Background: Short T2 tissues can be directly visualized by dual-echo ultrashort echo time imaging with weighted subtraction. As a type of post-processing method, exponential subtraction of ultrashort echo time images with an optimal exponential factor is expected to provide improved positive short T2 contrast.
Purpose: To test the feasibility and effectiveness of exponential subtraction in three-dimensional ultrashort echo time imaging and to determine the optimal exponential factor.
Material and methods: A dual-echo three-dimensional ultrashort echo time sequence was implemented on a 3-T MRI system. Exponential subtraction was performed on dual three-dimensional ultrashort echo time images of the tibia of seven healthy volunteers with exponential factors in the range of 1.00-3.00 in increments of 0.01. The regions of interest, including cortical bone, marrow, and muscle, were depicted on subtracted images of different exponential factors. Contrast-to-noise ratio values were calculated from these regions of interest and then used to assess the optimal exponential factor. To determine intra-observer agreement regarding region of interest selection, paired intra-observer measurements of regions of interest in all direct subtraction images were conducted with a one-week interval and the paired measurements were assessed using Bland-Altman analysis and paired-samples t-test.
Results: Cortical bone can be better visualized by using exponential subtraction in three-dimensional ultrashort echo time imaging; the suggested optimal exponential factor is 1.99-2.03 in the tibia. Paired measurements showed excellent intra-observer agreement.
Conclusion: It is feasible to visualize cortical bone of the tibia using exponential subtraction in three-dimensional ultrashort echo time imaging. Compared with weighted subtraction images, exponential subtraction images with an optimal exponential factor provide enhanced visualization of short T2 tissues.
Keywords: Ultrashort echo time; exponential subtraction; magnetic resonance imaging.