Learning objectives
The joint synovia is the first indicator of primary and secondary inflammated joint diseases.
Furthermore smallest cartilage and ligament pathologies chronic or traumatic need a high fluid contrast in order to be detected.
Background
T1 weightings are robust with a low artifact count,
while their high fat contrast allows them to produce excellent anatomic images.
The lack of fluid contrast,
however,
proves to be a disadvantage.
Inspired by a little-known publication by Radlbauer et al.
[1],
we have been using T1 RESTORE measurements in all joint diagnostics since June 2011,
adding a -90° pulse to the T1 sequence.
This option is also available for Turbo Spin Echo (TSE) sequences with turbo factor 3–4.
Findings and procedure details
Extending the TE echo times from 11 to 22 and 33 ms had a similar ‘whitening effect’.
The RESTORE version of the T1 measurement did not cause any significant increase to the measurement time.
High bandwidths (BW) were selected to produce as few chemical-shift artifacts as possible: 250 Hz/pixel for 1.5T and 450 Hz/pixel for 3T.
Adaptation of a standard T1 sequence: High bandwidth to ensure less chemical shift in the case of 1.5T BW 250 Hz/ pixel (less than 1 pixel shift).
450 Hz/...
Conclusion
- It is thanks to the moderate fluid contrast in the T1 RESTORE sequence that it is possible to depict the smallest synovial,
cartilage,
and ligament pathologies,
which are frequently concealed (at least partially) in the significantly sharper contrast of the conventional PD FS measurements.
- Furthermore,
PD FS sequences are often blurred due to their significantly greater susceptibility to artifacts,
which is why we always perform T1 measurements with a RESTORE pulse in joint diagnostics.
- Amongst other reasons,
this allows us to focus...
References
1.
Radlbauer R,
Lomoschitz F,
Salomonowitz E,
Eberhardt KE,
Stadlbauer A.
MR imaging of the knee: Improvement of signal and contrast of T1 Weighted turbo spin echo sequences by applying a driven equilibrium pulse (DRIVE).
Eur J Radiol.
2010 Aug;75(2).
2.
Hargreaves BA et al.
MR_Imaging of articular cartilage using driven equilibrium.
Magn Reson Med 1999,
42; 42:695-703
3.
Woertler K,
Fast high Resolution multislice T1 –weightedTSE Sequence with a driven Equilibrium(DRIVE) PulsAJR 2005 12 185
