Musculoskeletal 3D MRI: A Decade of Developments and Innovations Coming to Fruition

Three-dimensional magnetic resonance imaging (3D MRI) with isotropic high spatial resolution data sets has advanced into a key technology for multiple advanced musculoskeletal (MSK) imaging applications, such as dynamic multiplanar evaluation of small and complex anatomical structures, curved multiplanar reformation of long-winded structures (e.g., nerves and tendons), the realization of efficient joint and whole-body MRI protocols, and advanced MR image reformations, including the creation of cartilage maps, as well as volume rendering and cinematic rendering-type 3D MR images.[1] [2] [3]

Gradient-echo pulse sequences predominated in the early days of 3D MRI because the short repletion times permitted clinically feasible acquisition times and easier accomplished echo train designs.[4] [5] However, because gradient-echo pulse sequences are limited to T2* contrasts, developing and refining spin-echo–based 3D MRI pulse sequences became a priority.[6] [7] Like two-dimensional (2D) MRI, 3D fast/turbo spin-echo–based pulse sequences can create true intermediate- and T2-weighted contrast weightings that are most versatile for MSK MRI.[8] [9] [10]

Innovation and developments during the past decade have advanced both gradient and fast/turbo spin-echo–based pulse sequences substantially. One of the most relevant advancements was implementing advanced acceleration techniques, such as parallel imaging and compressed sensing-based undersampling, that achieve unprecedented four- to sixfold faster pulse sequence acquisitions.[11] [12] [13] In practice, accelerated high-resolution 3D gradient-echo and 3D fast/turbo spin-echo data sets can now often be acquired in <3 and <5 minutes, respectively.[14] [15] All major vendors offer different varieties of these modern 3D pulse sequences: SPACE (Siemens Healthcare, Erlangen, Germany), CUBE (GE Healthcare, Chicago, IL), VISTA (Philips Healthcare, Eindhoven, Netherlands), mVox (Canon Medical Systems, Otawara, Japan), and isoFSE (Hitachi Medical, Tokyo, Japan).

Refined flip angle modulation schemes have improved contrast resolutions of 3D pulse sequences that are now much closer to 2D MRI contrasts and span the entire spectrum from T1-weighted over intermediate- to T2-weighted contrasts.[16] [17] [18] The implementation of more advanced fat suppression techniques, such as selective water excitation, combined chemical shift and inversion recovery fat suppression, and Dixon techniques, have further improved the quality and homogeneity of 3D-based fat suppression, as well as fluid conspicuity.

The traditional 3D pulse sequence family has been expanded by zero and ultrashort echo time pulse sequences that can derive signal from bone and create synthetic computed tomography-like MR images.[19] In addition, PSIF-type pulse sequences (reverse FISP, i.e., fast imaging with steady-state free precession) permit the inclusion of diffusion weighting components to increase the specificity of neural elements and MR neurography.[20]

Although the higher signal-to-noise ratios of 3-T field strength provide many advantages for 3D MRI, such as higher possible spatial resolution, faster sampling, or combinations thereof, all techniques are equally available and technically feasible at 1.5-T field strength.[21]

This issue of Seminars in Musculoskeletal Radiology, “3D MRI of the Musculoskeletal System,” features 14 concise state-of-the-art 3D MRI summaries and practical guides for the clinical spectrum of applications within MSK imaging. The author groups comprise world experts in MSK 3D MRI, who based their articles on practical experiences gleaned from the daily clinical use of 3D MRI. The 14 articles cover the technical aspects of 3D MRI methods,[22] how to create 3D MRI models,[23] 3D MRI of articular cartilage,[24] 3D MR neurography,[25] 3D MRI in orthopaedic oncology[26] and rheumatology,[27] 3D MRI of the spine,[28] 3D whole-body MRI,[29] 3D MRI of the knee,[30] and osteoarthritis,[31] as well as 3D MRI of the shoulder,[32] hip,[33] wrist and hand,[34] as well as 3D MRI of the ankle and foot.[35]

I am grateful to each author group for their superb contributions and dedication to writing manuscripts during the COVID-19 pandemic. We hope these articles about state-of-the-art 3D MRI will embolden the MSK community to continue to expand the boundaries, explore new applications, and inspire others to join in using 3D MRI.

Publikationsverlauf

Artikel online veröffentlicht:
21. September 2021

• References

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• 18 Kalia V, Fritz B, Johnson R, Gilson WD, Raithel E, Fritz J. CAIPIRINHA accelerated SPACE enables 10-min isotropic 3D TSE MRI of the ankle for optimized visualization of curved and oblique ligaments and tendons. Eur Radiol 2017; 27 (09) 3652-3661
• 19 Breighner RE, Endo Y, Konin GP, Gulotta LV, Koff MF, Potter HG. Technical developments: zero echo time imaging of the shoulder: enhanced osseous detail by using MR imaging. Radiology 2018; 286 (03) 960-966
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• 22 Del Grande F, Natalie Hinterholzer N, Nanz D. 3D MRI: technical considerations and practical integration. Semin Musculoskelet Radiol 2021; 25: 381-387
• 23 Samim M. 3D MRI models of the musculoskeletal system. Semin Musculoskelet Radiol 2021; 25: 388-396
• 24 Kijowski R. 3D MRI of articular cartilage. Semin Musculoskelet Radiol 2021; 25: 397-408
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• 27 Ezzati F, Chalian M, Pezeshk P. 3D MRI of the rheumatic diseases. Semin Musculoskelet Radiol 2021; 25: 425-432
• 28 Sahr M, Tsoon Tan E, Sneag D. 3D MRI of the spine. Semin Musculoskelet Radiol 2021; 25: 433-440
• 29 Pasoglou V, Nieuwenhove S, Peeters F. et al. 3D whole-body MRI of the musculoskeletal system. Semin Musculoskelet Radiol 2021; 25: 441-454
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• 33 Ashikyan O, Wells J, Chhabra A. 3D MRI of the hip joint: technical considerations, advantages, applications, and current perspectives. Semin Musculoskelet Radiol 2021; 25: 488-500
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