Pulse sequences of Ankle MRI


 The SNR in the ankle and foot is usually good if using a dedicated coil, such as the extremity coil or small surface coils.  For all sequences, slice thickness should not exceed 4mm to minimize partial volume effects.  No standard protocol has been established and the sequences and imaging planes differ according to the diagnostic question.  Generally, spin echo sequences are used to examine the foot and ankle.  These sequences allow the acquisition of high-resolution images with T1, proton density and T2-weigh.  The major drawback to spin echo sequences is the relatively long acquisition times especially for T2-weighted sequences.  The introduction of fast sin echo (FSE) sequence has reduced scanning time considerably whilst providing the same contrast properties as those of conventional spin echo.  However, as already mentioned there are at least two differences between CSE and FSE.  First fat appears considerably brighter in FSE than in CSE.  This affects the detection of bone marrow abnormalities.  Thus it is generally necessary to use fat suppression with FSE sequences.  Secondly, there can be loss of high resolution detail in FSE images at short TE.  This is most noticeable when using high ETL (more than 2) longer interecho spacing and a smaller acquisition matrix (Kneeland, 1994).

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Gradient echo techniques with 2D or 3D acquisitions may be used in the ankle for the evaluation of cartilage and ligaments.  3D provides contiguous sections of less then 3mm with a high signal to noise ratio.  The major disadvantage of gradient echo technique is the loss of signal within the bone marrow as a result of magnetic susceptibility artefacts.  Similarly to other areas of the musculoskeletal system, our radiologists prefer spin echo (FSE or CSE) sequences because the resultant effects of modifications of the spin echo parameters are well known.  

Source:Joseph Castillo

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