Current musculoskeletal MR imagiing utilizes multiple imaging planes and multiple weightings of two-dimensional turbo spin echo (2D TSE) to precisely delineate and characterize intra-articular abnormalities. Three-dimensional (3D) TSE sequences are currently available on most MRI vendor platforms. High resolution isotropic 3D imaging of the small joints reduces partial volume artifacts and allows for the reconstruction in any orientation, thus eliminating the need to acquire additional scans of different orientations with identical tissue contrast. However, the typical trade off of achieving very high resolution (under 0.5mm isotropic) is long acquisition time. Scan time reduction can be achieved with parallel imaging at the expense of reducing the signal-to-noise ratio (SNR) and with increasing the echo train length at the expense of image blurring. The addition of compressed sensing (CS), a recently commercially available acceleration technique, allows for decrease in acquisition time without the significant loss of SNR experienced with identical acceleration factors achieved with parallel imaging alone. CS exploits (1) image data sparsity via application of a sparsity transform of the image data; (2) pseudo-random-type of k-space sampling; (3) non-linear iterative reconstruction. We utilized CS to decrease scan time (range 4:55 to 5:35 minutes) of 3D PD FS TSE sequences to obtain high resolution (voxel size 0.45 x 0.45 x 0.45) imaging of the fingers, toes, wrist and feet. In this educational exhibit, we will review the normal anatomy and pathology of small joints Read More

Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019

Authors: Padua Eric, Kammen Bamidele, Karakas S Pinar, Hitt Dave, Tai Chau, Pandya Nirav, Lu Quin, Chung Taylor

Keywords: musculoskeletal

Adnexal torsion is a common emergency room query in young girls and teenagers presenting with pelvic pain. It is a consequence of an underlying adnexal lesion or to anatomical laxity of the suspensory/anchoring ligaments. Clinical symptoms at presentation can be confusing and nonspecific, yet prompt diagnosis and surgical intervention are essential to save the adnexa. Radiology plays a crucial role in the diagnosis of adnexal torsion. Our exhibit will review and promote the rapid MRI as the first line, one-stop imaging in the diagnosis of adnexal torsion and other causes of pelvic pain. Some cases will be presented with initial ultrasound images and demonstrate how MRI increased the confidence in the diagnosis. All presented cases have pathology correlation and or operative reports and follow-up imaging. We will show various cases of ovarian and tubal torsions and their mimickers. In particular, we include torsions due to anatomical laxity of the suspensory ligaments, resulting from tubo-ovarian cysts and solid adnexal masses as well as cases of isolated tubal torsions. <b>Table of Contents/Outline:</b> Review of the embryology and anatomy of adnexa including suspensory/ anchoring ligaments. Review pathophysiology and progression of ovarian torsion Review rapid motion insensitive high-resolution MRI protocol for adnexal torsion Review hallmark imaging findings of adnexal torsion with MRI (with accompanying ultrasound comparison in some cases) Review MRI findings of adnexal viability and demise Review multiple MRI examples of adnexal torsion and its mimickers Read More

Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019

Authors: Karakas S Pinar, Udayasankar Unni, Park Ellen S, Kammen Bamidele, Su Wendy, Kim Sunghoon, Hui Thomas, Chung Taylor

Keywords: Adnexal Torsion, Tubal Torsion, Rapid MRI