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Ultrashort echo time (UTE) MRI of the spine in thalassaemia

Departments of ¹ Imaging and ² Haematology, University College London Hospitals NHS Trust, University College Hospital, Grafton Way, London W1CE 6DB, ³ The Cardiac Magnetic Resonance Unit, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK and ⁴ Department of Radiology, University of California San Diego, 200 West Arbor Drive, San Diego, CA 92103-8756, USA

View larger version (114K): [in a new window]   Figure 1. Normal spine in a 33-year-old volunteer. Sagittal fat and long T2 suppressed ultrashort echo time (FLUTE) (repetition time/echo time=500/0.08 ms) image. The lumbar and lower thoracic discs have a faint high signal in the region of the annulus fibrosus and low signal in the nucleus pulposus. (High signal is seen posteriorly in the lower thoracic/upper lumbar region and in the sacral region adjacent to the spine coil. Artefacts associated with the small useful field of view are seen in the pelvic region and superiorly).

View larger version (108K): [in a new window]   Figure 2. Advanced degenerative disc disease in a 71-year-old woman. Fat and long T2 suppressed ultrashort echo time (FLUTE) (repetition time/echo time=500/0.08 ms) image. There is considerable loss of alignment and disc height. Signal is seen in the annulus fibrosus at T12/L1 disc but elsewhere there are only small irregular areas of higher signal.

View larger version (237K): [in a new window]   Figure 3. Case 1: Male aged 29 years with -thalassaemia major. (a) Two dimensional Fourier transformation (2DFT) T1 weighted (repetition time (TR)/echo time (TE)=500/8 ms), (b) T2 weighted (TR/TEeff=2500/91 ms), (c) Fat suppressed ultrashort echo time (FUTE) (TR/TE=500/0.08 ms) and (d) fat and long T2 suppressed UTE (FLUTE) (TR/TE=500/0.08 ms) images. The bone marrow has a patchy low signal in (a). The vertebral bodies are expanded and the discs show loss of height and variable signal patterns with some high signal areas. The 2DFT T2 weighted scan (b) shows low signal in the marrow with central high centrally in T12/L1 and the three lower discs.(c) shows a moderate signal from the vertebral bodies. There is a loss of disc height with very low signal in L4/L5 centrally and anteriorly in T12/L1, L1/L2 and L2/L3. Diffuse low signal is seen centrally in the discs and the vertebral bodies as T12/L1, L1/L2 and L2/L3. The FLUTE image (d) shows high signal bands parallel to the end-plates at all levels as well as more centrally in the discs at the highest levels.

View larger version (117K): [in a new window]   Figure 4. Case 2: Female aged 33 years with -thalassaemia major. (a) T2 weighted (repetition time (TR)/echo time (TE)eff=2500/91 ms) and (b) fat and long T2 suppressed ultrashort echo time (FLUTE) (TR/TE=500/0.08 ms) images. The marrow signal is moderately reduced in (a) where there is loss of disc signal except at L2/L3 which shows high signal centrally with adjacent reactive changes. The FLUTE image (b) shows high signal in the T10/T11 disc with less marked change in T11/T12 and T12/L1. Low signal is seen centrally in the discs at the lower levels.

View larger version (119K): [in a new window]   Figure 5. Case 3: Female aged 43 years with thalassaemia intermedia. (a) T2 weighted (repetition time (TR)/echo time (TE)eff=2500/91 ms) and (b) fat and long T2 suppressed ultrashort TE (FLUTE) (TR/TE=500/0.08 ms images. The T2 weighted images show a decreased marrow signal and loss of height in the body of T12 but normal disc signal at all levels. The FLUTE scan showed increased signal intensity bands at T11/T12 and T12/L1.