Imaging articular cartilage defects in the ankle joint with 3D fat-suppressed echo planar imaging: Comparison with conventional 3D fat-suppressed gradient echo imaging

Purpose: To shorten the examination time for articular cartilage imaging, using a recently developed three-dimensional (3D) multishot echo planar imaging (EPI) sequence with fat saturated (FS), compared to aconventional 3D fat-saturated spoiled gradient echo sequence (3D FS GRE). Material and Methods: There were 32 consecutive patients with ankle joint disorders who underwent magnetic resonance imaging (MRI) in a 1.0-T unit. Hyaline cartilage was imaged with a 3D FS EPI sequence and a 3D FS GRE sequence. Image assessment criteria included lesion conspicuity, contrast between different types of normal tissue, and image artifacts. In addition, contrast-to-noise ratios (CNRs) of cartilage vs. joint fluid and bone marrow were measured. Results: The 3D FS EPI sequence provided a high CNR between cartilage and subchondral bone, similar to that of the 3D FS GRE sequence. The CNR between cartilage and effusion was significantly lower on the 3D EPI sequence due to the higher signal intensity of fluid. Both sequences were equal in lesion detection ability. the image quality of the 3D FS GRE sequence was slightly higher than that of the 3D FS EPI, but the difference was not significant. Conclusion: We conclude that the 3D FS EPI sequence is comparable to the 3D FS GRE sequence in the detection of cartilage lesions, with the additional advantage of reduction in scan time by a factor of 4.