Skeletal Radiology

, Volume 46, Issue 1, pp 7–15 | Cite as

Comparing an accelerated 3D fast spin-echo sequence (CS-SPACE) for knee 3-T magnetic resonance imaging with traditional 3D fast spin-echo (SPACE) and routine 2D sequences

  • Faysal F. AltahawiEmail author
  • Kevin J. Blount
  • Nicholas P. Morley
  • Esther Raithel
  • Imran M. Omar
Scientific Article



To compare a faster, new, high-resolution accelerated 3D-fast-spin-echo (3D-FSE) acquisition sequence (CS-SPACE) to traditional 2D and high-resolution 3D sequences for knee 3-T magnetic resonance imaging (MRI).

Materials and methods

Twenty patients received knee MRIs that included routine 2D (T1, PD ± FS, T2-FS; 0.5 × 0.5 × 3 mm3; ∼10 min), traditional 3D FSE (SPACE-PD-FS; 0.5 × 0.5 × 0.5 mm3; ∼7.5 min), and accelerated 3D-FSE prototype (CS-SPACE-PD-FS; 0.5 × 0.5 × 0.5 mm3; ∼5 min) acquisitions on a 3-T MRI system (Siemens MAGNETOM Skyra). Three musculoskeletal radiologists (MSKRs) prospectively and independently reviewed the studies with graded surveys comparing image and diagnostic quality. Tissue-specific signal-to-noise ratios (SNR) and contrast-to-noise ratios (CNR) were also compared.


MSKR-perceived diagnostic quality of cartilage was significantly higher for CS-SPACE than for SPACE and 2D sequences (p < 0.001). Assessment of diagnostic quality of menisci and synovial fluid was higher for CS-SPACE than for SPACE (p < 0.001). CS-SPACE was not significantly different from SPACE but had lower assessments than 2D sequences for evaluation of bones, ligaments, muscles, and fat (p ≤ 0.004). 3D sequences had higher spatial resolution, but lower overall assessed contrast (p < 0.001). Overall image quality from CS-SPACE was assessed as higher than SPACE (p = 0.007), but lower than 2D sequences (p < 0.001). Compared to SPACE, CS-SPACE had higher fluid SNR and CNR against all other tissues (all p < 0.001).


The CS-SPACE prototype allows for faster isotropic acquisitions of knee MRIs over currently used protocols. High fluid-to-cartilage CNR and higher spatial resolution over routine 2D sequences may present a valuable role for CS-SPACE in the evaluation of cartilage and menisci.


3D MRI Accelerated MRI 2D vs. 3D MRI Compressed sensing Incoherent k-space undersampling Nonlinear SENSE-type reconstruction Multiplanar reconstruction Knee MRI 3-T knee MRI 



We would like to acknowledge Bruce Spottiswoode, PhD, and Ke Cheng Liu, PhD, from Siemens for their role in applying the CS-SPACE sequence and setting up the sequence on the institutional MRI scanner. We would also like to acknowledge Dipl-Inf Christoph Forman from Siemens Healthcare GmbH and Jens Wetzl, MSc from the Department of Computer Science of Friedrich-Alexander-University Erlangen-Nuremburg, Germany for their important role in developing the CS-SPACE reconstruction framework.

Compliance with ethical standards

Conflict of interest

This research study was not sponsored financially by any institution. Dr. Raithel is employed by Siemens Healthcare GmbH (Erlangen, Germany). Her contribution to the paper was limited to development of the accelerated sequence and elucidation of the technical factors and descriptive language of the MRI sequences. The study design, data acquisition, data analysis, and interpretation were performed entirely by the remaining authors, who declare that they have no conflicts of interest.


  1. 1.
    Gold GE, Busse RF, Beehler C, et al. Isotropic MRI of the knee with 3D fast spin-echo extended echo-train acquisition (XETA): initial experience. AJR Am J Roentgenol. 2007;188(5):1287–93.CrossRefPubMedGoogle Scholar
  2. 2.
    Gold GE, Fuller SE, Hargreaves BA, Stevens KJ, Beaulieu CF. Driven equilibrium magnetic resonance imaging of articular cartilage: initial clinical experience. J Magn Reson Imaging. 2005;21(4):476–81.CrossRefPubMedGoogle Scholar
  3. 3.
    Kijowski R, Davis KW, Woods MA, et al. Knee joint: comprehensive assessment with 3D isotropic resolution fast spin-echo MR imaging—diagnostic performance compared with that of conventional MR imaging at 3.0 T. Radiology. 2009;252(2):486–95.CrossRefPubMedGoogle Scholar
  4. 4.
    Yao L, Pitts JT, Thomasson D. Isotropic 3D fast spin-echo with proton-density-like contrast: a comprehensive approach to musculoskeletal MRI. AJR Am J Roentgenol. 2007;188(2):W199–201.CrossRefPubMedGoogle Scholar
  5. 5.
    Ristow O, Steinbach L, Sabo G, et al. Isotropic 3D fast spin-echo imaging versus standard 2D imaging at 3.0 T of the knee—image quality and diagnostic performance. Eur Radiol. 2009;19(5):1263–72.CrossRefPubMedGoogle Scholar
  6. 6.
    Subhas N, Kao A, Freire M, Polster JM, Obuchowski NA, Winalski CS. MRI of the knee ligaments and menisci: comparison of isotropic-resolution 3D and conventional 2D fast spin-echo sequences at 3 T. AJR Am J Roentgenol. 2011;197(2):442–50.CrossRefPubMedGoogle Scholar
  7. 7.
    Kijowski R, Davis KW, Blankenbaker DG, Woods MA, Del Rio AM, De Smet AA. Evaluation of the menisci of the knee joint using three-dimensional isotropic resolution fast spin-echo imaging: diagnostic performance in 250 patients with surgical correlation. Skeletal Radiol. 2011.Google Scholar
  8. 8.
    Van Dyck P, Gielen JL, Vanhoenacker FM, et al. Diagnostic performance of 3D SPACE for comprehensive knee joint assessment at 3 T. Insights Imaging. 2012;3(6):603–10.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Kijowski R, Gold GE. Routine 3D magnetic resonance imaging of joints. J Magn Reson Imaging. 2011;33(4):758–71.CrossRefPubMedGoogle Scholar
  10. 10.
    Naraghi A, White LM. Three-dimensional MRI of the musculoskeletal system. AJR Am J Roentgenol. 2012;199(3):W283–93.CrossRefPubMedGoogle Scholar
  11. 11.
    Jung JY, Yoon YC, Kwon JW, Ahn JH, Choe BK. Diagnosis of internal derangement of the knee at 3.0-T MR imaging: 3D isotropic intermediate-weighted versus 2D sequences. Radiology. 2009;253(3):780–7.CrossRefPubMedGoogle Scholar
  12. 12.
    Jung JY, Yoon YC, Kim HR, Choe BK, Wang JH, Jung JY. Knee derangements: comparison of isotropic 3D fast spin-echo, isotropic 3D balanced fast field-echo, and conventional 2D fast spin-echo MR imaging. Radiology. 2013;268(3):802–13.CrossRefPubMedGoogle Scholar
  13. 13.
    Lefevre N, Naouri JF, Bohu Y, Klouche S, Herman S. Partial tears of the anterior cruciate ligament: diagnostic performance of isotropic three-dimensional fast spin-echo (3D-FSE-cube) MRI. Eur J Orthop Surg Traumatol. 2014;24(1):85–91.CrossRefPubMedGoogle Scholar
  14. 14.
    Al saleh H, Hernandez L, Lee KS, Rosas HG, Block WF, Kijowski R. Rapid isotropic resolution cartilage assessment using radial alternating repetition time balanced steady-state free-precession imaging. J Magn Reson Imaging. 2014;40(4):796–803.CrossRefPubMedGoogle Scholar
  15. 15.
    Chen CA, Kijowski R, Shapiro LM, et al. Cartilage morphology at 3.0T: assessment of three-dimensional magnetic resonance imaging techniques. J Magn Reson Imaging. 2010;32(1):173–83.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Kijowski R, Blankenbaker DG, Woods M, Del Rio AM, De Smet AA, Reeder SB. Clinical usefulness of adding 3D cartilage imaging sequences to a routine knee MR protocol. AJR Am J Roentgenol. 2011;196(1):159–67.CrossRefPubMedGoogle Scholar
  17. 17.
    Welsch GH, Zak L, Mamisch TC, et al. Advanced morphological 3D magnetic resonance observation of cartilage repair tissue (MOCART) scoring using a new isotropic 3D proton-density, turbo spin-echo sequence with variable flip angle distribution (PD-SPACE) compared to an isotropic 3D steady-state free precession sequence (true-FISP) and standard 2D sequences. J Magn Reson Imaging. 2011;33(1):180–8.CrossRefPubMedGoogle Scholar
  18. 18.
    Gustas CN, Blankenbaker DG, Rio AM, Winalski CS, Kijowski R. Evaluation of the articular cartilage of the knee joint using an isotropic resolution 3D fast spin-echo sequence with conventional and radial reformatted images. AJR Am J Roentgenol. 2015;205(2):371–9.CrossRefPubMedGoogle Scholar
  19. 19.
    Tsao J. Ultrafast imaging: principles, pitfalls, solutions, and applications. J Magn Reson Imaging. 2010;32(2):252–66.CrossRefPubMedGoogle Scholar
  20. 20.
    Sodickson DK, Manning WJ. Simultaneous acquisition of spatial harmonics (SMASH): fast imaging with radiofrequency coil arrays. Magn Reson Med. 1997;38(4):591–603.CrossRefPubMedGoogle Scholar
  21. 21.
    Pruessmann KP, Weiger M, Scheidegger MB, Boesiger P. SENSE: sensitivity encoding for fast MRI. Magn Reson Med. 1999;42(5):952–62.CrossRefPubMedGoogle Scholar
  22. 22.
    Griswold MA, Jakob PM, Heidemann RM, et al. Generalized autocalibrating partially parallel acquisitions (GRAPPA). Magn Reson Med. 2002;47(6):1202–10.CrossRefPubMedGoogle Scholar
  23. 23.
    Tsao J, Kozerke S. MRI temporal acceleration techniques. J Magn Reson Imaging. 2012;36(3):543–60.CrossRefPubMedGoogle Scholar
  24. 24.
    Donoho DL. Compressed sensing. IEEE Trans Inf Theory. 2006;52(4):1289–306.CrossRefGoogle Scholar
  25. 25.
    Lustig M, Donoho D, Pauly JM. Sparse MRI: The application of compressed sensing for rapid MR imaging. Magn Reson Med. 2007;58(6):1182–95.CrossRefPubMedGoogle Scholar
  26. 26.
    Hamilton LH, Fabregat JA, Moratal D, et al. “PINOT”: time-resolved parallel magnetic resonance imaging with a reduced dynamic field of view. Magn Reson Med. 2011;65(4):1062–74.CrossRefPubMedGoogle Scholar
  27. 27.
    Jung H, Sung K, Nayak KS, Kim EY, Ye JC. K-t FOCUSS: a general compressed sensing framework for high resolution dynamic MRI. Magn Reson Med. 2009;61(1):103–16.CrossRefPubMedGoogle Scholar
  28. 28.
    Otazo R, Kim D, Axel L, Sodickson DK. Combination of compressed sensing and parallel imaging for highly accelerated first-pass cardiac perfusion MRI. Magn Reson Med. 2010;64(3):767–76.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Stalder AF, Schmidt M, Quick HH, et al. Highly undersampled contrast-enhanced MRA with iterative reconstruction: integration in a clinical setting. Magn Reson Med. 2014.Google Scholar
  30. 30.
    Li G, Zaitsev M, Buchert M, et al. Improving the robustness of 3D turbo spin-echo imaging to involuntary motion. MAGMA. 2015;28(4):329–45.CrossRefPubMedGoogle Scholar

Copyright information

© ISS 2016

Authors and Affiliations

  • Faysal F. Altahawi
    • 1
    Email author
  • Kevin J. Blount
    • 1
  • Nicholas P. Morley
    • 2
  • Esther Raithel
    • 3
  • Imran M. Omar
    • 1
  1. 1.Department of RadiologyNorthwestern University Feinberg School of MedicineChicagoUSA
  2. 2.Department of RadiologyMarshfield ClinicMarshfieldUSA
  3. 3.Siemens Healthcare GmbHErlangenGermany

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