Combined 5-minute double-echo in steady-state with separated echoes and 2-minute proton-density-weighted 2D FSE sequence for comprehensive whole-joint knee MRI assessment
__Background:__ Clinical knee MRI protocols require upwards of 15 minutes of scan time. __Purpose/Hypothesis:__ To compare the imaging appearance of knee abnormalities depicted with a 5-minute 3D double-echo in steady-state (DESS) sequence with separate echo images, with that of a routine clinical knee MRI protocol. A secondary goal was to compare the imaging appearance of knee abnormalities depicted with 5-minute DESS paired with a 2-minute coronal proton-density fat-saturated (PDFS) sequence. __Study Type:__ Prospective. __Subjects:__ Thirty-six consecutive patients (19 male) referred for a routine knee MRI. __Field Strength/Sequences:__ DESS and PDFS at 3T. __Assessment:__ Five musculoskeletal radiologists evaluated all images for the presence of internal knee derangement using DESS, DESS+PDFS, and the conventional imaging protocol, and their associated diagnostic confidence of the reading. __Statistical Tests:__ Differences in positive and negative percent agreement (PPA and NPA, respectively) and 95% confidence intervals (CIs) for DESS and DESS+PDFS compared with the conventional protocol were calculated and tested using exact McNemar tests. The percentage of observations where DESS or DESS+PDFS had equivalent confidence ratings to DESS+Conv were tested with exact symmetry tests. Interreader agreement was calculated using Krippendorff's alpha. Results: DESS had a PPA of 90% (88–92% CI) and NPA of 99% (99–99% CI). DESS+PDFS had increased PPA of 99% (95–99% CI) and NPA of 100% (99–100% CI) compared with DESS (both P < 0.001). DESS had equivalent diagnostic confidence to DESS+Conv in 94% of findings, whereas DESS+PDFS had equivalent diagnostic confidence in 99% of findings (both P < 0.001). All readers had moderate concordance for all three protocols (Krippendorff's alpha 47–48%). __Data Conclusion:__ Both 1) 5-minute 3D-DESS with separated echoes and 2) 5-minute 3D-DESS paired with a 2-minute coronal PDFS sequence depicted knee abnormalities similarly to a routine clinical knee MRI protocol, which may be a promising technique for abbreviated knee MRI. Level of Evidence: 2. Technical Efficacy: Stage 2. J. Magn. Reson. Imaging 2018.
|Keywords||abbreviated protocol, DESS, fast imaging, knee MRI, quantitative imaging|
|Persistent URL||dx.doi.org/10.1002/jmri.26582, hdl.handle.net/1765/113533|
|Journal||Journal of Magnetic Resonance Imaging|
Chaudhari, A.S. (Akshay S.), Stevens, K.J. (Kathryn J.), Sveinsson, B. (Bragi), Wood, J.P. (Jeff P.), Beaulieu, C.F. (Christopher F.), Oei, E.H.G, … Hargreaves, B.A. (Brian A.). (2018). Combined 5-minute double-echo in steady-state with separated echoes and 2-minute proton-density-weighted 2D FSE sequence for comprehensive whole-joint knee MRI assessment. Journal of Magnetic Resonance Imaging. doi:10.1002/jmri.26582