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Shoulder imaging on Panorama HFO with ST Extremity-M coil

Application Tip
Rosen, Philip, Ph.D. Philips Medical Systems Israel

Imaging the shoulder requires good signal-to-noise ratio (SNR) over a sufficiently large field-of-view. This Application Tip describes use of the ST Extremity-M coil for obtaining a high SNR over the entire shoulder. An ExamCard is also included.

 

This work was done at Kolding Hospital, Denmark.

Introduction

The two most common methods for shoulder imaging are to position the single loop ST Multi-Purpose coil at the patient's side or with the arm threaded through the coil and the coil set around the armpit. Alternatively, the ST Extremity-M coil is used in an overlapped or parallel configuration.

 

In the new Panorama HFO Application Guide Release 2.5 (p. 5-21), the configuration shown in the left photo is recommended for imaging the knee with the ST Extremity-M coil.

We used a similar perpendicular arrangement for the shoulder, as shown in the right photo. We found that this setup gives a high SNR over the entire region of the joint.

ST Extremity-M coil for knee imaging Coil positioning for imaging the knee.ST Extremity-M coil for shoulder imaging Shoulder imaging using the coil configuration recommended for the knee.
ST Extremity-M coil for knee imaging
ST Extremity-M coil for shoulder imaging
Coil positioning for imaging the knee.
Shoulder imaging using the coil configuration recommended for the knee.

Patient preparation

For imaging the shoulder, the arm is threaded through one coil, and this coil is set in place around the armpit. The second coil is positioned perpendicular to the first, as shown in the photo, and held by a fixation strap. The coils are kept apart to prevent coupling. Sand bags are not used.

Example images

T1w TSE Tra FOV 160 mm<br>
Voxel 0.50x0.57x3.5mm<br>
Scan time 4:18 minT2w SPAIR Cor FOV 170 mm<br>
Voxel 0.66x0.82x3.5 mm<br>
Scan time 5:12 minT1w a-TSE Cor FOV 180 mm<br>
Voxel 0.55x0.58x3.5 mm<br>
Scan time 5:58 min
T1w TSE Tra
T2w SPAIR Cor
T1w a-TSE Cor
FOV 160 mm
Voxel 0.50x0.57x3.5mm
Scan time 4:18 min
FOV 170 mm
Voxel 0.66x0.82x3.5 mm
Scan time 5:12 min
FOV 180 mm
Voxel 0.55x0.58x3.5 mm
Scan time 5:58 min
T2w SPIR Cor FOV 170 mm<br>
Voxel 0.66x0.82x3.5 mm<br>
Scan time 4:18 minT2w TSE Sag FOV 180 mm<br>
Voxel 0.56x0.69x3.5 mm<br>
Scan time 3:33 min
T2w SPIR Cor
T2w TSE Sag
FOV 170 mm
Voxel 0.66x0.82x3.5 mm
Scan time 4:18 min
FOV 180 mm
Voxel 0.56x0.69x3.5 mm
Scan time 3:33 min

 

The ExamCard that we used to obtain these images can be downloaded here:

Download
Login is required to download ExamCards.

ExamCard overview

Shoulder 1.0T-HFO
Scan 1Survey
Scan 2Reference scan
Scan 3Survey
Scan 4T1w TSE Tra
Scan 5T2w SPAIR Cor
Scan 6T1w a-TSE Cor
Scan 7T2w SPIR Cor
Scan 8T2w TSE Sag

Sequence description

Scan 1: Survey images in three orthogonal planes for the shoulder placed at the magnet isocenter.

 

Scan 2: Reference scan for the mapping of the sensitivity profiles of the Extremity-M coils for the CLEAR algorithm.

 

Scan 3: Survey in three planes aligned to the anatomy of the shoulder.

 

Scan 4: T1w TSE transverse scan with a linear profile (TSE factor=3, TE=21 ms) to image the humeral head, glenoid fossa and articulating cartilage.

 

Scan 5: T2w SPAIR coronal for imaging the rotator cuff and the superior and inferior labrum. SPAIR fat suppression is applied to enhance the fluid signal.

 

Scan 6: T1w coronal asymmetric TSE (TSE factor=8, ES=9.5 ms, TE=20 ms) as an alternative to the linear TSE for a sharper image.

 

Scan 7: T2w SPIR coronal as an alternative to the SPAIR fat suppression.

 

Scan 8: T2w TSE sagittal to show the glenoid fossa and gleno-humeral ligament



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Application Tip
Panorama HFO
Release 1, Release 2
Pulsar
1.0T, 1T, Musculoskeletal, Shoulder
 

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