J Korean Soc Magn Reson Med.  2013 Jun;17(2):110-122. 10.13104/jksmrm.2013.17.2.110.

Quantitative Assessment and Ligament Traceability of Volume Isotropic Turbo Spin Echo Acquisition (VISTA) Ankle Magnetic Resonance Imaging: Fat Suppression versus without Fat Suppression

• Cho KE
• Yoon CS
• Song HT
• Lee YH
• Lim D
• Suh JS
• Kim S

• KMID: 2099870
• DOI: http://doi.org/10.13104/jksmrm.2013.17.2.110

Abstract

PURPOSE
To compare the image quality and ligament traceability in ankle images obtained using Volume Isotropic Turbo Spin Echo Acquisition (VISTA) MRI with and without fat suppression.
MATERIALS AND METHODS
The signal-to-noise ratios (SNRs) in images from a phantom and from the ankle of a volunteer were compared. Ten ankles from 10 non-symptomatic volunteers were imaged for comparisons of contrast ratio (CR) and ligament traceability. All examinations were performed using VISTA sequences with and without fat suppression on a 3T MRI scanner. The SNRs were obtained from images with subjects and without subjects (noise-only). Contrast ratios from images of the 10 ankles were acquired between fluid and tendon (F-T), F-cartilage (C), F-ligament (L), fat (f)-T, f-C and f-L. Two musculoskeletal radiologists independently scored the traceability of 7 ligaments, in sagittal, axial and coronal images respectively, based on a 4-point scale (1 as not traceable through 4 as clearly traceable). The Wilcoxon signed-rank test was used to compare the CR. Fisher's exact test and Pearson's chi-squared test were used to compare the ligament traceability.
RESULTS
The SNRs did not differ significantly between the two sequences except in bone marrow. VISTA SPAIR showed the higher CR only in F-T (p = 0.04), whereas VISTA showed higher CR in f-T (p = 0.005), f-C (p = 0.005) and f-L (p = 0.005). The calcaneofibular ligament traceability with VISTA was superior to that obtained with VISTA SPAIR (p < 0.05) in all planes.
CONCLUSION
VISTA showed significant superiority to VISTA SPAIR in tracing CFL due to the superior CR between fat and ligament.

Keyword

Magnetic resonance imaging (MRI); Ankle; 3D isotropic imaging; Fat suppression; Ligaments

MeSH Terms

Animals
Ankle
Bone Marrow
Ligaments
Magnetic Resonance Spectroscopy
Magnetics
Magnets
Signal-To-Noise Ratio
Tendons

Figure

• 

  Fig. 1 Signal to noise ratio (SNR) analysis from images obtained from a phantom (a, b) and a non symptomatic volunteer (c-f) using Volume Isotropic Turbo Spin Echo Acquisition (VISTA) sequence. (a, b) A bottle phantom containing white mineral oil (liquid petroleum at 20℃) 27 cm in height with a 2000 ml capacity was scanned (a). To calculate the SNR, 430.12 mm2 sized region-of-interests (ROIs) were placed at the same position in the reconstructed object images (a) to measure mean signal intensities. The region-of-interest was duplicated in the noise-only reconstruction image (b) to measure noise on console. (c-f) ROIs were placed in the respective tissues, including fluid (c, d), cartilage (not seen), bone marrow (e, f) and muscle with the area as large as possible avoiding the inclusion of confounding structures.

• 

  Fig. 2 MR images of right ankle in a 31-year-old man which showed similar traceability between VISTA and VISTA SPAIR of anterior talofibular ligament (ATFL). For both non-fat suppressed VISTA (a, c, e) and fat-suppressed (b, d, f) VISTA, both reader a and b gave high score traceability for ATFL (arrows) on sagittal (a, b), coronal (c, d) and axial (e, f) images.

• 

  Fig. 3 MR images of right ankle in a 31-year-old man which showed similar traceability between VISTA and VISTA SPAIR of calcaneofibular ligament (CFL). For both non-fat suppressed VISTA (a, c, e) and fat-suppressed (b, d, f) VISTA, both reader a and b gave high score traceability for CFL (arrows) sagittal (a, b), coronal (c, d) and axial (e, f) images.

• 

  Fig. 4 MR images of right ankle in a 28-year-old man which showed significantly different traceability between VISTA and VISTA SPAIR of calcaneofibular ligament (CFL). For non-fat suppressed VISTA (a, c, e), reader a and b gave high score traceability for CFL (arrows) on sagittal (a), coronal (d) and axial (e) images. For fat suppressed VISTA (b, d, f), however, both readers gave score 1 or 2 for CFL (arrowheads) on sagittal (b), coronal (d), and axial images.

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