Fast low-angle dual spin-echo (FLADE): a new robust pulse sequence for structural imaging of trabecular bone.

Mechanical strength and fracture resistance of trabecular bone (TB) are largely determined by the structural arrangement of individual trabeculae. Fast 3D spin-echo approaches are preferable to gradient echoes in that they are less sensitive to local induced gradients at the bone/marrow interface caused by magnetic susceptibility difference between the two tissues. FLASE is a 3D pulse sequence that serves this purpose. Here, we present a new pulse sequence dubbed FLADE (fast low-angle dual spin-echo) that overcomes some of the limitations inherent to FLASE, such as sensitivity to artifactual stimulated echoes. The double-echo sequence features a flip angle <90 degrees allowing for TR << T(1). The second phase-reversal pulse has the dual function of creating a second echo and restoring inverted longitudinal magnetization. The prolonged TR, made possible by sampling only half of k(z)-space, is used to collect navigator echoes in adjacent slabs for sensing subpixel translational displacements. FLADE is shown to provide SNR comparable to FLASE while having narrower point-spread function and being more robust to imperfections in the nonselective 180 degree pulses. Structural parameters derived from the in vivo images with the two pulse sequences are highly correlated, therefore suggesting that clinical data obtained with either pulse sequence can be merged.