Cartilage imaging at 3.0T with gradient refocused acquisition in the steady-state (GRASS) and IDEAL fat-water separation

Purpose: To demonstrate the feasibility of evaluating the articular cartilage of the knee joint at 3.0T using gradient refocused acquisition in the steady-state (GRASS) and iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) fat-water separation. Materials and Methods: Bloch equation simulations and a clinical pilot study (n = 10 knees) were performed to determine the influence of flip angle of the IDEAL-GRASS sequence on the signal-to-noise ratio (SNR) of cartilage and synovial fluid and the contrast-to-noise ratio (CNR) between cartilage and synovial fluid at 3.0T. The optimized IDEAL-GRASS sequence was then performed on 30 symptomatic patients as part of the routine 3.0T knee MRI examination at our institution. Results: The optimal flip angle was 50 degrees for IDEAL-GRASS cartilage imaging, which maximized contrast between cartilage and synovial fluid. The IDEAL-GRASS sequence consistently produced high-quality fat- and water-separated images of the knee with bright synovial fluid and 0.39 X 0.67 X 1.0 mm resolution in 5 minutes. IDEAL-GRASS images had high cartilage SNR and high contrast between cartilage and adjacent joint structures. The IDEAL-GRASS sequence provided excellent visualization of cartilage lesions in all patients. Conclusion: The IDEAL-GRASS sequence shows promise for use as a morphologic cartilage imaging sequence at 3.0T.