Seminars in musculoskeletal radiology
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Semin Musculoskelet Radiol · Sep 2009
Comparative StudyPediatric musculoskeletal imaging at 3 Tesla.
High signal-to-noise ratio (SNR) and the ability to acquire high-resolution thin section images are major advantages of 3 Tesla (T) that benefit musculoskeletal (MSK) imaging. Use of 3 T for pediatric MSK imaging is still in its early phase, and actual clinical benefits are not yet clear. However, initial reports in adult and our experience suggest that 3 T is better in imaging cartilage and small joints. ⋯ It shows cartilage, ligaments, and nerves better. After optimization, overall examination time is shorter at 3 T, which has the potential to reduce the need for sedation and increase throughput. 3-T imaging has the potential to improve small lesion evaluation and tumor staging, and it can be used for whole-body screening for metastasis. We discuss the technical differences, artifacts, and safety issues of 3 T, followed by our initial clinical experience with illustrative examples in pediatric MSK imaging at 3 T.
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For bone marrow screening, multimodality algorithms including conventional radiographs, bone scintigraphy, multislice computed tomography CT (MS-CT) scan, and dedicated magnetic resonance imaging (MRI) are widely established in clinical routine. Although radiographs are used as a basic imaging procedure for clarification of suspected focal bone pathologies, low sensitivity has been reported for the detection of limited osteolytic bone marrow destruction. Therefore, skeletal scintigraphy often is used as a more sensitive and integrated method in patients with suspected malignant bone marrow disease. ⋯ WB-MRI has successfully been applied for screening of bone metastases and hematologic bone marrow diseases, like multiple myeloma, lymphoma, and histiocytosis X. Furthermore, it has recently been proposed for the assessment of primarily benign bone diseases predisposing for malignancy (e.g., multiple cartilaginous exostoses). This article provides an overview of state-of-art whole-body imaging of the bone marrow and highlights present and potential future applications, especially in the field of WB-MRI.
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This article reviews the technical principles of novel contrast mechanisms for musculoskeletal imaging. Ultrashort echo-time imaging allows the visualization of fast T2 relaxing tissue components that are not directly detectable by standard magnetic resonance imaging. ⋯ Finally, diffusion-weighted imaging represents a further technique to detect bone marrow pathologies or indicate collagen degradation and water content in cartilage. The technical details and implementation techniques of these dedicated imaging modalities are demonstrated and reviewed in this article, and some clinical examples are presented.
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Magnetic resonance imaging (MRI) has developed dramatically in the 25 years since its clinical introduction. Advances in hardware design have included the development of high field magnets and more sophisticated and sensitive coils. Improvements in sequences, data sampling, and postprocessing software have benefited the attainable spatial and temporal resolution to the point at which the fine depiction of anatomical structure and pathological processes is now routine. ⋯ Particular benefits are seen in diagnostic imaging of the spine where MRI is clearly superior to both conventional radiography and computed tomography. In this article, we discuss the impact of the most recent technological advance in MRI, namely the advent of 3 Tesla (3-T) imaging, on diagnostic imaging of the spine. Comparisons are drawn with imaging at 1.5 T, and emphasis is placed on MR physics and on the benefits and principal difficulties associated with spine imaging at high field strength.
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Semin Musculoskelet Radiol · Sep 2008
ReviewTechnical considerations and potential advantages of musculoskeletal imaging at 3.0 Tesla.
High field magnetic resonance imaging at 3.0 T is rapidly gaining clinical acceptance as the preferred platform for magnetic resonance (MR) imaging. This is spurred in part because advances in the manufacture of magnet technology have brought the cost of 3.0-T magnets into the range of previous 1.5-T machines, as well as ongoing research demonstrating numerous advantages of 3.0 T over 1.5 T in neurological imaging. ⋯ Many issues must be considered beyond what might be expected from simply doubling the field strength, including hardware design, protocol modifications because of changes in tissue characteristics at higher fields, artifact reduction, and safety. This article addresses many of these concerns, focusing on techniques to optimize high field MR imaging of the musculoskeletal system.