Optimizing Musculoskeletal Imaging: When and How to Use Ultrashort Echo Time Magnetic Resonance Imaging Sequences

Purpose or Learning Objective: To explore the appropriate use of ultrashort echo time (UTE) magnetic resonance imaging (MRI) sequences for musculoskeletal (MSK) imaging, highlighting their benefits and optimal application.

Methods or Background: UTE MRI sequences offer unique advantages in MSK imaging, particularly in visualizing tissues with very short T2* relaxation times. We present insights from a retrospective review of MRIs conducted at our institution, focusing on the indications and techniques for incorporating UTE sequences into clinical practice. A comprehensive review of MSK MRIs was undertaken, analyzing cases where both conventional sequences and UTE sequences were used. The rationale behind selecting UTE sequences, imaging planes, and imaging protocols, and the potential clinical scenarios where UTE sequences can provide additional diagnostic value are highlighted and discussed. Some of these illustrate optimal use for imaging the glenohumeral and hip joints, talar dome, as well as the spine and sacroiliac joints.

Results or Findings: The analysis underscores the importance of incorporating UTE sequences judiciously into MSK MRI protocols. Specific clinical scenarios, such as assessment of bony contour, benefit from the unique contrast and isotropic properties provided by UTE sequences. We also highlighted techniques for optimizing image acquisition parameters to maximize the usefulness of UTE sequences in various MSK pathologies.

Conclusion: Understanding when and how to use UTE MRI sequences is essential for optimizing MSK imaging. We offered guidance on the appropriate indications, techniques, and clinical scenarios where UTE sequences can enhance diagnostic accuracy and provide valuable insights into MSK pathologies.

Publication History

Article published online:
22 May 2024