European Radiology

, Volume 27, Issue 9, pp 3652–3661 | Cite as

CAIPIRINHA accelerated SPACE enables 10-min isotropic 3D TSE MRI of the ankle for optimized visualization of curved and oblique ligaments and tendons

  • Vivek Kalia
  • Benjamin Fritz
  • Rory Johnson
  • Wesley D. Gilson
  • Esther Raithel
  • Jan FritzEmail author



To test the hypothesis that a fourfold CAIPIRINHA accelerated, 10-min, high-resolution, isotropic 3D TSE MRI prototype protocol of the ankle derives equal or better quality than a 20-min 2D TSE standard protocol.


Following internal review board approval and informed consent, 3-Tesla MRI of the ankle was obtained in 24 asymptomatic subjects including 10-min 3D CAIPIRINHA SPACE TSE prototype and 20-min 2D TSE standard protocols. Outcome variables included image quality and visibility of anatomical structures using 5-point Likert scales. Non-parametric statistical testing was used. P values ≤0.001 were considered significant.


Edge sharpness, contrast resolution, uniformity, noise, fat suppression and magic angle effects were without statistical difference on 2D and 3D TSE images (p > 0.035). Fluid was mildly brighter on intermediate-weighted 2D images (p < 0.001), whereas 3D images had substantially less partial volume, chemical shift and no pulsatile-flow artifacts (p < 0.001). Oblique and curved planar 3D images resulted in mildly-to-substantially improved visualization of joints, spring, bifurcate, syndesmotic, collateral and sinus tarsi ligaments, and tendons (p < 0.001, respectively).


3D TSE MRI with CAIPIRINHA acceleration enables high-spatial resolution oblique and curved planar MRI of the ankle and visualization of ligaments, tendons and joints equally well or better than a more time-consuming anisotropic 2D TSE MRI.

Key Points

• High-resolution 3D TSE MRI improves visualization of ankle structures.

• Limitations of current 3D TSE MRI include long scan times.

• 3D CAIPIRINHA SPACE allows now a fourfold-accelerated data acquisition.

• 3D CAIPIRINHA SPACE enables high-spatial-resolution ankle MRI within 10 min.

• 10-min 3D CAIPIRINHA SPACE produces equal-or-better quality than 20-min 2D TSE.





The authors would like to thank Zhang Qiong for his work on the pulse sequence prototype.

Compliance with ethical standards


The scientific guarantor of this publication is Jan Fritz.

Conflict of interest

The authors of this manuscript declare relationships with the following companies: Siemens AG and and Alexion Pharmaceuticals, Inc.


This study has received funding by Siemens AG.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was obtained from all subjects in this study.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

No study subjects or cohorts have been previously reported.


Prospective, experimental, performed at one institution.


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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  1. 1.Department of RadiologyUniversity of Vermont Medical CenterBurlingtonUSA
  2. 2.Russell H. Morgan Department of Radiology and Radiological Science, Section of Musculoskeletal RadiologyJohns Hopkins University School of MedicineBaltimoreUSA
  3. 3.Department of RadiologyUniversity Medical Center FreiburgFreiburg im BreisgauGermany
  4. 4.Siemens Healthcare USA, IncCaryUSA
  5. 5.Siemens Healthcare USA, IncBaltimoreUSA
  6. 6.Siemens Healthcare GmbHErlangenGermany

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