Morphological MR imaging of the articular cartilage of the knee at 3 T : comparison of standard and novel 3D sequences

Objectives: This study sought to compare various 3D cartilage sequences and to evaluate the usefulness of ultrashort TE (UTE) imaging, a new technique to isolate signal from the osteochondral junction. Methods: Twenty knees were examined at 3 T with 3D spoiled GRE (FLASH), double-echo steady-state (DESS), balanced SSFP, 3D turbo spin-echo (TSE), and a prototype UTE sequence. Two radiologists independently evaluated all images. Consensus readings of all sequences were the reference standard. Statistical analysis included Friedman and pairwise Wilcoxon tests. Retrospective analysis of UTE morphology of osteochondral tissue in normal and abnormal cartilage seen at conventional MR was also performed. Results: Three-dimensional TSE was superior to other sequences for detecting cartilage lesions. FLASH and DESS performed best in the subjective quality analysis. On UTE images, normal cartilage exhibited a high-intensity linear signal near the osteochondral junction. Retrospective analysis revealed abnormal UTE morphology of the osteochondral junction in 50 % of cartilage lesions diagnosed at conventional MR. Conclusions: Cartilage imaging of the knee at 3 T can be reliably performed using 3D TSE, showing high accuracy when compared to standard sequences. Although UTE depicts signal from the deep cartilage layer, further studies are needed to establish its role for assessment of cartilage

Magnetic Resonance in Medicine 000:000–000 (2011) Ultrashort Echo Time Imaging Using Pointwise Encoding Time Reduction With Radial Acquisition (PETRA)

Sequences with ultrashort echo times enable new applications of MRI, including bone, tendon, ligament, and dental imaging. In this article, a sequence is presented that achieves the shortest possible encoding time for each k-space point, limited by pulse length, hardware switching times, and gradient performance of the scanner. In pointwise encoding time reduction with radial acquisition (PETRA), outer k-space is filled with radial half-projections, whereas the centre is measured single pointwise on a Cartesian trajectory. This hybrid sequence combines the features of single point imaging with radial projection imaging. No hardware changes are required. Using this method, 3D images with an isotropic resolution of 1 mm can be obtained in less than 3 minutes. The differences between PETRA and the ultrashort echo time (UTE) sequence are evaluated by simulation and phantom measurements. Advantages of pointwise encoding time reduction with radial acquisition are shown for tissue with a T2 below 1 ms. The signal to noise ratio and Contrast-tonoise ratio (CNR) performance, as well as possible limitations of the approach, are investigated. In-vivo head, knee, ankle, and wrist examples are presented to prove the feasibility of the sequence. In summary, fast imaging with ultrashort echo time is enabled by PETRA and may help to establish new routine clinical applications of ultrashort echo time sequences. Magn Reso

Magnetic Resonance in Medicine 67:510–518 (2012) Ultrashort Echo Time Imaging Using Pointwise Encoding Time Reduction With Radial Acquisition (PETRA)

Sequences with ultrashort echo times enable new applications of MRI, including bone, tendon, ligament, and dental imaging. In this article, a sequence is presented that achieves the shortest possible encoding time for each k-space point, limited by pulse length, hardware switching times, and gradient performance of the scanner. In pointwise encoding time reduction with radial acquisition (PETRA), outer k-space is filled with radial half-projections, whereas the centre is measured single pointwise on a Cartesian trajectory. This hybrid sequence combines the features of single point imaging with radial projection imaging. No hardware changes are required. Using this method, 3D images with an isotropic resolution of 1 mm can be obtained in less than 3 minutes. The differences between PETRA and the ultrashort echo time (UTE) sequence are evaluated by simulation and phantom measurements. Advantages of pointwise encoding time reduction with radial acquisition are shown for tissue with a T2 below 1 ms. The signal to noise ratio and Contrast-tonoise ratio (CNR) performance, as well as possible limitations of the approach, are investigated. In-vivo head, knee, ankle, and wrist examples are presented to prove the feasibility of the sequence. In summary, fast imaging with ultrashort echo time is enabled by PETRA and may help to establish new routine clinical applications of ultrashort echo time sequences. Magn Reso

MR neurographic orthopantomogram: Ultrashort echo-time imaging of mandibular bone and teeth complemented with high-resolution morphological and functional MR neurography

PURPOSE Panoramical radiographs or cone-beam computed tomography (CT) are the standard-of-care in dental imaging to assess teeth, mandible, and mandibular canal pathologies, but do not allow assessment of the inferior alveolar nerve itself nor of its branches. We propose a new technique for "MR neurographic orthopantomograms" exploiting ultrashort echo-time (UTE) imaging of bone and teeth complemented with high-resolution morphological and functional MR neurography. MATERIALS AND METHODS The Institutional Review Board approved the study in 10 healthy volunteers. Imaging of the subjects mandibles at 3.0T (Magnetom Skyra, Siemens-Healthcare) using a 64-channel head coil with isotropic spatial resolution for subsequent multiplanar reformatting, was performed. Bone images were acquired using a 3D PETRA sequence (TE, 0.07 msec). Morphological nerve imaging was performed using a dedicated 3D PSIF and 3D SPACE STIR sequence. Functional MR neurography was accomplished using a new accelerated diffusion-tensor-imaging (DTI) prototype sequence (2D SMS-accelerated RESOLVE). Qualitative and quantitative image analysis was performed and descriptive statistics are provided. RESULTS Image acquisition and subsequent postprocessing into the MR neurographic orthopantomogram by overlay of morphological and functional images were feasible in all 10 volunteers without artifacts. All mandibular bones and mandibular nerves were assessable and considered normal. Fiber tractography with quantitative evaluation of physiological diffusion properties of mandibular nerves yielded the following mean ± SD values: fractional anisotropy, 0.43 ± 0.07; mean diffusivity (mm(2) /s), 0.0014 ± 0.0002; axial diffusivity, 0.0020 ± 0.0002, and radial diffusivity, 0.0011 ± 0.0001. CONCLUSION The proposed technique of MR neurographic orthopantomogram exploiting UTE imaging complemented with high-resolution morphological and functional MR neurography was feasible and allowed comprehensive assessment of osseous texture and neural microarchitecture in a single examination. J. Magn. Reson. Imaging 2016

Free-Breathing Low-Field MRI of the Lungs Detects Functional Alterations Associated With Persistent Symptoms After COVID-19 Infection

OBJECTIVES: With the COVID-19 pandemic, repetitive lung examinations have become necessary to follow-up symptoms and associated alterations. Low-field MRI, benefiting from reduced susceptibility effects, is a promising alternative for lung imaging to limit radiations absorbed by patients during CT examinations, which also have limited capability to assess functional alterations. The aim of this investigative study was to explore the functional abnormalities that free-breathing 0.55 T MRI in combination with the phase-resolved functional lung (PREFUL) analysis could identify in patients with persistent symptoms after COVID-19 infection. MATERIALS AND METHODS: Seventy-four COVID-19 patients and 8 healthy volunteers were prospectively scanned in free-breathing with a balanced steady-state free-precession sequence optimized at 0.55 T, 5 months postinfection on average. Normalized perfusion (Q), fractional ventilation (FV), and flow-volume loop correlation (FVLc) maps were extracted with the PREFUL technique. Q, FV, and FVLc defects as well as defect overlaps between these metrics were quantified. Morphological turbo-spin-echo images were also acquired, and the extent of abnormalities was scored by a board-certified radiologist. To investigate the functional correlates of persistent symptoms, a recursive feature elimination algorithm was applied to find the most informative variables to detect the presence of persistent symptoms with a logistic regression model and a cross-validation strategy. All MRI metrics, sex, age, body mass index, and the presence of preexisting lung conditions were included. RESULTS: The most informative variables to detect persistent symptoms were the percentage of concurrent Q and FVLc defects and of areas free of those defects. A detection accuracy of 71.4% was obtained with these 2 variables when fitting the model on the entire dataset. Although none of the single variables differed between patients with and without persistent symptoms ( P > 0.05), the combined score of these 2 variables did ( P < 0.02). This score also showed a consistent increase from healthy volunteers (7.7) to patients without persistent symptoms (8.2) and with persistent symptoms (8.6). The morphological abnormality score showed poor correlation with the functional parameters. CONCLUSIONS: Functional pulmonary examinations using free-breathing 0.55 T MRI with PREFUL analysis revealed potential quantitative markers of impaired lung function in patients with persistent symptoms after COVID-19 infection, potentially complementing morphologic imaging. Future work is needed to explore the translational relevance and clinical implication of these findings