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Uniform Fat Suppression in Hands and Feet through the Use of Two-Point Dixon Chemical Shift MR Imaging

Mario Maas, MD1, Piet F. Dijkstra, MD, PhD1 and Erik M. Akkerman, PhD1

1 Department of Diagnostic Radiology, Academic Medical Center, Meibergdreef 9/G1-231, 1105 AZ Amsterdam, the Netherlands.



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  		Figure 1. Sagittal, water-only, non–contrast medium–enhanced, MR image (620/17) of the foot. There is homogeneous fat suppression in both the bone marrow and the subcutaneous fat. No displacement artifacts are seen.

 


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  		Figure 2a. (a) Sagittal, water-only, unenhanced, MR image (620/17) of the foot shows minor displacement artifacts (arrow) best appreciated at the margins of the bones. (b) Axial water-only MR image (620/17) of the foot shows severe displacement artifacts (arrows), which hampered interpretation.

 


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  		Figure 2b. (a) Sagittal, water-only, unenhanced, MR image (620/17) of the foot shows minor displacement artifacts (arrow) best appreciated at the margins of the bones. (b) Axial water-only MR image (620/17) of the foot shows severe displacement artifacts (arrows), which hampered interpretation.

 


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  		Figure 3a. Sagittal water-only MR images (620/17) (a) before and (b) after the intravenous administration of gadopentetate dimeglumine in a patient with neuropathic foot disease and an arthrodesis in the tibiotalar joint. a shows slight hyperintensity in the cuboid bone (solid arrow) and the base of the fourth metatarsal bone (open arrow). b shows marked focal enhancement in the cuboid bone (solid straight arrow) and the base of the fourth metatarsal bone (open arrow), which supports the clinical diagnosis of osteomyelitis. Also, note the plantar ulcer with cellulitis (solid curved arrow).

 


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  		Figure 3b. Sagittal water-only MR images (620/17) (a) before and (b) after the intravenous administration of gadopentetate dimeglumine in a patient with neuropathic foot disease and an arthrodesis in the tibiotalar joint. a shows slight hyperintensity in the cuboid bone (solid arrow) and the base of the fourth metatarsal bone (open arrow). b shows marked focal enhancement in the cuboid bone (solid straight arrow) and the base of the fourth metatarsal bone (open arrow), which supports the clinical diagnosis of osteomyelitis. Also, note the plantar ulcer with cellulitis (solid curved arrow).

 




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