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Meniscal calcifications: morphologic and quantitative evaluation by using 2D inversion-recovery ultrashort echo time and 3D ultrashort echo time 3.0-T MR imaging techniques--feasibility study.

ABSTRACT: To assess the ability of ultrashort echo time (UTE) magnetic resonance (MR) imaging techniques to enable morphologic assessment of different types of meniscal calcifications, to compare these sequences with standard clinical sequences, and to perform T2* measurements of meniscal calcifications.This study was exempted by the institutional review board, and informed consent was not required. Ten human cadaveric menisci were imaged with high-spatial-resolution radiography and 3.0-T MR imaging by using morphologic (T1-weighted fast spin-echo [FSE], T2-weighted FSE, proton density [PD]-weighted FSE, two-dimensional [2D] fast spoiled gradient-echo [FSPGR], three-dimensional [3D] FSPGR, and 3D UTE) and quantitative (2D inversion-recovery [IR] UTE and 3D UTE) sequences. The menisci were divided into thirds for regional analysis. Morphologic assessment was performed with MR imaging; MR imaging findings were correlated with radiographs. Calcifications were classified as punctate, linear, or globular. T2* measurements were performed by manual placement of regions of interest (ROIs) in calcifications and by automatically creating ROIs in the surrounding tissues. Mixed-effects linear regression was used to determine variations in T2* as a function of region, morphology, and tissue type.The two globular calcifications were visualized with all sequences. For punctate (n=21) and linear (n=21) calcifications, respectively, visibility rates were as follows: 9.5% for both with the T1-weighted FSE sequence, 0% for both with the T2-weighted FSE sequence, 19.0% and 23.8% with the PD-weighted FSE sequence, 0% for both with the 2D IR UTE sequence, 100% for both with the 3D UTE sequence, and 100% for both with the 3D FSPGR sequence. T2* values were significantly lower for calcifications than for the surrounding meniscal tissue (P<.001). There was a trend of globular calcifications having lower T2* values than other morphologies (P=.08). With the 2D IR UTE technique, the T2* of the globular calcifications tended to be lower than with the 3D UTE technique (0.13-0.16 vs 1.32-3.03 msec) (P=.14, analysis of variance).UTE MR imaging sequences may allow morphologic as well as quantitative evaluation of meniscal calcifications.

SUBMITTER: Omoumi P

PROVIDER: S-EPMC3380410 | biostudies-other | 2012 Jul

REPOSITORIES: biostudies-other

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Project description:Background Signal contamination from long T2 water is a major challenge in direct imaging of myelin with MRI. Nulling of the unwanted long T2 signals can be achieved with an inversion recovery (IR) preparation pulse to null long T2 white matter within the brain. The remaining ultrashort T2 signal from myelin can be detected with an ultrashort echo time (UTE) sequence. Purpose To develop patient-specific whole-brain myelin imaging with a three-dimensional double-echo sliding inversion recovery (DESIRE) UTE sequence. Materials and Methods The DESIRE UTE sequence generates a series of IR images with different inversion times during a single scan. The optimal inversion time for nulling long T2 signal is determined by finding minimal signal on the second echo. Myelin images are generated by subtracting the second echo image from the first UTE image. To validate this method, a prospective study was performed in phantoms, cadaveric brain specimens, healthy volunteers, and patients with multiple sclerosis (MS). A total of 20 healthy volunteers (mean age, 40 years ± 13 [standard deviation], 10 women) and 20 patients with MS (mean age, 58 years ± 8; 15 women) who underwent MRI between November 2017 and February 2019 were prospectively included. Analysis of variance was performed to evaluate the signal difference between MS lesions and normal-appearing white matter in patients with MS. Results High signal intensity and corresponding T2* and T1 of the extracted myelin vesicles provided evidence for direct imaging of ultrashort-T2 myelin protons using the UTE sequence. Gadobenate dimeglumine phantoms with a wide range of T1 values were selectively suppressed with DESIRE UTE. In the ex vivo brain study of MS lesions, signal loss was observed in MS lesions and was conformed with histologic analysis. In the human study, there was a significant reduction in normalized signal intensity in MS lesions compared with that in normal-appearing white matter (0.19 ± 0.10 vs 0.76 ± 0.11, respectively; P < .001). Conclusion The double-echo sliding inversion recovery ultrashort echo time sequence can generate whole-brain myelin images specifically with a clinical 3-T scanner. © RSNA, 2019 Online supplemental material is available for this article. See also the editorial by Port in this issue.

Project description:Background Water signal contamination is a major challenge for direct ultrashort echo time (UTE) imaging of myelin in vivo because water contributes most of the signals detected in white matter. Purpose To validate a new short repetition time (TR) adiabatic inversion recovery (STAIR) prepared UTE (STAIR-UTE) sequence designed to suppress water signals and to allow imaging of ultrashort T2 protons of myelin in white matter using a clinical 3-T scanner. Materials and Methods In this prospective study, an optimization framework was used to obtain the optimal inversion time for nulling water signals using STAIR-UTE imaging at different TRs. Numeric simulation and phantom studies were performed. Healthy volunteers and participants with multiple sclerosis (MS) underwent MRI between November 2018 and October 2019 to compare STAIR-UTE and a clinical T2-weighted fluid-attenuated inversion recovery sequence for assessment of MS lesions. UTE measures of myelin were also performed to allow comparison of signals in lesions and with those in normal-appearing white matter (NAWM) in patients with MS and in normal white matter (NWM) in healthy volunteers. Results Simulation and phantom studies both suggest that the proposed STAIR-UTE technique can effectively suppress long T2 tissues with a broad range of T1s. Ten healthy volunteers (mean age, 33 years ± 8 [standard deviation]; six women) and 10 patients with MS (mean age, 51 years ± 16; seven women) were evaluated. The three-dimensional STAIR-UTE sequence effectively suppressed water components in white matter and selectively imaged myelin, which had a measured T2* value of 0.21 msec ± 0.04 in the volunteer study. A much lower mean UTE measure of myelin proton density was found in MS lesions (3.8 mol/L ± 1.5), and a slightly lower mean UTE measure was found in NAWM (7.2 mol/L ± 0.8) compared with that in NWM (8.0 mol/L ± 0.8) in the healthy volunteers (P < .001 for both comparisons). Conclusion The short repetition time adiabatic inversion recovery-prepared ultrashort echo time sequence provided efficient water signal suppression for volumetric imaging of myelin in the brain and showed excellent myelin signal contrast as well as marked ultrashort echo time signal reduction in multiple sclerosis lesions and a smaller reduction in normal-appearing white matter compared with normal white matter in volunteers. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Messina and Port in this issue.

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Meniscal calcifications: morphologic and quantitative evaluation by using 2D inversion-recovery ultrashort echo time and 3D ultrashort echo time 3.0-T MR imaging techniques--feasibility study.

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