HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Gerdes, C. M. Articles by Reeder, S. B. Search for Related Content PubMed PubMed Citation Articles by Gerdes, C. M. Articles by Reeder, S. B. Social Bookmarking                      What's this? Hotlight (NEW!) What's Hotlight?

IDEAL Imaging of the Musculoskeletal System: Robust Water–Fat Separation for Uniform Fat Suppression, Marrow Evaluation, and Cartilage Imaging

¹ Department of Radiology, University of Wisconsin, Madison, WI.
² Present address: Medford Radiological Group, 842 E Main St., Medford, OR 97504.
³ Departments of Medical Physics, Biomedical Engineering, and Medicine, University of Wisconsin, Madison, WI.

View larger version (88K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1A —41-year-old man with foot pain. Sagittal fat-saturated T2-weighted fast spin-echo image (1.5 T, TR/TE = 2,200/58, field of view = 26 cm, slice = 4 mm, 256 x 224, acquisition time = 2 minutes 52 seconds) of foot shows multiple areas of failed chemical shift selective fat suppression within midfoot (arrow) and forefoot (arrowhead).

View larger version (94K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1B —41-year-old man with foot pain. Corresponding sagittal iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) T2-weighted fast spin-echo water image (1.5 T, 2,200/60, field of view = 26 cm, slice = 4 mm, 256 x 224, acquisition time = 4 minutes 24 seconds) shows robust, uniform fat suppression within foot.

View larger version (118K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2A —Asymptomatic 35-year-old man. Coronal fat-saturated T2-weighted fast spin-echo image (1.5 T, TR/TE = 2,200/60, field of view = 22 cm, slice = 3 mm, 256 x 224, acquisition time = 2 minutes 52 seconds) of hand shows failure of chemically selective fat-saturation pulse within first metacarpal (arrow) because of field inhomogeneity created by challenging geometry of hand.

View larger version (106K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2B —Asymptomatic 35-year-old man. Corresponding coronal iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) T2-weighted fast spin-echo water image (1.5 T, 2,200/62, field of view = 22 cm, slice = 3 mm, 256 x 224, acquisition time = 5 minutes 4 seconds) shows uniform fat suppression unaffected by magnetic field inhomogeneity and geometry of hand and fingers.

View larger version (101K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —33-year-old woman with hand pain and swelling. Coronal contrast-enhanced fat-saturated T1-weighted spin-echo image (1.5 T, TR/TE = 700/10, field of view = 32 cm, slice = 4 mm, 256 x 192, acquisition time = 2 minutes 40 seconds) of wrist and forearm using large field of view to cover area of interest shows high T1 signal within osseous structures of first digit and overlying soft tissues (arrows), raising concern for cellulitis with associated osteomyelitis.

View larger version (102K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —33-year-old woman with hand pain and swelling. Corresponding coronal contrast-enhanced iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) T1-weighted fast spin-echo image (1.5 T, 500/16, field of view = 32 cm, slice = 4 mm, 256 x 192, acquisition time = 5 minutes 42 seconds) shows no abnormal signal within osseous structures. However, diffuse inflammatory enhancement is seen within soft tissues of hand (arrows), confirming presence of cellulitis.

View larger version (124K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4A —57-year-old HIV-positive man with bilateral hip pain. Coronal STIR image (3 T, TR/TE = 6,250/40, inversion time = 130 milliseconds, field of view = 36 cm, slice = 5 mm, 256 x 192, acquisition time = 4 minutes 42 seconds) of pelvis reveals high-signal edema within both acetabuli (arrows). There is associated linear area of low signal within right acetabulum (arrowhead), which suggests presence of insufficiency fracture.

View larger version (127K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4B —57-year-old HIV-positive man with bilateral hip pain. Corresponding coronal iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) T2-weighted fast spin-echo water image (3 T, 3,567/82, field of view = 36 cm, slice = 5 mm, 320 x 256, acquisition time = 4 minutes 59 seconds) also shows high-signal edema within both acetabuli (arrows) with associated linear area of low signal within right acetabulum (arrowhead). Improved signal-to-noise ratio and higher resolution of IDEAL image allow better visualization of trabecular detail.

View larger version (96K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5A —37-year-old woman with postoperative knee pain. Sagittal fat-saturated T2-weighted fast spin-echo image (3 T, TR/TE = 5,367/83, field of view = 14 cm, slice = 4 mm, 384 x 224, acquisition time = 3 minutes 19 seconds) of knee shows large areas of failed chemical selective fat suppression in distal femur (arrows) and proximal tibia (arrowheads) due to field inhomogeneity from patient's orthopedic hardware.

View larger version (111K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5B —37-year-old woman with postoperative knee pain. Corresponding sagittal 3D iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) spoiled gradient-recalled echo image (3 T, 12.1/5.75, field of view = 16 cm, slice = 1.2 mm, 512 x 224, flip angle = 14°, acquisition time = 4 minutes 45 seconds) shows uniform robust fat suppression within knee.

View larger version (137K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 6 —15-year-old girl with knee pain and swelling. Sagittal contrast-enhanced 3D iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) spoiled gradient-recalled echo image (3 T, TR/TE = 10.9/4.6, field of view = 16 cm, slice = 1.2 mm, 512 x 224, flip angle = 14°, acquisition time = 4 minutes 45 seconds) of knee shows thickened and nodular enhancing synovium (arrows), which is consistent with synovitis.

View larger version (72K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 7 —48-year-old man with foot pain and swelling. Sagittal contrast-enhanced iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) T1-weighted fast spin-echo image (1.5 T, TR/TE = 567/16, field of view = 16 cm, slice = 4 mm, 256 x 224, acquisition time = 4 minutes 45 seconds) of foot allows radiologist to be confident abnormal signal within bone (arrows) and adjacent soft tissues (arrowheads) is enhancement due to osteomyelitis and cellulitis and not inhomogeneous fat suppression.

View larger version (153K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 8A —Coronal iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) images (3 T, TR/TE = 3,567/82, field of view = 36 cm, slice = 5 mm, 256 x 192) of 48-year-old man with bilateral hip pain. Both images were acquired during single acquisition (4 minutes 59 seconds). In-phase image of pelvis shows geographic intermediate signal within both proximal femurs (arrows).

View larger version (152K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 8B —Coronal iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) images (3 T, TR/TE = 3,567/82, field of view = 36 cm, slice = 5 mm, 256 x 192) of 48-year-old man with bilateral hip pain. Both images were acquired during single acquisition (4 minutes 59 seconds). Opposed-phase image shows signal drop (arrows) in areas corresponding to intermediate signal on in-phase image, which confirms normal red marrow.

View larger version (110K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 9A —65-year-old man with osseous metastatic disease of spine. All four sagittal iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) T2-weighted fast spin-echo images (3 T, TR/TE = 3,900/98, field of view = 32 cm, slice = 4 mm, 320 x 224) of lumbar spine were acquired simultaneously during single acquisition (4 minutes 18 seconds). Large arrowhead = T12 vertebral body, arrow = posterior L5 vertebral body, and small arrowhead = entire S1 vertebral body. IDEAL water image shows marrow signal abnormality within anterior T12 vertebral body, posterior L5 vertebral body, and entire S1 vertebral body.

View larger version (111K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 9B —65-year-old man with osseous metastatic disease of spine. All four sagittal iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) T2-weighted fast spin-echo images (3 T, TR/TE = 3,900/98, field of view = 32 cm, slice = 4 mm, 320 x 224) of lumbar spine were acquired simultaneously during single acquisition (4 minutes 18 seconds). Large arrowhead = T12 vertebral body, arrow = posterior L5 vertebral body, and small arrowhead = entire S1 vertebral body. Corresponding IDEAL fat image shows absence of fat signal within involved vertebral bodies.

View larger version (115K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 9C —65-year-old man with osseous metastatic disease of spine. All four sagittal iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) T2-weighted fast spin-echo images (3 T, TR/TE = 3,900/98, field of view = 32 cm, slice = 4 mm, 320 x 224) of lumbar spine were acquired simultaneously during single acquisition (4 minutes 18 seconds). Large arrowhead = T12 vertebral body, arrow = posterior L5 vertebral body, and small arrowhead = entire S1 vertebral body. Corresponding IDEAL in-phase (C) and IDEAL opposed-phase (D) images show no signal drop in involved vertebral bodies, which indicates presence of metastatic disease.

View larger version (122K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 9D —65-year-old man with osseous metastatic disease of spine. All four sagittal iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) T2-weighted fast spin-echo images (3 T, TR/TE = 3,900/98, field of view = 32 cm, slice = 4 mm, 320 x 224) of lumbar spine were acquired simultaneously during single acquisition (4 minutes 18 seconds). Large arrowhead = T12 vertebral body, arrow = posterior L5 vertebral body, and small arrowhead = entire S1 vertebral body. Corresponding IDEAL in-phase (C) and IDEAL opposed-phase (D) images show no signal drop in involved vertebral bodies, which indicates presence of metastatic disease.

View larger version (102K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 10A —Asymptomatic 29-year-old man. Sagittal 3D iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) spoiled gradient-recalled echo image (3 T, TR/TE = 10.9/5.4, field of view = 16 cm, slice = 1.2 mm, 512 x 224, flip angle = 14°, acquisition time = 4 minutes 45 seconds) of knee shows excellent contrast between high-signal articular cartilage (arrow) and low-signal-intensity synovial fluid (arrowhead).

View larger version (96K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 10B —Asymptomatic 29-year-old man. Corresponding sagittal 3D IDEAL nonspoiled gradient-recalled echo acquisition in steady-state image (3 T, 10.9/5.4, field of view = 16 cm, slice = 1.2 mm, 512 x 224, flip angle = 50°, acquisition time = 4 minutes 45 seconds) of knee shows excellent contrast between intermediate-signal articular cartilage (arrow) and high-signal synovial fluid (arrowhead).

View larger version (127K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 11A —18-year-old man with knee pain. Of incidental note is bipartite patella (arrowhead). Sagittal fat-suppressed T2-weighted fast spin-echo image (3 T, TR/TE = 4,967/81, field of view = 14 cm, slice = 4 mm, 384 x 224, acquisition time = 3 minutes 4 seconds) of knee shows normal articular cartilage on femoral trochlea.

View larger version (149K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 11B —18-year-old man with knee pain. Of incidental note is bipartite patella (arrowhead). Corresponding sagittal 3D iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) spoiled gradient-recalled echo image (3 T, 10.9/5.4, field of view = 16 cm, slice = 1.2 mm, 512 x 224, flip angle = 14°, acquisition time - 4 minutes 45 seconds) shows small superficial partial-thickness cartilage defect on femoral trochlea (arrow).

CiteULike

Complore

Connotea

Del.icio.us

Digg

Reddit

Technorati