Magnetic resonance imaging of ankle tendon pathology: Benefits of additional axial short-tau inversion recovery imaging to reduce magic angle effects

Waraporn Srikhum, Lorenzo Nardo, Dimitrios C. Karampinos, Gerd Melkus, Theresa Poulos, Lynne S. Steinbach, Thomas M. Link

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objectives: Our goals were to quantify the reduction of the magic angle effect using short-tau inversion recovery (STIR) imaging and to determine the value of adding an axial STIR sequence to the magnetic resonance imaging ankle protocol. Materials and methods: Axial STIR sequences were used to measure normal tendon T1 and to estimate signal loss due to the inversion recovery preparation of our clinical protocol. In addition, 102 ankles were imaged with axial fat-suppressed intermediate-weighted fast spin echo and STIR sequences. Two radiologists analyzed the tendons for signal intensity, size, abnormalities, and magic angle effect. The diagnostic value and image quality of the two sequences were compared. Results: We calculated a 50 % reduction of signal intensity in healthy tendons on the STIR sequence at TI = 170 ms compared with TI = 0 ms, explaining the decrease in the magic angle effect. Using the STIR sequence, our study demonstrated significantly lower signal intensity within the tendons, more precise tendon size, and a lower magic angle effect compared with the standard intermediate-weighted FSE sequence (p < 0.001). Diagnostic classification of tendon abnormalities using the STIR sequences showed higher sensitivity (82.35 % vs 75.27 %) and better agreement with a reference standard than the intermediate-weighted sequences, and superior image quality (p < 0.01). Conclusions: Axial STIR sequences reduce magic angle effects and improve visualization of ankle tendon pathology.

Original languageEnglish (US)
Pages (from-to)499-510
Number of pages12
JournalSkeletal Radiology
Volume42
Issue number4
DOIs
StatePublished - Apr 1 2013
Externally publishedYes

Fingerprint

Sequence Inversion
Ankle
Tendons
Magnetic Resonance Imaging
Pathology
Clinical Protocols
Fats

Keywords

  • Ankle tendon pathology
  • Magic angle effect
  • Magnetic resonance imaging
  • MRI protocol
  • STIR sequence

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Magnetic resonance imaging of ankle tendon pathology : Benefits of additional axial short-tau inversion recovery imaging to reduce magic angle effects. / Srikhum, Waraporn; Nardo, Lorenzo; Karampinos, Dimitrios C.; Melkus, Gerd; Poulos, Theresa; Steinbach, Lynne S.; Link, Thomas M.

In: Skeletal Radiology, Vol. 42, No. 4, 01.04.2013, p. 499-510.

Research output: Contribution to journalArticle

Srikhum, Waraporn ; Nardo, Lorenzo ; Karampinos, Dimitrios C. ; Melkus, Gerd ; Poulos, Theresa ; Steinbach, Lynne S. ; Link, Thomas M. / Magnetic resonance imaging of ankle tendon pathology : Benefits of additional axial short-tau inversion recovery imaging to reduce magic angle effects. In: Skeletal Radiology. 2013 ; Vol. 42, No. 4. pp. 499-510.
@article{8bf6da36e7f04d82a49e117489b32478,
title = "Magnetic resonance imaging of ankle tendon pathology: Benefits of additional axial short-tau inversion recovery imaging to reduce magic angle effects",
abstract = "Objectives: Our goals were to quantify the reduction of the magic angle effect using short-tau inversion recovery (STIR) imaging and to determine the value of adding an axial STIR sequence to the magnetic resonance imaging ankle protocol. Materials and methods: Axial STIR sequences were used to measure normal tendon T1 and to estimate signal loss due to the inversion recovery preparation of our clinical protocol. In addition, 102 ankles were imaged with axial fat-suppressed intermediate-weighted fast spin echo and STIR sequences. Two radiologists analyzed the tendons for signal intensity, size, abnormalities, and magic angle effect. The diagnostic value and image quality of the two sequences were compared. Results: We calculated a 50 {\%} reduction of signal intensity in healthy tendons on the STIR sequence at TI = 170 ms compared with TI = 0 ms, explaining the decrease in the magic angle effect. Using the STIR sequence, our study demonstrated significantly lower signal intensity within the tendons, more precise tendon size, and a lower magic angle effect compared with the standard intermediate-weighted FSE sequence (p < 0.001). Diagnostic classification of tendon abnormalities using the STIR sequences showed higher sensitivity (82.35 {\%} vs 75.27 {\%}) and better agreement with a reference standard than the intermediate-weighted sequences, and superior image quality (p < 0.01). Conclusions: Axial STIR sequences reduce magic angle effects and improve visualization of ankle tendon pathology.",
keywords = "Ankle tendon pathology, Magic angle effect, Magnetic resonance imaging, MRI protocol, STIR sequence",
author = "Waraporn Srikhum and Lorenzo Nardo and Karampinos, {Dimitrios C.} and Gerd Melkus and Theresa Poulos and Steinbach, {Lynne S.} and Link, {Thomas M.}",
year = "2013",
month = "4",
day = "1",
doi = "10.1007/s00256-012-1550-y",
language = "English (US)",
volume = "42",
pages = "499--510",
journal = "Skeletal Radiology",
issn = "0364-2348",
publisher = "Springer Verlag",
number = "4",

}

TY - JOUR

T1 - Magnetic resonance imaging of ankle tendon pathology

T2 - Benefits of additional axial short-tau inversion recovery imaging to reduce magic angle effects

AU - Srikhum, Waraporn

AU - Nardo, Lorenzo

AU - Karampinos, Dimitrios C.

AU - Melkus, Gerd

AU - Poulos, Theresa

AU - Steinbach, Lynne S.

AU - Link, Thomas M.

PY - 2013/4/1

Y1 - 2013/4/1

N2 - Objectives: Our goals were to quantify the reduction of the magic angle effect using short-tau inversion recovery (STIR) imaging and to determine the value of adding an axial STIR sequence to the magnetic resonance imaging ankle protocol. Materials and methods: Axial STIR sequences were used to measure normal tendon T1 and to estimate signal loss due to the inversion recovery preparation of our clinical protocol. In addition, 102 ankles were imaged with axial fat-suppressed intermediate-weighted fast spin echo and STIR sequences. Two radiologists analyzed the tendons for signal intensity, size, abnormalities, and magic angle effect. The diagnostic value and image quality of the two sequences were compared. Results: We calculated a 50 % reduction of signal intensity in healthy tendons on the STIR sequence at TI = 170 ms compared with TI = 0 ms, explaining the decrease in the magic angle effect. Using the STIR sequence, our study demonstrated significantly lower signal intensity within the tendons, more precise tendon size, and a lower magic angle effect compared with the standard intermediate-weighted FSE sequence (p < 0.001). Diagnostic classification of tendon abnormalities using the STIR sequences showed higher sensitivity (82.35 % vs 75.27 %) and better agreement with a reference standard than the intermediate-weighted sequences, and superior image quality (p < 0.01). Conclusions: Axial STIR sequences reduce magic angle effects and improve visualization of ankle tendon pathology.

AB - Objectives: Our goals were to quantify the reduction of the magic angle effect using short-tau inversion recovery (STIR) imaging and to determine the value of adding an axial STIR sequence to the magnetic resonance imaging ankle protocol. Materials and methods: Axial STIR sequences were used to measure normal tendon T1 and to estimate signal loss due to the inversion recovery preparation of our clinical protocol. In addition, 102 ankles were imaged with axial fat-suppressed intermediate-weighted fast spin echo and STIR sequences. Two radiologists analyzed the tendons for signal intensity, size, abnormalities, and magic angle effect. The diagnostic value and image quality of the two sequences were compared. Results: We calculated a 50 % reduction of signal intensity in healthy tendons on the STIR sequence at TI = 170 ms compared with TI = 0 ms, explaining the decrease in the magic angle effect. Using the STIR sequence, our study demonstrated significantly lower signal intensity within the tendons, more precise tendon size, and a lower magic angle effect compared with the standard intermediate-weighted FSE sequence (p < 0.001). Diagnostic classification of tendon abnormalities using the STIR sequences showed higher sensitivity (82.35 % vs 75.27 %) and better agreement with a reference standard than the intermediate-weighted sequences, and superior image quality (p < 0.01). Conclusions: Axial STIR sequences reduce magic angle effects and improve visualization of ankle tendon pathology.

KW - Ankle tendon pathology

KW - Magic angle effect

KW - Magnetic resonance imaging

KW - MRI protocol

KW - STIR sequence

UR - http://www.scopus.com/inward/record.url?scp=84879689133&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84879689133&partnerID=8YFLogxK

U2 - 10.1007/s00256-012-1550-y

DO - 10.1007/s00256-012-1550-y

M3 - Article

C2 - 23229628

AN - SCOPUS:84879689133

VL - 42

SP - 499

EP - 510

JO - Skeletal Radiology

JF - Skeletal Radiology

SN - 0364-2348

IS - 4

ER -