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Background and purposeMR imaging has been widely used for the noninvasive evaluation of MS. Although clinical MR imaging sequences are highly effective in showing focal macroscopic tissue abnormalities in the brains of patients with MS, they are not specific to myelin and correlate poorly with disability. We investigated direct imaging of myelin using a 2D adiabatic inversion recovery ultrashort TE sequence to determine its value in assessing disability in MS.Materials and methodsThe 2D inversion recovery ultrashort TE sequence was evaluated in 14 healthy volunteers and 31 patients with MS. MPRAGE and T2-FLAIR images were acquired for comparison. Advanced Normalization Tools were used to correlate inversion recovery ultrashort TE, MPRAGE, and T2-FLAIR images with disability assessed by the Expanded Disability Status Scale.ResultsWeak correlations were observed between normal-appearing white matter volume (R = -0.03, P = .88), lesion load (R = 0.22, P = .24), and age (R = 0.14, P = .44), and disability. The MPRAGE signal in normal-appearing white matter showed a weak correlation with age (R = -0.10, P = .49) and disability (R = -0.19, P = .31). The T2-FLAIR signal in normal-appearing white matter showed a weak correlation with age (R = 0.01, P = .93) and disability (R = 0.13, P = .49). The inversion recovery ultrashort TE signal was significantly negatively correlated with age (R = -0.38, P = .009) and disability (R = -0.44; P = .01).ConclusionsDirect imaging of myelin correlates with disability in patients with MS better than indirect imaging of long-T2 water in WM using conventional clinical sequences.

Objective: This study aimed to implement qualitative and quantitative magnetic resonance sequences for the evaluation of labral pathology. Methods: Six glenoid labrawere dissected, and the anterior and posterior portions were divided into normal, mildly degenerated, or severely degenerated groups using gross and magnetic resonance findings. Qualitative evaluation was performed using T1-weighted, proton density-weighted, spoiled gradient echo and ultrashort echo time (UTE) sequences. Quantitative evaluation included T2 and T1rho measurements as well as T1, T2∗, and T1rho measurements acquired with UTE techniques. Results: Spoiled gradient echo and UTE sequences best demonstrated labral fiber structure. Degenerated labra had a tendency toward decreased T1 values, increased T2/T2∗ values, and increased T1rho values. T2∗ values obtainedwith theUTE sequence allowed for delineation among normal, mildly degenerated, and severely degenerated groups (P < 0.001). Conclusions: Quantitative T2∗ measurements acquired with the UTE technique are useful for distinguishing among normal, mildly degenerated, and severely degenerated labra.

In this study, we describe a comprehensive 3D magnetic resonance imaging (MRI) protocol designed to assess major tissue and fluid components in the brain. The protocol comprises four different sequences: 1) magnetization transfer prepared Cones (MT-Cones) for two-pool MT modeling to quantify macromolecular content; 2) short-TR adiabatic inversion-recovery prepared Cones (STAIR-Cones) for myelin water imaging; 3) proton-density weighted Cones (PDw-Cones) for total water imaging; and 4) highly T 2 weighted Cones (T 2 w-Cones) for free water imaging. By integrating these techniques, we successfully mapped key brain components-namely macromolecules, myelin water, intra/extracellular water, and free water-in ten healthy volunteers and five patients with multiple sclerosis (MS) using a 3T clinical scanner. Brain macromolecular proton fraction (MMPF), myelin water proton fraction (MWPF), intra/extracellular water proton fraction (IEWPF), and free water proton fraction (FWPF) values were generated in white matter (WM), grey matter (GM), and MS lesions. Excellent repeatability of the protocol was demonstrated with high intra-class correlation coefficient (ICC) values. In MS patients, the MMPF and MWPF values of the lesions and normal-appearing WM (NAWM) were significantly lower than those in normal WM (NWM) in healthy volunteers. Moreover, we observed significantly higher FWPF values in MS lesions compared to those in NWM and NAWM regions. This study demonstrates the capability of our technique to volumetrically map major brain components. The technique may have particular value in providing a comprehensive assessment of neuroinflammatory and neurodegenerative diseases of the brain., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

The divided subtracted inversion recovery (dSIR) is a high T 1 contrast technique that shows changes in white matter in patients with traumatic brain injury and hypoxic injury. The changes can be explained by small differences in T 1 ; however, to date, there has been no independent validation of the technique using a standard reference. The present study develops the theory of the dSIR signal and performs validation using the NIST/ISMRM T 1 phantom. Non-idealities are explored, including the influence of noise bias and finite repetition time (TR), which leads to the introduction of an optimally efficient TR for inversion recovery acquisitions. Results show excellent agreement with theoretical calculations., (© 2024 John Wiley & Sons Ltd.)

The cartilaginous endplate (CEP) plays a pivotal role in facilitating the supply of nutrients and, transport of metabolic waste, as well as providing mechanical support for the intervertebral disc (IVD). Recent technological advances have led to a surge in MR imaging studies focused on the CEP. This article describes the anatomy and functions of the CEP as well as MRI techniques for both qualitative and quantitative assessment of the CEP. Effective CEP MR imaging sequences require two key features: high spatial resolution and relatively short echo time. High spatial resolution spoiled gradient echo (SPGR) and ultrashort echo time (UTE) sequences, fulfilling these requirements, are the basis for most of the sequences employed in CEP imaging. This article reviews existing sequences for qualitative CEP imaging, such as the fat-suppressed SPGR and UTE, dual-echo subtraction UTE, inversion recovery prepared and fat-suppressed UTE, and dual inversion recovery prepared UTE sequences. These sequences are employed together with other techniques for quantitative CEP imaging, including measurements of T 2 *, T 2 , T 1 , T 1ρ , magnetization transfer, perfusion, and diffusion tensor parameters. EVIDENCE LEVEL: 1 TECHNICAL EFFICACY: Stage 2., (© 2024 International Society for Magnetic Resonance in Medicine.)

Ultra-high contrast (UHC) MRI describes forms of MRI in which little or no contrast is seen on conventional MRI images but very high contrast is seen with UHC techniques. One of these techniques uses the divided subtracted inversion recovery (dSIR) sequence, which, in modelling studies, can produce ten times the contrast of conventional inversion recovery (IR) sequences. When used in cases of mild traumatic brain injury (mTBI), the dSIR sequence frequently shows extensive abnormalities in white matter that appears normal when imaged with conventional T 2 -fluid-attenuated IR (T 2 -FLAIR) sequences. The changes are bilateral and symmetrical in white matter of the cerebral and cerebellar hemispheres. They partially spare the anterior and posterior central corpus callosum and peripheral white matter of the cerebral hemispheres and are described as the whiteout sign. In addition to mTBI, the whiteout sign has also been seen in methamphetamine use disorder and Grinker's myelinopathy (delayed post-hypoxic leukoencephalopathy) in the absence of abnormalities on T 2 -FLAIR images, and is a central component of post-insult leukoencephalopathy syndromes. This paper describes the concept of ultra-high contrast MRI, the whiteout sign, the theory underlying the use of dSIR sequences and post-insult leukoencephalopathy syndromes.

Background: Delayed Post-Hypoxic Leukoencephalopathy (DPHL), or Grinker's myelinopathy, is a syndrome in which extensive changes are seen in the white matter of the cerebral hemispheres with MRI weeks or months after a hypoxic episode. T 2 -weighted spin echo (T 2 -wSE) and/or T 2 -Fluid Attenuated Inversion Recovery (T 2 -FLAIR) images classically show diffuse hyperintensities in white matter which are thought to be near pathognomonic of the condition. The clinical features include Parkinsonism and akinetic mutism. DPHL is generally regarded as a rare condition. Methods and Results: Two cases of DPHL imaged with MRI nine months and two years after probable hypoxic episodes are described. No abnormalities were seen on the T 2 -FLAIR images with MRI, but very extensive changes were seen in the white matter of the cerebral and cerebellar hemisphere on divided Subtraction Inversion Recovery (dSIR) images. dSIR sequences may produce ten times the contrast of conventional inversion recovery (IR) sequences from small changes in T 1 . The clinical findings in both cases were of cognitive impairment without Parkinsonism or akinetic mutism. Conclusion: The classic features of DPHL may only represent the severe end of a spectrum of diseases in white matter following global hypoxic injury to the brain. The condition may be much more common than is generally thought but may not be recognized using conventional clinical and MRI criteria for diagnosis. Reappraisal of the syndrome of DPHL to include clinically less severe cases and to encompass recent advances in MRI is advocated.

Background: Myelin water imaging (MWI) is a myelin-specific technique, which has great potential for the assessment of demyelination and remyelination. This study develops a new MWI method, which employs a short repetition time adiabatic inversion recovery (STAIR) technique in combination with a commonly used fast spin echo (FSE) sequence and provides quantification of myelin water (MW) fractions., Method: Whole-brain MWI was performed using the short repetition time adiabatic inversion recovery prepared-fast spin echo (STAIR-FSE) technique on eight healthy volunteers (mean age: 38±14 years, four-males) and seven patients with multiple sclerosis (MS) (mean age: 53.7±8.7 years, two-males) on a 3T clinical magnetic resonance imaging scanner. To facilitate the quantification of apparent myelin water fraction (aMWF), a proton density-weighted FSE was also used during the scans to allow total water imaging. The aMWF measurements of MS lesions and normal-appearing white matter (NAWM) regions in MS patients were compared with those measured in normal white matter (NWM) regions in healthy volunteers. Both the analysis of variance (ANOVA) test and paired comparison were performed for the comparison., Results: The MW in the whole-brain was selectively imaged and quantified using the STAIR-FSE technique in all participants. MS lesions showed much lower signal intensities than NAWM in the STAIR-FSE images. ANOVA analysis revealed a significant difference in the aMWF measurements between the three groups. Moreover, the aMWF measurements in MS lesions were significantly lower than those in both NWM of healthy volunteers and NAWM of MS patients. Lower aMWF measurements in NAWM were also found in comparison with those in NWM., Conclusions: The STAIR-FSE technique is capable of measuring aMWF values for the indirect detection of myelin loss in MS, thus facilitating clinical translation of whole brain MWI and quantification, which show great potential for the detection and evaluation of changes in myelin in the brain of patients with MS for future larger cohort studies., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-23-1021/coif). J.D. serves as an unpaid editorial board member of Quantitative Imaging in Medicine and Surgery. G.M.B. is a clinical consultant to Magnetica, Brisbane, Australia. The other authors have no conflicts of interest to declare., (2024 Quantitative Imaging in Medicine and Surgery. All rights reserved.)

This review describes targeted magnetic resonance imaging (tMRI) of small changes in the T 1 and the spatial properties of normal or near normal appearing white or gray matter in disease of the brain. It employs divided subtracted inversion recovery (dSIR) and divided reverse subtracted inversion recovery (drSIR) sequences to increase the contrast produced by small changes in T 1 by up to 15 times compared to conventional T 1 -weighted inversion recovery (IR) sequences such as magnetization prepared-rapid acquisition gradient echo (MP-RAGE). This increase in contrast can be used to reveal disease with only small changes in T 1 in normal appearing white or gray matter that is not apparent on conventional MP-RAGE, T 2 -weighted spin echo (T 2 -wSE) and/or fluid attenuated inversion recovery (T 2 -FLAIR) images. The small changes in T 1 or T 2 in disease are insufficient to produce useful contrast with conventional sequences. To produce high contrast dSIR and drSIR sequences typically need to be targeted for the nulling TI of normal white or gray matter, as well as for the sign and size of the change in T 1 in these tissues in disease. The dSIR sequence also shows high signal boundaries between white and gray matter. dSIR and drSIR are essentially T 1 maps. There is a nearly linear relationship between signal and T 1 in the middle domain (mD) of the two sequences which includes T 1 s between the nulling T 1 s of the two acquired IR sequences. The drSIR sequence is also very sensitive to reductions in T 1 produced by Gadolinium based contrast agents (GBCAs), and when used with rigid body registration to align three-dimensional (3D) isotropic pre and post GBCA images may be of considerable value in showing subtle GBCA enhancement. In serial MRI studies performed at different times, the high signal boundaries generated by dSIR and drSIR sequences can be used with rigid body registration of 3D isotropic images to demonstrate contrast arising from small changes in T 1 (without or with GBCA enhancement) as well as small changes in the spatial properties of normal tissues and lesions, such as their site, shape, size and surface. Applications of the sequences in cases of multiple sclerosis (MS) and methamphetamine dependency are illustrated. Using targeted narrow mD dSIR sequences, widespread abnormalities were seen in areas of normal appearing white matter shown with conventional T 2 -wSE and T 2 -FLAIR sequences. Understanding of the features of dSIR and drSIR images is facilitated by the use of their T 1 -bipolar filters; to explain their targeting, signal, contrast, boundaries, T 1 mapping and GBCA enhancement. Targeted MRI (tMRI) using dSIR and drSIR sequences may substantially improve clinical MRI of the brain by providing unequivocal demonstration of abnormalities that are not seen with conventional sequences., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-23-232/coif). JD serves as an unpaid editorial board member of Quantitative Imaging in Medicine and Surgery. MNJP is a scientific and technical adviser to Magnetica, Brisbane, Australia. GMB is a clinical consultant to Magnetica, Brisbane, Australia. The other authors have no conflicts of interest to declare., (2023 Quantitative Imaging in Medicine and Surgery. All rights reserved.)

Purpose: Using ultrashort echo time (UTE) MRI, we determined prevalence of abnormal cartilaginous endplate (CEP), and the relationship between CEP and disc degeneration in human lumbar spines., Materials and Methods: Lumbar spines from 71 cadavers (age 14-74 years) were imaged at 3 T using sagittal UTE and spin echo T2 map sequences. On UTE images, CEP morphology was defined as "normal" with linear high signal intensity or "abnormal" with focal signal loss and/or irregularity. On spin echo images, disc grade and T2 values of the nucleus pulposus (NP) and annulus fibrosus (AF) were determined. 547 CEPs and 284 discs were analysed. Effects of age, sex, and level on CEP morphology, disc grade, and T2 values were determined. Effects of CEP abnormality on disc grade, T2 of NP, and T2 of AF were also determined., Results: Overall prevalence of CEP abnormality was 33% and it tended to increase with older ages (p = 0.08) and at lower spinal levels of L5 than L2 or L3 (p = 0.001). Disc grades were higher and T2 values of the NP were lower in older spines (p < 0.001) and at lower disc level of L4-5 (p < 0.05). We found significant association between CEP and disc degeneration; discs adjacent to abnormal CEPs had high grades (p < 0.01) and lower T2 values of the NP (p < 0.05)., Conclusion: These results suggest that abnormal CEPs are frequently found, and it associates significantly with disc degeneration, suggesting an insight into pathoetiology of disc degeneration., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Magnetic resonance imaging (MRI) uses a large magnetic field and radio waves to generate images of tissues in the body. Conventional MRI techniques have been developed to image and quantify tissues and fluids with long transverse relaxation times (T 2 s), such as muscle, cartilage, liver, white matter, gray matter, spinal cord, and cerebrospinal fluid. However, the body also contains many tissues and tissue components such as the osteochondral junction, menisci, ligaments, tendons, bone, lung parenchyma, and myelin, which have short or ultrashort T 2 s. After radio frequency excitation, their transverse magnetizations typically decay to zero or near zero before the receiving mode is enabled for spatial encoding with conventional MR imaging. As a result, these tissues appear dark, and their MR properties are inaccessible. However, when ultrashort echo times (UTEs) are used, signals can be detected from these tissues before they decay to zero. This review summarizes recent technical developments in UTE MRI of tissues with short and ultrashort T 2 relaxation times. A series of UTE MRI techniques for high-resolution morphological and quantitative imaging of these short-T 2 tissues are discussed. Applications of UTE imaging in the musculoskeletal, nervous, respiratory, gastrointestinal, and cardiovascular systems of the body are included., (© 2022 Author(s).)

This paper updates and extends three previous papers on tissue property filters (TP-filters), Multiplied, Added, Divided and/or Subtracted Inversion Recovery (MASTIR) pulse sequences and synergistic contrast MRI (scMRI). It does this by firstly adding the central contrast theorem (CCT) to TP-filters, secondly including division with MASTIR sequences to make them Multiplied, Added, Subtracted and/or Divided IR (MASDIR) sequences, and thirdly incorporating division into the image processing needed for scMR to increase synergistic T 1 contrast. These updated concepts are then used to explain and improve contrast at tissue boundaries, as well as to develop imaging regimes to detect and monitor small changes to the brain over time and quantify T 1 . The CCT is in two parts: the first part states that contrast produced by each TP is the product of the change in TP multiplied by the TP sequence weighting which is the first partial derivative of the TP-filter. The second part states that the overall fractional contrast is the algebraic sum of the fractional contrasts produced by each of the TPs. Subtraction of two IR sequences alone about doubles contrast relative to a conventional single IR sequence. Division of this subtraction can amplify contrast 5-15 times compared with conventional IR sequences. Dividing sequences can be problematic in areas where the signal is zero but this is avoided by dividing the difference in signal of two magnitude reconstructed IR sequences by the sum of their signals. The basis for the production of high contrast, high spatial resolution boundaries at white-gray matter junctions, between cerebral cortex and cerebrospinal fluid (CSF) and at other sites with subtracted IR (SIR) and divided subtracted IR (dSIR) sequences is explained and examples are shown. A key concept is the tissue fraction f, which is the proportion of a tissue in a mixture of two tissues within a voxel. Contrast at boundaries is a function of the partial derivative of the TP-filter, the partial derivative of the relevant TP with respect to f, and the partial derivative of f with respect to distance, x. Location of tissue boundaries is important for segmentation and is helpful in determining if inversion times have been chosen correctly. In small change regimes, the high sensitivity to small changes in T 1 provided by dSIR images, together with the high definition boundaries, afford mechanisms for detecting small changes due to contrast agents, disease, perfusion and other causes. 3D isotropic rigid body registration provides a technique for following these changes over time in serial studies. Images showing high lesion contrast, high definition tissue and fluid boundaries, and the detection of small changes are included. T1 maps can be created by linearly scaling dSIR images., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-22-394/coif). JD serves as an unpaid editorial board member of Quantitative Imaging in Medicine and Surgery. GMB is a consultant to Magnetica. The other authors have no conflicts of interest to declare., (2022 Quantitative Imaging in Medicine and Surgery. All rights reserved.)

Purpose: To develop a new myelin water imaging (MWI) technique using a short-TR adiabatic inversion-recovery (STAIR) sequence on a clinical 3T MR scanner., Methods: Myelin water (MW) in the brain has both a much shorter T 1 and a much shorter T 2 * than intracellular/extracellular water. A STAIR sequence with a short TR was designed to efficiently suppress long T 1 signals from intracellular/extracellular water, and therefore allow selective imaging of MW, which has a much shorter T 1 . Numerical simulation and phantom studies were performed to investigate the effectiveness of long T 1 signal suppression. TheT 2 * in white matter (WM) was measured with STAIR and compared with T 2 * measured with a conventional gradient recall echo in in vivo study. Four healthy volunteers and 4 patients with multiple sclerosis were recruited for qualitative and quantitative MWI. Apparent MW fraction was generated to compare MW in normal WM in volunteers to MW in lesions in patients with multiple sclerosis., Results: Both simulation and phantom studies showed that when TR was sufficiently short (eg, 250 ms), the STAIR sequence effectively suppressed long T 1 signals from tissues with a broad range of T 1 s using a single TR/TI combination. The volunteer study showed a short T 2 * of 9.5 ± 1.7 ms in WM, which is similar to reported values for MW. Lesions in patients with multiple sclerosis showed a significantly lower apparent MW fraction (4.5% ± 1.0%) compared with that of normal WM (9.2% ± 1.5%) in healthy volunteers (p < 0.05)., Conclusions: The STAIR sequence provides selective MWI in brain and can quantify reductions in MW content in patients with multiple sclerosis., (© 2022 International Society for Magnetic Resonance in Medicine.)

Background: T 1ρ has been extensively reported as a sensitive biomarker of biochemical changes in the nucleus pulposus (NP) and annulus fibrosis of intervertebral discs (IVDs). However, no T 1ρ study of cartilaginous endplates (CEPs) has yet been reported because the relatively long echo times (TEs) of conventional clinical T 1ρ sequences cannot effectively capture the fast-decaying magnetic resonance signals of CEPs, which have very short T 2 /T 2 *s. This can be overcome by using ultrashort echo time (UTE) T 1ρ acquisitions., Methods: Seventeen subjects underwent UTE with adiabatic T 1ρ preparation (UTE-Adiab-T 1ρ ) and T 2 -weighted fast spin echo imaging of their lumbar spines. Each IVD was manually segmented into seven regions (i.e., outer anterior annulus fibrosis, inner anterior annulus fibrosis, outer posterior annulus fibrosis, inner posterior annulus fibrosis, superior CEP, inferior CEP, and NP). T 1ρ values of these sub-regions were correlated with IVD modified Pfirrmann grades and subjects' ages. In addition, T 1ρ values were compared in subjects with and without low back pain (LBP)., Results: Correlations of T 1ρ values of the outer posterior annulus fibrosis, superior CEP, inferior CEP, and NP with modified Pfirrmann grades were significant (P<0.05) with R values of 0.51, 0.36, 0.38, and -0.94, respectively. Correlations of T 1ρ values of the outer anterior annulus fibrosis, outer posterior annulus fibrosis, and NP with ages were significant with R equal to 0.52, 0.71, and -0.76, respectively. T 1ρ differences of the outer posterior annulus fibrosis, inferior CEP, and NP between the subjects with and without LBP were significant (P=0.005, 0.020, and 0.000, respectively)., Conclusions: The UTE-Adiab-T 1ρ sequence can quantify T 1ρ of whole IVDs including CEPs. This is an advance, and of value for comprehensive assessment of IVD degeneration., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://dx.doi.org/10.21037/qims-21-308). JD serves as an unpaid editorial board member of Quantitative Imaging in Medicine and Surgery. The other authors have no other conflicts of interest to declare., (2022 Quantitative Imaging in Medicine and Surgery. All rights reserved.)

Background: Center-out radial sampling of k-space in magnetic resonance imaging employs a different direction for each readout. Off-resonance artifacts (including those produced by chemical shift between water and fat) found with this type of sampling are usually described as blurring, however more specific characterization of these artifacts can be ascertained from the fact that their point spread function is ring-shaped. This produces effects that differ from those seen with Cartesian sampling of k-space. Experiments were designed to demonstrate the origin of these artifacts and a volunteer was imaged to show them., Methods: Two phantoms containing oil in a syringe and an annulus of oil surrounded by water were scanned with a range of bandwidths from 62.5 down to 4 kHz. In a human volunteer, head, pelvis and spine images were obtained with bandwidths of 62.5 and 4 kHz., Results: The two phantoms showed displacement of the oil signal away from the center into the region of the surrounding water. The effect increased as the bandwidth was decreased. In the head of the volunteer, signal from fat in red bone marrow in the skull was displaced centrally and peripherally relative to water within the marrow, and appeared in the region between the skull and the brain, as well as in the surrounding scalp. Displacements of the former type simulated subdural hematomas. Displacement of perivesical fat signal centrally over the wall of the bladder simulated bladder tumor, and displacement of fat signal from red bone marrow in the lumbar spine to the intervertebral discs simulated their cartilaginous endplates., Conclusions: Center-out radial artifacts are important to recognize on clinical images since they may mimic anatomy and simulate pathology. The article shows how these artifacts originate, includes examples, and describes how the artifacts differ from Cartesian chemical shift artifacts., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/qims-21-115). Dr. JD serves as an unpaid editorial board member of Quantitative Imaging in Medicine and Surgery. The other authors have no conflicts of interest to declare., (2021 Quantitative Imaging in Medicine and Surgery. All rights reserved.)

Purpose: To describe a new method for accurate T 1 measurement of cortical bone that fits the data sets of both 3D UTE actual flip angle imaging (UTE-AFI) and UTE with a single TR (UTE-STR) simultaneously (UTE-AFI-STR)., Theory and Methods: To make both the constant values and longitudinal mapping functions in the signal equations for UTE-AFI and UTE-STR identical, the same RF pulses and flip angles were used. Therefore, there were three unknowns in the three equations. This was sufficient to fit the data. Numerical simulation as well as ex vivo and in vivo cortical bone studies were performed to validate the T 1 measurement accuracy with the UTE-AFI-STR method. The original UTE-AFI variable TR (VTR) (ie, combined UTE-AFI and UTE with VTR) and simultaneous fitting (sf) of UTE-AFI and UTE-VTR (sf-UTE-AFI-VTR) methods were performed for comparison., Results: The numerical simulation study showed that the UTE-AFI-STR method provided accurate value of T 1 when the SNR of the UTE-STR image was higher than 40. The ex vivo study showed that the UTE-AFI-STR method measured the T 1 of cortical bone accurately, with difference ratios ranging from -5.0% to 0.4%. The in vivo study showed a mean T 1 of 246 ms with the UTE-AFI-STR method, and mean difference ratios of 2.4% and 5.0%, respectively, compared with the other two methods., Conclusion: The 3D UTE-AFI-STR method provides accurate mapping of the T 1 of cortical bone with improved time efficiency compared with the UTE-AFI-VTR/sf-UTE-AFI-VTR methods., (© 2021 International Society for Magnetic Resonance in Medicine.)

Background and Purpose: MR imaging has been widely used for the noninvasive evaluation of MS. Although clinical MR imaging sequences are highly effective in showing focal macroscopic tissue abnormalities in the brains of patients with MS, they are not specific to myelin and correlate poorly with disability. We investigated direct imaging of myelin using a 2D adiabatic inversion recovery ultrashort TE sequence to determine its value in assessing disability in MS., Materials and Methods: The 2D inversion recovery ultrashort TE sequence was evaluated in 14 healthy volunteers and 31 patients with MS. MPRAGE and T2-FLAIR images were acquired for comparison. Advanced Normalization Tools were used to correlate inversion recovery ultrashort TE, MPRAGE, and T2-FLAIR images with disability assessed by the Expanded Disability Status Scale., Results: Weak correlations were observed between normal-appearing white matter volume ( R = -0.03, P = .88), lesion load ( R = 0.22, P = .24), and age ( R = 0.14, P = .44), and disability. The MPRAGE signal in normal-appearing white matter showed a weak correlation with age ( R = -0.10, P = .49) and disability ( R = -0.19, P = .31). The T2-FLAIR signal in normal-appearing white matter showed a weak correlation with age ( R = 0.01, P = .93) and disability ( R = 0.13, P = .49). The inversion recovery ultrashort TE signal was significantly negatively correlated with age ( R = -0.38, P = .009) and disability ( R = -0.44; P = .01)., Conclusions: Direct imaging of myelin correlates with disability in patients with MS better than indirect imaging of long-T2 water in WM using conventional clinical sequences., (© 2021 by American Journal of Neuroradiology.)

Long T 2 water contamination is a major challenge with direct in vivo UTE imaging of ultrashort T 2 components in the brain since water contributes most of the signal detected from white and gray matter. The Short TR Adiabatic Inversion Recovery prepared Ultrashort TE (STAIR-UTE) sequence can significantly suppress water signals and simultaneously image ultrashort T 2 components. However, the TR used may not be sufficiently short to allow the STAIR preparation to completely suppress all the water signals in the brain due to specific absorption rate (SAR) limitations on clinical MR scanners. In this study, we describe a STAIR prepared dual-echo UTE sequence with complex Echo Subtraction (STAIR-dUTE-ES) which improves water suppression for selective ultrashort T 2 imaging compared with that achieved with the STAIR-UTE sequence. Numerical simulations showed that the STAIR-dUTE-ES technique can effectively suppress water signals and allow accurate quantification of ultrashort T 2 protons. Volunteer and Multiple Sclerosis (MS) patient studies demonstrated the feasibility of the STAIR-dUTE-ES technique for selective imaging and quantification of ultrashort T 2 components in vivo. A significantly lower mean UltraShort T 2 Proton Fraction (USPF) was found in lesions in MS patients (5.7 ± 0.7%) compared with that in normal white matter of healthy volunteers (8.9 ± 0.6%). The STAIR-dUTE-ES sequence provides robust water suppression for volumetric imaging and quantitation of ultrashort T 2 component. The reduced USPF in MS lesions shows the clinical potential of the sequence for diagnosis and monitoring treatment in MS., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background Water signal contamination is a major challenge for direct ultrashort echo time (UTE) imaging of myelin in vivo because water contributes most of the signals detected in white matter. Purpose To validate a new short repetition time (TR) adiabatic inversion recovery (STAIR) prepared UTE (STAIR-UTE) sequence designed to suppress water signals and to allow imaging of ultrashort T2 protons of myelin in white matter using a clinical 3-T scanner. Materials and Methods In this prospective study, an optimization framework was used to obtain the optimal inversion time for nulling water signals using STAIR-UTE imaging at different TRs. Numeric simulation and phantom studies were performed. Healthy volunteers and participants with multiple sclerosis (MS) underwent MRI between November 2018 and October 2019 to compare STAIR-UTE and a clinical T2-weighted fluid-attenuated inversion recovery sequence for assessment of MS lesions. UTE measures of myelin were also performed to allow comparison of signals in lesions and with those in normal-appearing white matter (NAWM) in patients with MS and in normal white matter (NWM) in healthy volunteers. Results Simulation and phantom studies both suggest that the proposed STAIR-UTE technique can effectively suppress long T2 tissues with a broad range of T1s. Ten healthy volunteers (mean age, 33 years ± 8 [standard deviation]; six women) and 10 patients with MS (mean age, 51 years ± 16; seven women) were evaluated. The three-dimensional STAIR-UTE sequence effectively suppressed water components in white matter and selectively imaged myelin, which had a measured T2* value of 0.21 msec ± 0.04 in the volunteer study. A much lower mean UTE measure of myelin proton density was found in MS lesions (3.8 mol/L ± 1.5), and a slightly lower mean UTE measure was found in NAWM (7.2 mol/L ± 0.8) compared with that in NWM (8.0 mol/L ± 0.8) in the healthy volunteers ( P < .001 for both comparisons). Conclusion The short repetition time adiabatic inversion recovery-prepared ultrashort echo time sequence provided efficient water signal suppression for volumetric imaging of myelin in the brain and showed excellent myelin signal contrast as well as marked ultrashort echo time signal reduction in multiple sclerosis lesions and a smaller reduction in normal-appearing white matter compared with normal white matter in volunteers. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Messina and Port in this issue.

This paper reviews magnetic resonance (MR) pulse sequences in which the same or different tissue properties (TPs) such as T 1 and T 2 are used to contribute synergistically to lesion contrast. It also shows how synergistic contrast can be created with Multiplied, Added, Subtracted and/or fiTted Inversion Recovery (MASTIR) sequences, and be used to improve the sensitivity, specificity and scope of clinical magnetic resonance imaging (MRI) protocols. Synergistic contrast can be created from: (i) the same TP, e.g., T 1 used twice or more in a pulse sequence; (ii) different TPs such as ρ m , T 1 , T 2 , and D* used once or more within a sequence, and (iii) additional suppression or reduction of signals from tissues and/or fluids such as fat, long T 2 tissues and cerebrospinal fluid (CSF). The short inversion time (TI) inversion recovery (IR) (STIR) and double IR (DIR) sequences usually show synergistic positive contrast for lesions which have increases in both T 1 and T 2 . The diffusion weighted pulsed gradient spin echo (PGSE) sequence shows synergistic contrast for lesions which have an increase in T 2 and a decrease in D*; the sequence is both positively weighted for T 2 and negatively weighted for D*. In the brain, when an IR sequence nulling white matter has subtracted from it an IR sequence nulling gray matter to form the subtracted IR (SIR) sequence, increases in the single TP T 1 between the two nulling points of the original two sequences generate high synergistic positive contrast. In addition, the subtraction to produce the SIR sequence reduces fat and CSF signals. To provide high sensitivity to changes in TPs in disease the SIR sequence can be used (i) alone to provide synergistic T 1 contrast as above; (ii) with T 2 -weighting to provide synergistic T 1 and T 2 contrast, and (iii) with T 2 - and D*-weighting to provide synergistic T 1 , T 2 , and D* contrast. The SIR sequence can also be used in reversed form (longer TI form minus shorter TI form) to produce very high positive synergistic T 1 contrast for reductions in T 1 , and so increase the positive contrast enhancement produced by clinical gadolinium-based contrast agents (GBCAs) when they reduce T 1 . The specificity of MRI examinations can be improved by using the reversed SIR sequence with a long echo time (TE) gradient echo as well as echo subtraction to show synergistic high contrast from T 1 and T 2 * shortening produced by organic iron. Other added and subtracted forms of the MASTIR sequence can be used synergistically to selectively show myelin, myelin water and fluids including blood and CSF. Protocols using MASTIR sequences to provide synergistic contrast in MRI of the brain, prostate and articular cartilage are included as illustrative examples, and the features of synergistic contrast MRI (scMRI) are compared to those of multiparametric MRI (mpMRI) and functional MRI (fMRI)., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/qims-20-795). JD serves as an unpaid editorial board member of Quantitative Imaging in Medicine and Surgery. The other authors have no conflicts of interest to declare., (2020 Quantitative Imaging in Medicine and Surgery. All rights reserved.)

Purpose: We describe the measurement of bound water T 1 ( T 1 BW ) of cortical bone in vitro and in vivo with a 3D adiabatic inversion recovery ultrashort echo time (IR-UTE) Cones sequence using a clinical 3T scanner., Methods: A series IR-UTE data from 6 repetition times (TRs) with 5 inversion times (TIs) at each TR were acquired from 12 human tibial bone specimens, and data from 4 TRs with 5 TIs at each TR were acquired from the tibial midshafts of 8 healthy volunteers. The pore water nulling point was calculated from exponential fitting of the inversion recovery curve at each TR. Bone specimens and volunteers were then scanned again with the calculated nulling point at each TR. T 1 BW was derived through exponential fitting of data from IR-UTE images acquired at different TRs using the calculated pore water nulling point for each TR., Results: In vitro pore water nulling TIs were 141.3 ± 11.6, 123.4 ± 8.9, 101.3 ± 6.2, 88.9 ± 5.3, 74.8 ± 4.2, and 59.2 ± 3.9 ms for the 6 TRs of 500, 400, 300, 250, 200, and 150 ms, respectively. In vivo pore water nulling TIs were 132.8 ± 12.8, 110.3 ± 10.0, 80.0 ± 7.2, and 63.9 ± 5.4 ms for the 4 TRs of 400, 300, 200, and 150 ms, respectively. Excellent exponential fitting was achieved for IR-UTE imaging of bound water with pore water nulled at each TR. The mean T 1 BW was 106.9 ± 6.3 ms in vitro and 112.3 ± 16.4 ms in vivo., Conclusion: Using the 3D IR-UTE Cones with a variable TR/TI approach, T 1 BW of cortical bone was calculated after complete nulling of pore water signals., (© 2019 International Society for Magnetic Resonance in Medicine.)

The first metatarsophalangeal joint (MTPJ) is vital to the biomechanics of the foot and supports a weight up to eight times heavier than the body during athletic activities. The first MTPJ comprises osseous and cartilaginous surfaces along with a complex of supporting structures, including the dorsal extensor tendons, collateral ligaments, and a plantar plate complex. In contradistinction to the lesser MTPJ plantar plates, a single dominant fibrocartilaginous capsular thickening does not exist at the first MTPJ. Instead, the plantar plate complex comprises a fibrocartilaginous pad that invests the hallux sesamoids and is inseparable from the plantar capsule, the intersesamoid ligament, paired metatarsosesamoid and sesamoid phalangeal ligaments (SPLs), and the musculotendinous structures. Acute injury at the first MTPJ is typically secondary to forced hyperextension-turf toe-and can involve multiple structures. During hyperextension, the resulting forces primarily load the distal SPLs, making these structures more susceptible to injury. SPL injuries are best seen in the sagittal plane at MRI. Radiography can also aid in diagnosis of full-thickness SPL tears, demonstrating reduced sesamoid excursion at lateral dorsiflexed (stress) views. Hallux valgus is another common condition, resulting in progressive disabling deformity at the first MTPJ. Without appropriate treatment, first MTPJ injuries may progress to degenerative hallux rigidus. The authors detail the anatomy of the first MTPJ in cadaveric forefeet by using high-resolution 3-T and 11.7-T MRI and anatomic-pathologic correlation. Injuries to the plantar plate complex, collateral ligaments, and extensor mechanism are discussed using clinical case examples. Online supplemental material is available for this article. © RSNA, 2020.

The group of Multiplied, Added, Subtracted and/or fiTted Inversion Recovery (MASTIR) pulse sequences in which usually two or more inversion recovery (IR) images of different types are combined is described, and uses for this type of sequence are outlined. IR sequences of different types can be multiplied, added, subtracted, and/or fitted together to produce variants of the MASTIR sequence. The sequences provide a range of options for increasing image contrast, demonstrating specific tissues and fluids of interest, and suppressing unwanted signals. A formalism using the concept of pulse sequences as tissue property filters is used to explain the signal, contrast and weighting of the pulse sequences with both univariate and multivariate filter models. Subtraction of one magnitude reconstructed IR image from another with a shorter TI can produce very high T 1 dependent positive contrast from small increases in T 1 . The reverse subtracted IR sequence can provide high positive contrast enhancement with gadolinium chelates and iron deposition which decrease T 1 . Additional contrast to that arising from increases in T 1 can be produced by supplementing this with contrast arising from concurrent increases in ρ m and T 2 , as well as increases or decreases in diffusion using subtraction IR with echo subtraction and/or diffusion subtraction. Phase images may show 180º differences as a result of rotating into the transverse plane both positive and negative longitudinal magnetization. Phase images with contrast arising in this way, or other ways, can be multiplied by magnitude IR images to increase the contrast of the latter. Magnetization Transfer (MT) and susceptibility can be used with IR sequences to improve contrast. Selective images of white and brown adipose tissue lipid and water components can be produced using different TIs and in and out-of-phase TEs. Selective images of ultrashort and short T 2 tissue components can be produced by nulling long T 2 tissue components with an inversion pulse and subtraction of images with longer TEs from images with ultrashort TEs. The Double Echo Sliding IR (DESIRE) sequence provides images with a wide range of TIs from which it is possible to choose values of TI to achieve particular types of tissue and/or fluid contrast (e.g., for subtraction with different TIs, as described above, and for long T 2 tissue signal nulling with UTE sequences). Unwanted tissue and fluid signals can be suppressed by addition and subtraction of phase-sensitive (ps) and magnitude reconstructed images. The sequence also offers options for synergistic use of the changes in blood and tissue ρ m , T 1 , T 2 /T 2 *, D* and perfusion that can be seen with fMRI of the brain. In-vivo and ex-vivo illustrative examples of normal brain, cartilage, multiple sclerosis, Alzheimer's disease, and peripheral nerve imaged with different forms of the MASTIR sequence are included., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/qims-20-568). JD serves as an unpaid editorial board member of Quantitative Imaging in Medicine and Surgery. The other authors have no conflicts of interest to declare., (2020 Quantitative Imaging in Medicine and Surgery. All rights reserved.)

This paper describes a quantitative approach to understanding the signal, contrast and weighting of magnetic resonance (MR) images. It uses the concept of pulse sequences as tissue property (TP) filters and models the signal, contrast and weighting of sequences using either a single TP-filter (univariate model) or several TP-filters (the multivariate model). For the spin echo (SE) sequence using the Bloch equations, voxel signal intensity is plotted against the logarithm of the value of the TPs contributing to the sequence signal to produce three TP-filters, an exponential ρ m -filter, a low pass T 1 -filter and a high pass T 2 -filter. Using the univariate model which considers signal changes in only one of ρ m , T 1 , or T 2 at a time, the first partial derivative of signal with respect to the natural logarithm of ρ m , T 1 or T 2 is the sequence weighting for each filter (for small changes in each TP). Absolute contrast is then the sequence weighting multiplied by the fractional change in TP for each filter. For large changes in TPs, the same approach is followed, but using the mean slope of the filter as the sequence weighting. These approaches can also be used for fractional contrast. The univariate TP-filter model provides a mathematical framework for converting conventional qualitative univariate weighting as used in everyday clinical practice into quantitative univariate weighting. Using the multivariate model which considers several TP-filters together, the relative contributions of each TP to overall sequence and image weighting are expressed as sequence and imaging weighting ratios respectively. This is not possible with conventional qualitative weighting which is univariate. The same approaches are used for inversion recovery (IR), pulsed gradient SE, spoiled gradient echo (SGE), balanced steady state free precession, ultrashort echo time and other pulse sequences. Other TPs such as susceptibility, chemical shift and flow can be included with phase along the Y axis of the TP-filter. Contrast agent effects are also included. In the text TP-filters are distinguished from k-space filters, signal filters (S-filters) which are used in imaging processing as well as to describe windowing the signal width and level of images, and spatial filters. The TP-filters approach resolves many of the ambiguities and inconsistencies associated with conventional qualitative weighting and provides a variety of new insights into the signal, contrast and weighting of MR images which are not apparent using qualitative weighting. The TP-filter approach relates the preparation component of pulse sequences to voxel signal, and contrast between two voxels. This is complementary to k-space which relates the acquisition component of pulse sequences to the spatial properties of MR images and their global contrast., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/qims.2020.04.07). JD serves as an unpaid editorial board member of Quantitative Imaging in Medicine and Surgery. The other authors have no conflicts of interest to declare., (2020 Quantitative Imaging in Medicine and Surgery. All rights reserved.)

Background Signal contamination from long T2 water is a major challenge in direct imaging of myelin with MRI. Nulling of the unwanted long T2 signals can be achieved with an inversion recovery (IR) preparation pulse to null long T2 white matter within the brain. The remaining ultrashort T2 signal from myelin can be detected with an ultrashort echo time (UTE) sequence. Purpose To develop patient-specific whole-brain myelin imaging with a three-dimensional double-echo sliding inversion recovery (DESIRE) UTE sequence. Materials and Methods The DESIRE UTE sequence generates a series of IR images with different inversion times during a single scan. The optimal inversion time for nulling long T2 signal is determined by finding minimal signal on the second echo. Myelin images are generated by subtracting the second echo image from the first UTE image. To validate this method, a prospective study was performed in phantoms, cadaveric brain specimens, healthy volunteers, and patients with multiple sclerosis (MS). A total of 20 healthy volunteers (mean age, 40 years ± 13 [standard deviation], 10 women) and 20 patients with MS (mean age, 58 years ± 8; 15 women) who underwent MRI between November 2017 and February 2019 were prospectively included. Analysis of variance was performed to evaluate the signal difference between MS lesions and normal-appearing white matter in patients with MS. Results High signal intensity and corresponding T2* and T1 of the extracted myelin vesicles provided evidence for direct imaging of ultrashort-T2 myelin protons using the UTE sequence. Gadobenate dimeglumine phantoms with a wide range of T1 values were selectively suppressed with DESIRE UTE. In the ex vivo brain study of MS lesions, signal loss was observed in MS lesions and was conformed with histologic analysis. In the human study, there was a significant reduction in normalized signal intensity in MS lesions compared with that in normal-appearing white matter (0.19 ± 0.10 vs 0.76 ± 0.11, respectively; P < .001). Conclusion The double-echo sliding inversion recovery ultrashort echo time sequence can generate whole-brain myelin images specifically with a clinical 3-T scanner. © RSNA, 2019 Online supplemental material is available for this article. See also the editorial by Port in this issue.

The purpose of this study is to develop a 3D adiabatic inversion recovery prepared ultrashort echo time Cones (3D IR-UTE-Cones) sequence for high resolution and contrast imaging of the region of osteochondral junction (OCJ) of human knee joint using a clinical 3 T scanner. A feasibility study on direct imaging of the OCJ region was performed on a human patellar cartilage sample and on eight cadaveric knee joints using T 1 -weighted, proton density (PD)-weighted and short-T 2 -weighted 3D IR-UTE-Cones sequences. Contrast to noise ratio was measured to evaluate the effectiveness of the 3D IR-UTE-Cones sequences for selective imaging of the OCJ region. Computed tomography imaging was performed in parallel for the cadaveric knee joints. The optimized T 1 -weighted 3D IR-UTE-Cones sequence was used to image the knee joints of eight healthy volunteers and six patients with osteoarthritis (OA) to evaluate morphological changes in the OCJ region. Clinical PD- and T 2 -weighted FSE sequences were also performed for comparison. The T 1 -weighted 3D IR-UTE-Cones sequence showed high resolution and contrast bright band of the normal OCJ region in the cadaveric joints. Normal OCJ appearances were also seen in healthy volunteers. Abnormal OCJ regions, manifested as ill-defined, focal loss or non-visualization of the high intensity band adjacent to the subchondral bone plate, were observed in the knee joints of both ex vivo and in vivo OA patients. The 3D IR-UTE-Cones sequence can image OCJ regions ex vivo and in vivo, with abnormalities depicted with high resolution and contrast. The technique may be useful for demonstrating involvement of OCJ regions in early OA., (© 2019 John Wiley & Sons, Ltd.)

Entheses are regions where tendons and ligaments attach to bone, and are the primary target in seronegative and other diseases of the musculoskeletal (MSK) system. MRI has been widely used for visualizing features of inflammatory and degenerative MSK disease; however, normal tendons and entheses have short transverse relaxation times (T 2 ), and show little or no signal with conventional clinical MRI pulse sequences, making it difficult to investigate their MR properties. In this study we examined the normal MR morphology of the cadaveric Achilles tendon and enthesis at 3 T using novel three-dimensional ultrashort echo time (3D UTE) Cones sequences, and at 11.7 T using conventional MRI sequences. We also studied the MR properties of the Achilles tendon and enthesis including T 2 *, T 1 , and magnetization transfer ratio (MTR). In addition, MT modeling of macromolecular proton fractions was investigated using 3D UTE Cones sequences at 3 T. Indentation testing was performed to investigate the mechanical properties of the tendons and entheses, and this was followed by histological examination. In total five specimens (<50 years) were investigated. On average, tendons and entheses respectively had T 2 * values of 0.93 ± 0.48 ms and 2.77 ± 0.79 ms, T 1 values of 644 ± 22 ms and 780 ± 55 ms, MTRs of 0.373 ± 0.03 and 0.244 ± 0.009 with an MT power of 1000° and frequency offset of 2 kHz, and macromolecular proton fractions of 18.0 ± 2.2% and 13.9 ± 1.9%. Compared with the tendon, the enthesis generally had a longer T 2 *, a longer T 1 , a lower MTR, and a lower macromolecular proton fraction as well as both a higher Young's modulus and stiffness. Results from this study are likely to provide a useful baseline for identifying deviations from the normal in seronegative arthritis and other disease of the entheses., (© 2018 John Wiley & Sons, Ltd.)

Purpose: UTE sequences with a minimal nominal TE of 8 µs have shown promise for direct imaging of myelin protons (T 2 , < 1 ms). However, there is still debate about the efficiency of 2D slice-selective UTE sequences in exciting myelin protons because the half excitation pulses used in these sequences have a relatively long duration (e.g., 0.3-0.6 ms). Here, we compared UTE and inversion-recovery (IR) UTE sequences used with either hard or half excitation pulses (durations 32 µs or 472 µs, respectively) for imaging myelin in native and deuterated ovine brain at 3T., Methods: Freshly frozen ovine brains were dissected into ∼2 mm-thick pure white matter and ∼3 to 8 mm-thick cerebral hemisphere specimens, which were imaged before and/or after different immersion time in deuterium oxide., Results: Bicomponent T2* analysis of UTE signals obtained with hard excitation pulses detected an ultrashort T 2 component (STC) fraction (f S ) of 0% to 10% in native specimens, and up to ∼86% in heavily deuterated specimens. f S values were significantly affected by the TIs used in IR-UTE sequences with either hard or half excitation pulses in native specimens but not in heavily deuterated specimens. The STC T2* was in the range of 150 to 400 µs in all UTE and IR-UTE measurements obtained with either hard or half excitation pulses., Conclusion: Our results further support myelin protons as the major source of the ultrashort T2* signals seen on IR-UTE images and demonstrate the potential of IR-UTE sequences with half excitation pulses for directly imaging myelin using clinical scanners. Magn Reson Med 80:538-547, 2017. © 2017 International Society for Magnetic Resonance in Medicine., (© 2017 International Society for Magnetic Resonance in Medicine.)

Purpose: To develop an accurate T 1 measurement method for short T 2 tissues using a combination of a 3-dimensional ultrashort echo time cones actual flip angle imaging technique and a variable repetition time technique (3D UTE-Cones AFI-VTR) on a clinical 3T scanner., Methods: First, the longitudinal magnetization mapping function of the excitation pulse was obtained with the 3D UTE-Cones AFI method, which provided information about excitation efficiency and B 1 inhomogeneity. Then, the derived mapping function was substituted into the VTR fitting to generate accurate T 1 maps. Numerical simulation and phantom studies were carried out to compare the AFI-VTR method with a B 1 -uncorrected VTR method, a B 1 -uncorrected variable flip angle (VFA) method, and a B 1 -corrected VFA method. Finally, the 3D UTE-Cones AFI-VTR method was applied to bovine bone samples (N = 6) and healthy volunteers (N = 3) to quantify the T 1 of cortical bone., Results: Numerical simulation and phantom studies showed that the 3D UTE-Cones AFI-VTR technique provides more accurate measurement of the T 1 of short T 2 tissues than the B 1 -uncorrected VTR and VFA methods or the B 1 -corrected VFA method. The proposed 3D UTE-Cones AFI-VTR method showed a mean T 1 of 240 ± 25 ms for bovine cortical bone and 218 ± 10 ms for the tibial midshaft of human volunteers, respectively, at 3 T., Conclusion: The 3D UTE-Cones AFI-VTR method can provide accurate T 1 measurements of short T 2 tissues such as cortical bone. Magn Reson Med 80:598-608, 2018. © 2018 International Society for Magnetic Resonance in Medicine., (© 2018 International Society for Magnetic Resonance in Medicine.)