Comparison of 3D Gradient-Echo Versus 2D Sequences for Assessing Shoulder Joint Image Quality in MRI

Background: Three-dimensional gradient-echo (3D-GRE) sequences provide isotropic or nearly isotropic 3D images, leading to better visualization of smaller structures, compared to two-dimensional (2D) sequences. The aim of this study was to prospectively compare 2D and 3D-GRE sequences in terms of key imaging metrics, including signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), glenohumeral joint space, image quality, artifacts, and acquisition time in shoulder joint images, using 1.5-T MRI scanner. Methods: Thirty-five normal volunteers with no history of shoulder disorders prospectively underwent a shoulder MRI examination with conventional 2D sequences, including T ₁- and T ₂-weighted fast spin echo (T₁/T₂w FSE) as well as proton density-weighted FSE with fat saturation (PD-FS) followed by 3D-GRE sequences including VIBE, TRUEFISP, DESS, and MEDIC techniques. Two independent reviewers assessed all images of the shoulder joints. Pearson correlation coefficient and intra-RR were used for reliability test. Results: Among 3D-GRE sequences, TRUEFISP showed significantly the best CNR between cartilage-bone (31.37 ± 2.57, p < 0.05) and cartilage-muscle (13.51 ± 1.14, p < 0.05). TRUEFISP also showed the highest SNR for cartilage (41.65 ± 2.19, p < 0.01) and muscle (26.71 ± 0.79, p < 0.05). Furthermore, 3D-GRE sequences showed significantly higher image quality, compared to 2D sequences (p < 0.001). Moreover, the acquisition time of the 3D-GRE sequences was considerably shorter than the total acquisition time of PD-FS sequences in three orientations (p < 0.01). Conclusions: 3D-GRE sequences provide superior image quality and efficiency for evaluating articular joints, particularly in shoulder imaging. The TRUEFISP technique offers the best contrast and signal quality, making it a valuable tool in clinical practice.