Diffusion-weighted imaging of the appendicular skeleton with a non-Carr-Purcell-Meiboom-Gill single-shot fast spin-echo sequence

AJR Am J Roentgenol. 2007 Dec;189(6):1494-501. doi: 10.2214/AJR.07.2512.


Objective: The objective of our study was to prospectively evaluate the signal-to-noise ratio (SNR) improvement in diffusion-weighted imaging (DWI) of the appendicular skeleton with the use of a newly developed non-Carr-Purcell-Meiboom-Gill (non-CPMG) single-shot fast spin-echo (SSFSE) sequence and to evaluate its effect on apparent diffusion coefficient (ADC) measurements.

Subjects and methods: DWI of the bone was performed in 32 patients with an echo-planar imaging (EPI)-based sequence followed by a non-CPMG SSFSE technique. SNR and ADC values were measured over a lesion-free right femoral head. A score was assigned for each set of images to assess image quality. When a bone lesion was present, contrast-to-noise ratio (CNR) and ADC were also measured. Paired Student's t tests were used for statistical analysis.

Results: The mean (+/- SD) SNR values were 9.89 +/- 2.20 and 81.68 +/- 4.87 for EPI and non-CPMG SSFSE DWI, respectively. SNR values associated with the non-CPMG SSFSE technique were found to be significantly higher than those measured with the EPI-based DWI technique (p < 0.01). Mean ADCs of the bone were 0.57 +/- 0.20 and 0.29 +/- 0.15 x 10(-3) mm2/s, respectively, for EPI and non-CPMG SSFSE DWI. Image quality scores were higher for the non-CPMG SSFSE DWI technique (p < 0.05) than for the EPI-based DWI technique. Overall lesion CNR was found to be higher in DWI performed with the non-CPMG SSFSE technique.

Conclusion: The non-CPMG SSFSE technique provides a significant improvement over the currently used EPI-based DWI technique and has the potential to be a powerful tool in imaging the appendicular skeleton.

MeSH terms

  • Adult
  • Aged
  • Algorithms
  • Bone Neoplasms / diagnosis*
  • Bone Neoplasms / secondary*
  • Diffusion Magnetic Resonance Imaging / methods*
  • Echo-Planar Imaging / methods*
  • Female
  • Humans
  • Image Enhancement / methods
  • Image Interpretation, Computer-Assisted / methods*
  • Male
  • Middle Aged
  • Osteomyelitis / diagnosis*
  • Osteonecrosis / diagnosis*
  • Reproducibility of Results
  • Sensitivity and Specificity