer. Parameters for axial 2D turbo spin-echo (TSE) image, A, were TR/TE, 2,800/30 and echo-train length, 7. Parameters for various optimized, view planes reformatted from single 3D Fourier transform TSE acquisitions, B-F, were 720/40 and echo-train length, 11. Coronal oblique 3D TSE image reformatted to show separate fascicles of anterior tibiofibular ligament (arrowhead). This structure, which is deranged in high ankle sprain, is challenging diagnosis on routine 2D imaging. Tibiospring fibers of deltoid ligament (arrow) and tibiotalar joint are also well shown in this viewing plane.

 

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