Table 4 Sequences and indications

T1 SE/FSE

Excellent sequence for illustration of anatomy, bone marrow (conversion), fat content, haemorrhage, calcifications, fracture line, tumor margins, soft tissue. It pairs a good image quality with a high spatial resolution

T2 FSE +/- FS

Sensitive for oedema, bone marrow, effusion and soft tissue (muscle oedema)

Contrast enhanced T1 FS

Fat suppression technique in combination with gadolinium, make it easier to see the enhancement

Contrast will change sensitivity and specificity and increases the confidence in making the diagnosis of osteomyelitis on MR.

Delayed sequence (3-10 minutes)

High spatial resolution, or dynamic contrast series 3D GRE T1for functional imaging (perfusion) with high temporal resolution (3-15sec) and total acquisition time of 5 minutes

SE T1 pre/post injection (subtraction image),

SE T1 FS

3D GRE FS

Dynamic series

Are good for post-treatment evaluation. You should inject contrast agent if STIR/T2 and T1 sequences are normal.

STIR

Sensitive to oedema. It gives a homogenous fat saturation and the possibility of a large field of view. STIR sequences never after gadolinium injection, because the signal of gadolinium is suppressed

PD SE/FSE (FS)

Perfect for anatomy, oedema. Also for evaluating meniscus, ligaments (SE>FSE), articular cartilage, growth cartilage (zone of provisional calcification), and bone marrow (FS)

Gradient Echo FS

Excellent for cartilage, with 3DT1 or T2* is the best sequence for blood products

DWI

Perform a b=0 for the T2-shine-trough-effect. There is not enough evidence for the use of diffusion weighted imaging in osteomyelitis, although in the evaluation of osteomyelitis treatment this could have an application.

Whole body MRI

Evaluation of metastases/LCH, can be performed in case of multifocality