Three-dimensional double-echo steady-state (3D-DESS) magnetic resonance imaging of the knee: establishment of flip angles for evaluation of cartilage at 1.5 T and 3.0 T

BACKGROUND: The effect of flip angle (FA) on synovial fluid and cartilage signal and on image contrast using three-dimensional double-echo steady-state (3D-DESS) sequence have only been performed with 1.0-T but not with 1.5-T or 3.0-T scanners. PURPOSE: To identify the FA that gives the maximum synovial fluid and cartilage values, and to identify the FA at which maximum values of synovial fluid-cartilage contrast-to-noise ratio (CNR) in 3D-DESS sequences when 1.5-T and 3.0-T scanners are used. MATERIAL AND METHODS: Using 3D-DESS with water-excitation pulse, mid-sagittal plane images of the knees of 10 healthy volunteers (5 men, 5 women; age range, 21-42 years) were obtained with FA varying from 10° to 90°. Synovial fluid signals, cartilage signals, and background were measured at each FA, and the FA that gave the highest synovial fluid and cartilage values was obtained. Synovial fluid-cartilage CNR was also calculated, and the FA that gave the largest CNR was obtained. RESULTS: At 1.5 T, the maximum synovial fluid signal was at FA 90°, and the maximum cartilage signal was at FA 30°. Synovial fluid-cartilage CNR was highest at FA 90° (P < 0.05). At 3.0 T, the maximum synovial fluid signal was at FA 90°, and the maximum cartilage signal was at FA 20°. Synovial fluid-cartilage CNR was highest at FA 90° (P < 0.05). CONCLUSION: In order to improve the visibility of cartilage itself, FA settings of 30° at 1.5 T and 20° at 3.0 T are apparently ideal. For observing the cartilage surface, the most effective FA setting is 90° for both 1.5 T and 3.0 T.