Non-contrast diffusion-weighted double echo steady state (DESS) imaging has been proposed as an alternative to T1-weighted contrast-enhanced MRI for the evaluation of synovitis. We investigated various weighting values (β) for hybrid image creation from the weighted difference between echos of the DESS sequence in order to null joint fluid and enhance visualization of the synovium. We found that the extended phase graph (EPG) model provided the best β for low diffusion weighted DESS and fluid ROI mean suppression (FRMS) provided the best β for high diffusion DESS. Both methods showed potential for non-contrast evaluation of synovitis for routine knee scanning.
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