Overview of Magnetic Resonance Fingerprinting

This overview of Magnetic Resonance Fingerprinting describes the basic concepts of MRF and illustrates some clinical applications. [...]

New ‘ADC & b-value’ Tool in syngo.via

This article describes the feature ‘ADC & computed b-value’ available on Siemens’ syngo.via VB10. This new tool provides an increased degree of freedom in the choice of the b-value for disease detection and characterization. [...]

Pediatric Pathologies that have Leukocoria as Presenting Sign: the Podium

The article features the clinical and imaging signs and differential diagnosis of Retinoblastoma, persistent fetal vasculature and Coats’ disease. View/Download [...]

Launch of the world’s first 7 T MR platform intended for clinical use (Siemens)

Erlangen, Germany, May 31, 2015 — Siemens announced at the Toronto ISMRM (International Society for Magnetic Resonance in Medicine) meeting the launch of the world’s first 7 T MR platform intended for clinical use. Important advances include a new, light, actively shielded magnet with zero helium boil-off and dual operating modes, enabling rapid switching between research […] [...]

CAIPIRINHA – Revisited

The development ofmulti coil receiver hardware as well as dedicated parallel acquisition techniques (PAT) and respective reconstruction methods allowed for a significant decrease of acquisition times in almost all clinical applications. This article provides a brief overview of 2D- and MS-CAIPIRINHA. [...]

Accelerated Diffusion Tensor Imaging of Skeletal Muscle Using Simultaneous Multi-Slice Acquisition

Simultaneous multi-slice acquisition with CAIPIRINHA reduces the scan time in diffusion-weighted MRI. In this article, early experience with this technique for accelerated DTI of skeletal muscle is shown. [...]

Simultaneous Multi-Slice (SMS) Imaging for Pre-Surgical BOLD fMRI and Diffusion Tractography: Case Illustrations

The presented case studies illustrate that SMS can increase the statistical confidence of fMRI and diffusion tractography results. These gains may be used to increase spatial image resolution and coverage, to improve spatial coregistration to high-resolution anatomical scans for intra-operative neuro-navigation, and / or to shorten acquisition times. [...]

Quiescent Interval Single-Shot (QISS) Lower Extremity MRA for the Diagnosis of Peripheral Artery Disease: Case Presentations

Case presentation of non-contrast QISS MRA providing high diagnostic accuracy for the detection of hemodynamically significant arterial stenosis of the lower extremities at both 1.5 and 3T. [...]

Point-of-Care MR Imaging and How We can Learn from Other Imaging Modalities. Thoughts on a Potential New Strategy

The article introduces point-of-care MRI, an extremely focused and goal-directed examinations strategy, that could reduce examination time and patient comfort. [...]

Simultaneous Multi-Slice (Slice Accelerated) Diffusion EPI: Early Experience for Brain Ischemia and Cervical Lymphadenopathy

In single shot EPI, the entirety of k-space is traversed after one shot (excitation). Readout-segmentation acquires k-space in multiple shots for reduced TE and encoding time. Real-time reacquisition of unusable shots is also supported. [...]

Clinical Case: 3 Tesla MR Neurography-Guided Posterior Femoral Cutaneous Nerve Block

The high SNR available at 3T provides the ability to perform high-resolution MR neurography-guided perineural injections for highly accurate visualization of small nerve as well as needle targeting and perineural injection. This case report demonstrates how this techniques facilitates accurate targeting of the PFCN.  Download/View PDF [...]

Giant cell tumor

  Clinical History: 40 year old man with left knee pain for three months Diagnosis: Giant cell tumor involving the proximal tibia with intratumoral hemorrhage MR Technique: Knee imaging was performed on a 3T MR system (Skyra, Siemens). (A) Axial T1-weighted TSE (TR/TE 700/12ms) images and (B) axial T2-weighted TSE images with Dixon fat suppression […] [...]

Improving MR Joint Diagnostics with T1 Water Contrast Using a RESTORE Pulse

The article discusses technical considerations and various clinical applications of the DESS sequence. 3D DESS techniques have advantages in assessment of pediatric cartilage pathology including higher SNR, increased cartilage-to-fluid contrast and isotropic resolution, which helps to reduce partial volume effects. 3D DESS techniques are also of essential importance in the pediatric population due to the lack of ionizing radiation. [...]

Case Report: Assessment of Renal Allograft Function with DTI and Tractography

The article discusses technical considerations and various clinical applications of the DESS sequence. 3D DESS techniques have advantages in assessment of pediatric cartilage pathology including higher SNR, increased cartilage-to-fluid contrast and isotropic resolution, which helps to reduce partial volume effects. 3D DESS techniques are also of essential importance in the pediatric population due to the lack of ionizing radiation. [...]

3T MR Imaging of the Pediatric Cartilage Using 3D Dual Echo Steady State (DESS)

The article discusses technical considerations and various clinical applications of the DESS sequence. 3D DESS techniques have advantages in assessment of pediatric cartilage pathology including higher SNR, increased cartilage-to-fluid contrast and isotropic resolution, which helps to reduce partial volume effects. 3D DESS techniques are also of essential importance in the pediatric population due to the lack of ionizing radiation. [...]

Musculoskeletal Imaging at 3T with Simultaneous Use of Multipurpose Loop Coils

This paper shows how the simultaneous use of multipurpose loop coils in MRI allows high-resolution musculoskeletal studies with increased contrast and specificity for assessing muscles, tendons, ligaments, joints, and cartilage. Dr. Ferrer presents a number of different daily patient routine examinations, including specifically evaluation of the carpal bones, the thumb metacarpals, the metacarpals, the distal inter-phalangeal joints, the elbow and ankle. [...]

MAGNETOM Aera – Combining Throughput and Highest Quality MRI in an Optimized Clinical Workflow

This paper shows how the simultaneous use of multipurpose loop coils in MRI allows high-resolution musculoskeletal studies with increased contrast and specificity for assessing muscles, tendons, ligaments, joints, and cartilage. Dr. Ferrer presents a number of different daily patient routine examinations, including specifically evaluation of the carpal bones, the thumb metacarpals, the metacarpals, the distal inter-phalangeal joints, the elbow and ankle. [...]

MRI Assessment of Articular Cartilage Repair

The evolution of sophisticated surgical repair procedures for the treatment of isolated, focal traumatic or degenerative cartialge lesions has created the need for accurate, non-invasive assessment of the repair tissue. MRI depicts well subchondral bone and bone marrow, allowing examination of repair tissue and its interface with parent cartilage and complications of repair surgeries such as graft hypertrophy and delamination. [...]

syngo WARP – Metal Artifact Reduction Techniques in Magnetic Resonance Imaging

The term WARP summarizes methods to minimize the impact of metal implants on MR image quality. This article introduces different techniques such as high bandwidth, VAT and SEMAC. [...]

Magnetic Resonance Neurography Evaluation in Children

The term WARP summarizes methods to minimize the impact of metal implants on MR image quality. This article introduces different techniques such as high bandwidth, VAT and SEMAC. [...]

MSK Imaging Tips and Tricks

Mark Lourensz from the MRI Department at St. Vincent’s Hospital in Melbourne, Australia shares tips and tricks on a broad range of musculoskeletal topics extending from standard joint MRI to whole limb tumor evaluation. Some of these may be common sense, but it doesn’t hurt to revisit the basics occasionally. [...]

Achilles Tendon Rupture

A 63 year old male with leg pain after fall. [...]

Jumper’s knee

A 26 year old male with left knee pain. [...]

DeQuervain’s tenosynovitis

A 53 year old female with left wrist pain for the past 4 months without any inciting event. [...]

Tear of the prepatellar quadriceps continuation

A 71 year old male presenting with pain in the right knee. [...]

Radial tear with flipped meniscus

50 year old man with left knee pain which worsens with activity. [...]

Os-acromiale

This is a 26-year-old female with no history of trauma, who presents with left shoulder pain. [...]

Buford Complex

This is a 47-year-old male who has a chronic history of shoulder pain. [...]

Biceps tendon rupture

This is a 56-year-old female with a several month history of right shoulder pain. The pain started after exercise classes which involve lifting weights. The patient had no reported history of trauma. [...]

Haglund’s syndrome

66 yr old woman with right ankle pain. [...]

Posterior ankle impingement syndrome (Os trigonum syndrome)

42 year old woman with right heel pain that started 6-8 months ago. [...]

Synovial Osteochondromatosis

59 yr old woman with left knee pain. [...]

Talocalcaneal Fibrous Coalition

This is a 60-year-old male who presented with bilateral feet pain for five years. The pain was worse on the right and has been increasing recently. Sometimes he states that he cannot walk because the pain is so severe. Recently, he has noticed increased swelling. [...]

Cortical desmoid (distal femoral cortical irregularity)

12 year old female ballet dancer with slowly progressive knee pain, aggravated with flexion. [...]

Transient Patellar Dislocation

This is a 13-year-old male who presented for initial evaluation of his left knee, after having a non-contact injury during athletics at school one week prior. He was unsure of the position of his knee at the time of injury. The patient localized the pain to the medial aspect of his knee. He ambulates with difficulty using a single crutch. [...]

Osteochondral defect (unstable)

This is a 14-year-old female with right knee pain for several months. She first started noticing the pain while running track, which she has stopped due to the degree of pain. She obtained radiographs (not shown) which showed an osteochondral defect. An MRI was then obtained to determine stability of the lesion. [...]

Bucket handle tear in the left medial meniscus

58 yr old man with left knee pain. [...]

Labral Tear

This is a 51 year old female with chronic right hip pain with burning sensation. [...]

Fracture of the Scapula

This 56 year old came to emergency room after a motorcycle crash. He had a dislocated wrist and was treated for a distal radius and ulnar styloid fracture. No other fractures were detected on plain radiographs. The patient continued to have shoulder pain three weeks after discharge, for which MRI of the shoulder was performed. [...]

Articular Cartilage Defect

47 year old man presented with left knee pain and swelling and some loss of range of motion. He has no history of trauma to the left knee or locking of the left knee. [...]

Ganglion Cyst

22 yr old woman with injury to her wrist one month ago. She noticed mild right wrist pain and swelling the day after the injury. She had pain with movement of her fingers. Recent X-rays were negative. [...]

Severe Degenerative Changes of the Hip Joints

This 74-year-old woman presented with a longstanding history of hip and leg pain on both sides but more pronounced on the right side. She is also suffers from a significant scoliosis. [...]

Partial Rupture of the Posterior Cruciate Ligament

This 29-year-old man presented to his physician with pain in his left knee. He could remember a minor knee injury several weeks ago. In his spare time he goes running three times a week. His past medical history showed no relevant disease. [...]

Anterior Cruciate Ligament Disruption

.ima file Zip Download .ima file Zip Download .ima file Zip Download Clinical Topic Orthopedics Subtopic Trauma Examination Region Knee Key Points ACL disruption Bone marrow contusion Image Findings A complete ACL disruption is demonstrated. (ACL = Anterior Cruciate Ligament; figure A) Bone marrow contusion is seen involving the lateral femoral condyle. (figures B and C) Images Sagittal […] [...]

Perthes Lesion – Anterior Labral Separation

26 year old man who presents clinically following an anterior inferior dislocation of the left shoulder, with subsequent ventral instability [...]

Enchondroma

This 33-year-old man presented to clinic with left shoulder pain of two months duration, radiating to his fingertips. Plain film radiographs and a MR examination revealed a focal lesion in his left humeral metaphysis which was found to represent an enchondroma. [...]

Tenosynovial Giant-cell Tumor

This 28-year-old woman presented with an approximately 3 year history of slowly-progressive left ankle pain, worse with movement and at the end of the day. After detection of the illustrated mass, surgery was performed with pathologic examination confirming a tenosynovial giant-cell tumor. [...]

Synovial Sarcoma (monophasic fibrous type)

This 20-year-old man presented with increasing pain and swelling in his left shoulder—an ongoing problem for the prior three months. Physical exam revealed a slightly tender, indurated mass with normal overlying skin. [...]

Enchondroma

This 41-year-old female presented to clinic with continued pain and swelling in her left fifth finger. She reported an extensive history of injuries to that finger over the last 20 years. The patient’s MRI, illustrated below, revealed a lesion in the proximal phalanx of the left fifth finger which was confirmed as an enchondroma by subsequent surgery. [...]

Gout

This 56-year-old female presented to clinic complaining of right foot pain and swelling for the last year, particularly involving the base of the fifth metatarsal and the 3rd toe. A hard, painful nodule involving the base of the patient’s fifth metatarsal was noted on physical exam. [...]

Let’s TWIST again: Temporal and Spatial High-Resolution 3D MR-Angiography of the Hand

Compared to conventional contrastenhanced MR angiography (MRA), which provides a spatial high-resolution threedimensional (3D) MRA data set of the vascular target region, MRA with TWIST (time-resolved angiography with stochastic trajectories) with its high temporal resolution offers an additional dynamic component. It presents a broad range of advantages for all vascular diagnostic questions where blood flow dynamics play a role. [...]

Neurofibroma

This 35-year-old female presented to clinic complaining of pain and swelling posterior to her right knee of approximately 3 months duration. Physical examination confirmed the presence of a soft tissue mass in the patient’s right posterior lower leg. An MRI scan demonstrated a well-defined oval lesion, confirmed to be a neurofibroma by subsequent surgery. [...]

Osseous Lymphoma

This 92-year-old female presented to clinic with chronic right shoulder swelling and pain of several months duration which had become more severe in last 10 days. Her past history includes a diagnosis of lymphoma in the early 1980’s—a non-Hodgkin stage IIE variety with favorable histologic status. She underwent 4 cycles of CHOP therapy followed by radiation treatment. Lymphomatous involvement was initially found in her right salivary gland, right submandibular gland, and left inner cheek. Plain film radiographs and the illustrated MR examination of the patient’s right arm revealed an ill-defined mass involving right humeral metaphysis. [...]

Osteosarcoma

This 28-year-old man presented with increasing pain and swelling in his right shoulder for more than four months. Physical exam revealed an obvious swelling, with overlying normal skin, involving the right shoulder. Because of the swelling and pain, movement of the joint was restricted. [...]

3D High Resolution MRI of the Knee at 3T Using a Moderately T2-weighted 3D-TSE-fs (syngo SPACE) sequence – Useful or Not?

3D High Resolution MRI of the Knee at 3T SPACE is a new approach to MRI of the knee at 3T. It allows high spatial resolution isotropic true 3-dimensional acquisition and subsequent reconstruction. Overall acquisition time is shorter than that of three separate 2-dimensional datasets and SNR for 1 mm reconstructions is similar to conventional 2D-TSE-fs. The identification of anatomical structures is in general equal or superior to conventional scans, with superior discrimination of relevant small ligamentous structures. A simple protocol comprising 1 mm SPACE reconstructions in all three orientations is extremely useful for clinical evaluation. The additional possibility of free 3- dimensional reconstruction depending on the specific clinical need may become useful for diagnosis in difficult cases or with complex anatomy, and in particular for presurgical planning, i.e. for traumatic ligamentous lesions or complex meniscal tears. [...]

Case Report: Fast Joint Imaging at 1.5 Tesla with a Combination of the Quadrature Knee and Body Matrix Coil in Case of Severe Knee Pain of an Obese Patient

Knee MRI is challenging in both obese patients and patients in pain, requiring in some cases special coil setups as imaging is impossible with a conventional closed knee coil. In the presented case, a flexible coil setup is demonstrated in combination with open-bore MR technology. This illustrates the benefit of such setups in the diagnosis of knee pain in obese patients. [...]

Case Report: Knee MR Imaging of Haemarthrosis in a Case of Haemophilia A

Imaging pediatric joints is often still a domain of x-ray and ultrasound. However, the application of MRI is of growing importance, not only because of its excellent soft tissue contrast but also because of its capability to early and precisely detect bone destruction. In this case, Prof. Marc-André Weber (University of Heidelberg, Germany) reports on the imaging findings of a 14-year-old male with known hemophilia A. [...]

Tips for T2-weighted TSE Shoulder Imaging with Spectral Fat Saturation

Robust fat saturation can be achieved by different approaches including the application of inversion recovery sequences or advanced fat suppression pulses such as SPAIR. However, in some cases, such as the musculoskeletal imaging of the shoulder, the combination of a T2- weighted turbo spin echo (TSE) sequence with a conventional spectral fat saturation pulse is needed. When imaging obese or very tall patients, the shoulder has to be positioned off-center in many MR exams and therefore several factors will affect image quality with spectral fat saturation. This article provides tips on patient positioning and sequence set-up that will help you to achieve high quality spectral fat saturation. [...]