Zero Echo Time Magnetic Resonance Imaging; Techniques and Clinical Utility in Musculoskeletal System.

Zero echo time (ZTE) sequence is recent advanced magnetic resonance technique that utilizes ultrafast readouts to capture signals from short-T2 tissues. This sequence enables T2- and T2* weighted imaging of tissues with short intrinsic relaxation times by using an extremely short TE, and are increasingly used in the musculoskeletal system. We review the imaging physics of these sequences, practical limitations, and image reconstruction, and then discuss the clinical utilities in various disorders of the musculoskeletal system. ZTE can be readily incorporated into the clinical workflow, and is a promising technique to avoid unnecessary radiation exposure, cost, and time-consuming by computed tomography in some cases. LEVEL OF EVIDENCE: 4 TECHNICAL EFFICACY: Stage 1.

[Accuracy of VSRAD Analysis Using Scout Images: Comparison with Conventional 3D-T1WI].

The voxel-based specific regional analysis system for Alzheimer's disease (VSRAD), which targets volume loss in medial temporal lobe, was developed as a sensitive diagnostic tool to detect early stages of Alzheimer's disease. However, conventional three-dimensional T1 -weighted image (3D-T1WI) for VSRAD analysis acquires relatively long acquisition time. Recently, it became possible to acquire Scout images (Scout) for positioning as a 3D image in a short time. The aim of this study was to determine whether Scout was reliable in VSRAD. We measured voxel-based analysis of gray matter volume using VBM and Z-score of medial temporal lobe atrophy using VSRAD advance 2 from conventional 3D-T1WI and Scout. It showed significantly different gray mass between conventional 3D-T1WI and Scout. However, there was no significant difference in Z-score (p=0.41). The Z-scores measured from Scout and conventional 3D-T1WI were significantly correlated (r=0.96, p<0.05). There is a possibility that Scout can be used to detect brain morphometry abnormalities instead of conventional 3D-T1WI in the VSRAD analysis.

Correction to: Ultrashort time-to-echo quantitative magnetic resonance imaging of the triangular fibrocartilage: differences in position.

The original version of this article, published on 03 September 2018, unfortunately contained a mistake.

Ultrashort time-to-echo quantitative magnetic resonance imaging of the triangular fibrocartilage: differences in position.

PURPOSE: To compare T2* values of the triangular fibrocartilage (TFC) obtained by ultrashort time-to-echo (UTE) techniques at the neutral position, ulnar flexion of the wrist, and pronation of the forearm. MATERIALS AND METHODS: MR imaging was performed in ten healthy volunteers with a 3-T MR system by using an eight-channel knee coil. Coronal wrist T2* maps from three-dimensional cone UTE pulse sequences were obtained at the neutral, ulnar flexion, and pronation positions (TR: 19 ms, TE: 0.032 ms/4 ms/8 ms/12 ms, FOV: 18 cm, matrix: 430 × 430, section thickness: 1.5 mm, scan time: 8 min 31 s). UTE-T2* maps were calculated on a pixel-by-pixel basis for all structures of the wrist visualized in the coronal planes. The entire region of interest (ROI) for TFC was manually delineated, and the average T2* value was calculated for each ROI by three radiologists. The Kruskal-Wallis test, Wilcoxon signed-rank test, or intraclass correlation coefficients (ICC) were used for statistics. RESULTS: The difference in the average T2* value among the three groups according to the forearm/wrist position was significant (p < 0.001). The T2* value of the TFC at pronation (mean ± 2 SD: 7.92 ± 1.37 ms) was significantly lower than those at the neutral (10.08 ± 1.90 ms) and ulnar flexion positions (9.15 ± 1.03 ms) (p < 0.017). The ICC showed a substantial interobserver agreement in the T2* value measurements of the TFC (ICC = 0.986). CONCLUSION: T2* relaxation time measurement of the TFC using UTE may be useful for assessing the loading effect by the forearm/wrist position. KEY POINTS: • The T2* value of the TFC may reflect the biomechanics of the wrist joint. • Acute loading at pronation results in a decrease in the T2* value of the TFC. • Quantitative wrist UTE MRI was successfully performed in vivo.

Utility of real-time prospective motion correction (PROMO) for segmentation of cerebral cortex on 3D T1-weighted imaging: Voxel-based morphometry analysis for uncooperative patients.

OBJECTIVE: To assess the utility of the motion correction method with prospective motion correction (PROMO) in a voxel-based morphometry (VBM) analysis for 'uncooperative' patient populations. METHODS: High-resolution 3D T1-weighted imaging both with and without PROMO were performed in 33 uncooperative patients with Parkinson's disease (n = 11) or dementia (n = 22). We compared the grey matter (GM) volumes and cortical thickness between the scans with and without PROMO. RESULTS: For the mean total GM volume with the VBM analysis, the scan without PROMO showed a significantly smaller volume than that with PROMO (p < 0.05), which was caused by segmentation problems due to motion during acquisition. The whole-brain VBM analysis showed significant GM volume reductions in some regions in the scans without PROMO (familywise error corrected p < 0.05). In the cortical thickness analysis, the scans without PROMO also showed decreased cortical thickness compared to the scan with PROMO (p < 0.05). CONCLUSION: Our results with the uncooperative patients indicate that the use of PROMO can reduce misclassification during segmentation of the VBM analyses, although it may not prevent GM volume reduction. KEY POINTS: • Motion artifacts pose significant problems for VBM analyses. • PROMO correction can reduce the motion artifacts in high-resolution 3D T1WI. • The use of PROMO may improve the precision of VBM analyses.

Utility of real-time prospective motion correction (PROMO) on 3D T1-weighted imaging in automated brain structure measurements.

PROspective MOtion correction (PROMO) can prevent motion artefacts. The aim of this study was to determine whether brain structure measurements of motion-corrected images with PROMO were reliable and equivalent to conventional images without motion artefacts. The following T1-weighted images were obtained in healthy subjects: (A) resting scans with and without PROMO and (B) two types of motion scans ("side-to-side" and "nodding" motions) with and without PROMO. The total gray matter volumes and cortical thicknesses were significantly decreased in motion scans without PROMO as compared to the resting scans without PROMO (p < 0.05). Conversely, Bland-Altman analysis indicated no bias between motion scans with PROMO, which have good image quality, and resting scans without PROMO. In addition, there was no bias between resting scans with and without PROMO. The use of PROMO facilitated more reliable brain structure measurements in subjects moving during data acquisition.

Improved Detection of Cortical Gray Matter Involvement in Multiple Sclerosis with Quantitative Susceptibility Mapping.

RATIONALE AND OBJECTIVES: Quantitative susceptibility mapping (QSM) is a novel technique which allows determining the bulk magnetic susceptibility distribution of tissue in vivo from gradient echo magnetic resonance (MR) phase images. Our purpose was to evaluate if there is additional diagnostic value of QSM images in detecting the cortical gray matter involvement in multiple sclerosis (MS) patients. MATERIALS AND METHODS: Our institutional review board approved this study. Conventional MR imaging, including T2-weighted imaging and two- or three-dimensional fluid-attenuated inversion recovery images, and QSM imaging examinations were performed in 27 patients (19 male and eight female) with MS. Two radiologists (radiologists 1 and 2) assessed the MS lesions in the following 3 anatomic regions: intracortical, mixed white matter-gray matter (WM-GM), and juxtacortical regions. The numbers of lesions per region category were compared between conventional MR images with and without QSM images. RESULTS: For radiologists 1 and 2, QSM images identified 6 (50.0%) and 7 (50.0%) additional lesions that were not seen in the conventional MR images, respectively. In a lesion-by-lesion analysis, the substantial fraction (20 [25.3%] of 79 at radiologist 1, 22 [29.7%] of 74 at radiologist 2) of juxtacortical white matter lesions on the conventional MR images were scored as mixed WM-GM lesions with QSM images. CONCLUSIONS: Our preliminary results suggest that the MR imaging with QSM may increase the sensitivity in cortical lesion detection in the MS brain and improved distinction between juxtacortical and mixed WM-GM lesions.