Assessment and comparison of image quality between two real-time sequences for dynamic MRI of distal joints at 3.0...

Real-time sequences allow functional evaluation of various joint structures during a continuous motion and help understand the pathomechanics of underlying musculoskeletal diseases.

To assess and compare the image quality of the two most frequently used real-time sequences for joint dynamic magnetic resonance imaging (MRI), acquired during finger and ankle joint motion.

A real-time dynamic acquisition protocol, including radiofrequency (RF)-spoiled and balanced steady-state free precession (bSSFP) sequences, optimized for temporal resolution with similar spatial resolution, was performed using a 3.0-T MRI scanner on 10 fingers and 12 ankles from healthy individuals during active motion. Image quality criteria were evaluated on each time frame and compared between these two sequences. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were determined and compared from regions of interest placed on cortical bone, tendon, fat, and muscle. Visualization of anatomical structures and overall image quality appreciation were rated by two radiologists using a 0-10 grading scale.

Mean CNR was significantly higher with bSSFP sequence compared to RF-spoiled sequence. The grading score was in the range of 5-9.3 and was significantly higher with RF-spoiled sequence for bone and joint evaluation and overall image appreciation on the two joints. The standard deviation for SNR, CNR, and grading score during motion was smaller with RF-spoiled sequence for both the joints. The inter-reader reliability was excellent (>0.75) for evaluating anatomical structures in both sequences.

A RF-spoiled real-time sequence is recommended for the in vivo clinical evaluation of distal joints on a 3.0-T MRI scanner.