How I Do It: Fast MRI of the Joints

This article provides a practice-oriented overview of current concepts in rapid musculoskeletal MRI of central and peripheral joints, focusing on echo train optimization and the application of modern acceleration techniques. Parallel imaging, simultaneous multislice acquisition, and compressed sensing-based undersampling can be applied independently or in combination to expedite MRI of the joints. Clinically available three- to eightfold acceleration of two-dimensional (2D) and three-dimensional turbo spin-echo (TSE) pulse sequences enables comprehensive 5-10-minute MRI protocols of joints. This acceleration allows for the efficient integration of advanced metal artifact reduction techniques into clinical MRI protocols. When conventional image reconstruction techniques fail, clinically available deep learning-based image reconstruction and superresolution augmentation methods effectively reconstruct images from highly accelerated acquisitions. Together, moderate acceleration and advanced image reconstruction techniques provide high diagnostic image quality of heavily undersampled MRI data, enabling three- to sixfold accelerated 2D TSE MRI of multiple joints in 4-6 minutes. Recent studies indicate that specially designed and trained deep learning methods may achieve 10-fold accelerated musculoskeletal MRI, with acquisition times under 3 minutes. Although further research and data are necessary, these promising developments are poised to enhance the value of musculoskeletal MRI.