High resolution SE-fMRI in humans at 3 and 7 T using a motor task

Object The sensitivity of spin echo (SE) experiments to blood oxygenation level dependent (BOLD) contrast was explored in a study of the same six subjects carried out at 3 and 7 T. Materials and methods Multi-slice, single shot, spin echo, echo planar images with a voxel size of 1 × 1 × 3 mm³ were acquired at three different echo times, during execution of a simple motor task. Results Significant activation was observed at all echo times at both field strengths. Analysis of the fractional signal change as a function of echo time indicated that the change in relaxation rate, ΔR ₂, at 7 T was −0.51 ± 0.14 s ⁻¹, which was 1.3 times larger than the value found at 3 T. Measurements of the percentage signal change on activation and temporal signal to noise ratio showed that there was an increase in the BOLD contrast to noise ratio (CNR) at 7 versus 3 T by a factor of 1.9. There was no overlap of areas of significant activation in the SE data acquired at either field strength with the site of large veins. Conclusion SE-BOLD CNR in motor cortex was found to increase significantly at 7 T compared with 3 T.     

Effect of new manganese contrast agent on tissue intensities in human volunteers: comparison of 0.23, 0.6 and 1.5 T MRI,a part of a phase I trial

To evaluate the effect of a new oral manganese contrast agent (CMC-001) on magnetic resonance imaging (MRI) intensities at different magnetic field strengths. Twelve healthy volunteers underwent abdominal MRI 1 week before and within 2.5–4.5 h after CMC-001 (MnCl₂ and absorption promoters dissolved in water) intake at three different MR scanners of 0.23, 0.6 and 1.5 T. Image contrast and intensity enhancement of liver and pancreas were analysed relatively to muscle and fat intensities. Manganese blood levels were followed for 24 h. Whole-blood manganese concentration levels stayed within the normal range. The liver intensities on T2w images decreased about 10% for the 1/2 contrast dose and about 20% for the full contrast dose independent of the field strength. The liver intensities on T1w images increased more than 30% for 1/2 contrast dose and over 40% for full contrast dose. The maximum T1 enhancement was achieved at the highest field. Pancreas intensities were not affected. Contrast between liver, muscle and fat intensities increased with magnetic field, as well as standard errors of the volunteer-averaged intensities. Oral intake of CMC-001 influences liver intensities and does not affect pancreas intensities at different magnetic field strengths.     

Complete elimination of the hepatobiliary mr contrast agent Gd-EOB-DTPA in hepatic dysfunction: An experimental study using transport-deficient,mutant rats

Mutant Wistar rats (TR^– rats) are characterized by a defect in the canalicular transport system for organic anions in the hepatocytes. Anionic hepatobiliary contrast agents for X-ray and MR imaging usually depend on this transport system for biliary secretion. The current study investigated in rats whether Gd-EOB-DTPA, a hepatocyte-directed MR contrast agent, can be completely eliminated in the absence of biliary excretion, and whether urinary elimination may compensate for the hepatic dysfunction. In TR^/t- rats elimination of Gd-EOB-DTPA almost completely depended on renal excretion: following intravenous administration of 25µmol kg^–1 Gd-EOB-DTPA only 2.4±0.4% of the injected dose underwent biliary excretion. Nevertheless only 2% of a 10-fold higher dose (250µmolkg^–1 Gd-EOB-DTPA) was still detected in the body 24 hours p.a., and less than 0.5% 7 days p.a. (no statistically significant differences as compared to values in control rats). In TR^– rats, renal and liver signal intensities on T1-weighted MR images returned to baseline within 24 hours following administration of 25µmol kg^–1 Gd-EOB-DTPA. In control rats, return to baseline values was observed already 6 hours after injection of the contrast agent. In conclusion, the hepatobiliary MR contrast agent Gd-EOB-DTPA is effectively and completely cleared from the body even in the virtual absence of biliary excretion. The urinary elimination pathway is able to fully compensate for the deficient hepatic transport system.     

P846, a new gadolinium based low diffusion magnetic resonance contrast agent,in characterizing occlusive infarcts,reperfused ischemic myocardium and reperfused infarcts in rats

OBJECT: This study has two objectives: (1) to compare the kinetics of low diffusion P846 with Gd-DOTA using inversion recovery echo planar (IR-EPI) magnetic resonance (MR) imaging and (2) to determine the potential of P846 in defining myocardial viability in hearts subjected to various injuries using T1-weighted spin echo (T1-SE). MATERIALS AND METHODS: Rats were subjected to (1) occlusive infarcts (n = 16), (2) reperfused ischemic injuries (n = 8) or (3) reperfused infarcts (n = 16). A dose of 0.05 mmol/kg P846 was compared to 0.1 mmol/kg Gd-DOTA. IR-EPI and T1-SE images were obtained during 60 min. T(1), DeltaR(1) and DeltaR(1) ratio were measured on IR-EPI. Infarct extents were evaluated on T1-SE and compared with histochemical staining. RESULTS: Blood DeltaR(1) was higher at 5 min after P846 (6.36 +/- 0.32 s(-1)) than after Gd-DOTA (1.30 +/- 0.14 s(-1); P < 0.001). With P846, occlusive infarcts appeared as a hypoenhanced region surrounded by a hyperenhanced rim that lasted for 60 min. The increase in the DeltaR(1) ratio value was slower after P846 than with Gd-DOTA in the reperfused infarcts, suggesting low diffusion/convection of P846. Gd-DOTA homogenously enhanced both occlusive and reperfused infarcts at 30 min. CONCLUSION: P846 provides better contrast and extended discrimination between occlusive and reperfused infarcts compared with Gd-DOTA. The gadolinium dose could be reduced with P846.     

Contrast enhancement in atherosclerosis development in a mouse model: in vivo results at 2 Tesla

To develop an MRI method for the evaluation of contrast enhancement in early atherosclerotic plaque development in the abdominal aorta of a mouse model. Male apoE^–/– mice from three groups, respectively 4 (n = 6), 8 (n = 11) and 16 (n = 4) weeks were included. Axial T1 spin echo images of the abdominal aorta were obtained above and below the renal arteries (90 m spatial resolution) before and over 1 h after the injection of a macromolecular contrast agent. Signal enhancement was measured in the vessel wall and compared to histological features. Maximal arterial wall signal enhancement was obtained from 16 to 32 min post injection. During this time, the signal-to-noise ratio increased by a factor up to 1.7 in 16 week mice and 2.7 and 2.4 in 8 and 4 weeks mice, respectively. The enhancement of the arterial wall appeared less pronounced in the oldest mice, 16 weeks old, exhibiting more advanced lesions. Using a macromolecular gadolinium agent, contrast uptake in atherogenesis varies with lesion stage and may be related to vessel-wall permeability. Dynamic contrast-enhanced MRI may be useful to evaluate the atherosclerotic plaque activity in mice.     

Effect of Concentration of SH U 555A Labeled Human Melanoma Cells on MR Spin Echo and Gradient Echo Signal Decay at 0.2, 1.5, and 3T

In the current study the effect of increasing concentrations of superparamagnetic iron oxide labeled cells on the MRI signal decay at magnetic field strengths of 0.2, 1.5, and 3 T was evaluated. The spin echo and gradient echo cellular transverse relaxivity was systematically studied for various concentrations (N = 1, 5, 10, 20, 40, and 80 cells/μl_gel) of homogeneously suspended SH U 555A labeled SK-Mel28 human melanoma cells. For all field strengths investigated a linear relationship between cellular transverse relaxation enhancement and cell concentration was found. In the spin echo case, the cellular relaxivities [i.e., d(ΔR ₂)/dN] were determined to 0.12 s⁻¹ (cell/μl)⁻¹ at 0.2 T, 0.16 s⁻¹ (cell/μl)⁻¹ at 1.5 T, and 0.17 s⁻¹ (cell/μl) at 3 T. In the gradient echo case, the calculated cellular relaxivities (i.e., d(ΔR ₂ ^* )/dN) were 0.51 s⁻¹ (cell/μl)⁻¹ at 0.2 T, 0.69 s⁻¹ (cell/μl)⁻¹ at 1.5 T, and 0.71 s⁻¹ (cell/μl)⁻¹ at 3 T. The proposed preparation technique has proven to be a simple and reliable approach to quantify effects of magnetically labeled cells in vitro. On the basis of this quantification well suited tissue specific models can be derived.     

Dose and scanning delay using USPIO for central nervous system macrophage imaging

Rationale and objectives: In experimental allergic encephalomyelitis (EAE), central nervous system (CNS) macrophage imaging is achievable by MRI using AMI-227 an ultra-small particle iron oxide contrast agent at a dose of 300 μmol/kg Fe. The objective was to test the feasibility at the human recommended dose of 45 μmol/kg Fe.Methods: Two groups of EAE rats were tested with AMI-227 using 45 and 300 μmol/kg Fe respectively. Following i.v. injection of AMI-227, they were scanned after a delay of 4–6 and 20–24 h.Results: With a high dose of AMI-227, all animals showed low signal intensity related to iron-loaded macrophages in the CNS. At low dose no abnormalities were found in the CNS. Furthermore, a delay of 4–6 h failed to demonstrate abnormalities even at high dose.Conclusions: Dose, scanning delay after administration and blood half-life are major parameters for T2^* CNS macrophage imaging.     

Magnetic resonance imaging at 1.5 T with immunospecific contrast agent in vitro and in vivo in a xenotransplant model

Object: Demonstrating the feasibility of magnetic resonance imaging (MRI) at 1.5 T of ultrasmall particle iron oxide (USPIO)-antibody bound to tumor cells in vitro and in a murine xenotransplant model. Methods: Human D430B cells or Raji Burkitt lymphoma cells were incubated in vitro with different amounts of commercially available USPIO-anti-CD20 antibodies and cell pellets were stratified in a test tube. For in vivo studies, D430B cells and Raji lymphoma cells were inoculated subcutaneously in immunodeficient mice. MRI at 1.5 T was performed with T1-weighted three-dimensional fast field echo sequences (17/4.6/13°) and T2-weighted three-dimensional fast-field echo sequences (50/12/7°). For in vivo studies MRI was performed before and 24 h after USPIO-anti-CD20 administration. Results: USPIO-anti-CD20-treated D430B cells, showed a dose-dependent decrease in signal intensity (SI) on T2*-weighted images and SI enhancement on T1-weighted images in vitro. Raji cells showed lower SI changes, in accordance to the fivefold lower expression of CD20 on Raji with respect to D430B cells. In vivo 24 h after USPIO-anti-CD20 administration, both tumors showed an inhomogeneous decrease of SI on T2*-weighted images and SI enhancement on T1-weighted images. Conclusions: MRI at 1.5 T is able to detect USPIO-antibody conjugates targeting a tumor-associated antigen in vitro and in vivo.     

Benign prostate hyperplasia: evaluation of treatment response with DCE MRI

Benign prostate hyperplasia (BPH) is a major disease and its non-surgical therapy a major area of interest. The purpose of this study was to establish perfusion parameters in beagles with BPH using dynamic contrast-enhanced (DCE) MRI and to investigate changes due to the effects of finasteride treatment. Twelve male beagles (mean age 4.4±0.9,years) were divided into a control and treatment group that received a daily dose of 1 mg/kg finasteride. DCE MRI was carried out in a clinical scanner using a 3D spoiled gradient echo sequence prior to and during treatment. 0.2 mmol/kg contrast agent (gadoteridol) was administered with an injection rate of 0.2 ml/s followed by a 15 ml flush of saline. Contrast enhancement was evaluated by pharmacokinetic mapping of a two-compartment model with colour overlay images in addition to regional ROI analysis. Quantitative parameters were defined by the amplitude of contrast enhancement A, the exchange rate k_ep and the time to maximum signal enhancement. Dynamic contrast-enhanced MRI investigations of the prostate revealed two distinct zones, an inner, periurethral zone and an outer, parenchymal zone. The periurethral zone is highly vascularized, whereas the parenchymal zone is moderately vascularized when compared to other parenchymal organs. During treatment, in the parenchymal zone the intensity of enhancement (amplitude A) and the time to maximum signal enhancement increased, while the exchange rate k_ep decreased. Dynamic contrast-enhanced MRI of BPH reveals distinct differences between individual zones within the prostate. Moreover, changes during successful treatment suggest increased blood volume per volume of tissue and decreased vessel leakiness.     

MDEFT imaging of the human brain at 8 T

T ₁-weighted images of the human brain obtained with the MDEFT sequence at 8 T are presented. These images are characterized by an excellent contrast and good signal to noise ratio. Importantly, results were obtained with adiabatic spin inversion and demonstrate that such pulses can be used event in the ultra high frequency (>300 MHz) range. It is thus possible to obtain high quality results at this field strength without violating SAR guidelines.     

Contrast-enhanced abdominal echo planar imaging: Dynamic signal-intensity changes following intravenous injection of gadolinium-DOTA

Objectives: After I.V. administration of gadolinium-DOTA, the early contrast enhancement pattern and related signal-intensity (SI) changes in normal abdominal organs (kidney, spleen, liver) are evaluated over the first 4 min by using ultrafast spin-echo echo planar imaging (SE-EPI). Methods: On a 1.5-T magnetic resonance unit ultrafast EPI of the upper abdomen was performed in 12 patients in order to show the contrast enhancement pattern and related measurable SI changes onT ₁ andT ₂-weighted (w) images over the first 4 min after I.V. bolus injection of 0.1 mmol kg^–1 gadolinium (Gd)-DOTA in the spleen, liver, renal cortex, and renal medulla. A TR/TE of 500/44 or 45 ms inT ₁w SE-EPI and a TR/TE of 2000/80 or 100 ms inT ₂-w SE-EPI were used. Results: Typical time-dependent SI changes were noticed onT ₁w images: Subsequent to a SI increase in the renal cortex (starting 7 s after the I.V. injection of Gd-DOTA) SI increased first in the outer renal medulla (6 s later) and then in the inner renal medulla (21 s later). A SI increase was observed in the spleen (starting after 15 s) and in the liver (starting 7 s later). OnT ₂-w images, a SI decrease in the renal cortex (starting after 14 s) was followed by migration of a dark band from the outer (after 46 s) to the inner medulla (after 70 s). Only minimal changes were noticed in the spleen and liver. Conclusions: Ultrafast SE-EPI following I.V. bolus injection of Gd-DOTA enables the observation of the very early contrast agent kinetics in various abdominal organs. The associated SI changes onT ₁- andT ₂- SE EPI are related to organ perfusion and contrast agent tissue concentration and biodistribution.Additional reprints of this chapter may be obtained from the Reprints Department, Chapman & Hall, One Penn Plaza, New York, NY 10119.     

Preliminary experience with a new double-echo half-Fourier single-shot turbo spin echo acquisition in the characterization of liver lesions

A new double-echo half-Fourier single-shot turbo spin echo technique has been implemented in which two images are obtained per excitation pulse, one with an echo time (TE) of 60 ms and another with a TE of 438 ms. The acquisition window per image is 380 ms and is determined by the echo spacing of 4.3 ms and the echo train length of 88 for images with resolution of 160×256. No breath holding was performed. The aim of the study was to test whether the additional information of the late TE image improves the characterization of liver lesions. Twenty-eight patients with 39 focal liver lesions (9 cysts, 11 hemangiomas, and 19 solid lesions) were imaged with the new technique, and signal intensity (SI) ratios of lesion and liver were obtained. At-test analysis showed that in the TE 60 ms image, SI ratios of cysts and hemangiomas were not significantly different, whereas in the TE 438 ms images the two types of lesions can be classified. Signal intensity ratios of solid lesions were in both images clearly lower than those of cysts and hemangiomas. The technique, therefore, seems a promising and straightforward new tool for the characterization of liver lesions.     

Magnetic resonance imaging of the pituitary gland in patients with secondary hypogonadism due to transfusional hemochromatosis

To identify pituitary iron overload in patients with transfusional hemochromatosis causing secondary hypogonadism, we prospectively evaluated signal intensity abnormalities of the anterior lobe of the pituitary gland of 18 patients affected by transfusion-dependent thalassemia major and secondary hypogonadism. Magnetic resonance (MR) imaging is useful to assess pituitary iron overload in patients with transfusional hemochromatosis and secondary hypogonadism by detection of a significant decreased signal intensity of the anterior lobe of the pituitary gland on GRE T2^*-weighted images. The decreased signal intensity of the anterior lobe of the pituitary gland on GRE T2^*-weighted images was correlated to increasing serum ferritin level (r=−0.84,r ²=−0.70,P<0.001). Indeed, the lower the signal intensity of the pituitary gland the greater the serum ferritin level. However an exact quantification of pituitary iron overload by correlation with serum ferritin level is not allowed. No correlation was found between MR imaging results and hormonal status; however, the detection of pituitary iron overload on GRE T2^*-weighted images is consistent with the hypothesis of hypogonadotrophic pituitary insufficiency due to iron-induced cellular damage.     

Single-shot t1-and t2-weighted magnetic resonance imaging of the heart with black blood: preliminary experience

Purpose: To implement and evaluate two robust methods for T1-and T2-weighted snapshot imaging of the heart with data acquisition within a single heart beat and suppression of blood signal. Methods: Both Tl-and T2-weighted diastolic images of the heart can be obtained with half Fourier single-shot turbo spin echo (HASTE) and turbo fast low-angle shot (turboFLASH) sequences, respectively, in less than 350 ms. Signal from flowing blood in the ventricles and large vessels can be suppressed by a preceding inversion recovery preparing pulse pair (PRESTO). Fifteen volunteers and five patients have been evaluated quantitatively for signal-to-noise ratio (SNR) contrast-to-noise ratio (CNR) and flow void and qualitatively for image quality, artifacts, and black-blood effect. Results: Both PRESTO-HASTE and PRESTO-turboFLASH achieved consistently good image quality and blood signal suppression. In contrast to gradient-echo (GRE) echo-planar imaging techniques, (EPI) HASTE and turboFLASH are much less sensitive to local susceptibility differences in the thorax, resulting in a more robust imaging technique without the need for time-consuming system tuning. Compared to standard spin-echo sequences with cardiac triggering, HASTE and turboFLASH have significantly shorter image acquisition times and are not vulnerable to respiratory motion artifacts. Conclusion: PRESTO-HASTE and PRESTO-turboFLASH constitute suitable methods for fast and high-quality cardiac magnetic resonance imaging (MRI).     

Semi-quantitative approach to estimating GFR by magnetic resonance imaging

Objective: The purpose of this study was to compare a semi-quantitative approach to estimating glomerular filtration rate (GFR) by magnetic resonance imaging with radionuclide calculation of GFR, and to investigate whether spin echo or gradient echo is more suitable for estimating GFR.Methods and patients: Fourteen kidneys of seven patients (GFR ranging from 26 to 57 ml/min) were studied. Spin echo and gradient echo sequences interleaving each other at every excitation were used. After intravenous injection of gadopentetate dimeglumine, serial scans were performed. The signal intensities measured in the regions of interest were converted to time-transverse relaxation rate changes for both spin echo (ΔR2) and gradient echo (ΔR2^*). The areas under the time-ΔR2 and time-ΔR2^* curves were calculated as a semi-quantitative index of GFR for both spin echo and gradient echo images, and the results were compared by GFR measured by radionuclide imaging.Results: The semi-quantitative index of the GFR calculated from spin echo images showed a significant correlation with the GFR measured by radionuclide imaging (r=0.85,P<0.001). On the other hand, the semi-quantitative index of the GFR calculated from gradient echo images showed no such correlation (r=0.46,P=0.10).Conclusion: Spin echo sequences may be more suitable than gradient echo sequences for the evaluation of GFR.     

Characterization of late radiation effects in the rat thoracolumbar spinal cord by MR imaging using USPIO

The aim of this study was to detect late radiation effects in the rat spinal cord using MR imaging with ultra-small particles of iron oxide (USPIO) contrast agent to better understand the development of late radiation damage with emphasis on the period preceding neurological signs. Additionally, the role of an inflammatory reaction was assessed by measuring macrophages that internalized USPIO. T₂-weighted spin echo MR measurements were performed at 7T in six rats before paresis was expected (130–150 days post-irradiation, early group), and in six paretic rats (150–190 days post-irradiation, late group). Measurements were performed before, directly after and, only in the early group, 40 h after USPIO administration and compared with histology. In the early group, MR images showed focal regions in grey matter (GM) and white matter (WM) with signal intensity reduction after USPIO injection. Larger lesions with contrast enhancement were located in and around edematous GM of three animals of the early group and five of the late group. Forty hours after injection, additional lesions in WM, GM and nerve roots appeared in animals with GM edema. In the late paretic group, MR imaging showed WM necrosis adjacent to areas with large contrast enhancement. In conclusion, detection of early focal lesions was improved by contrast administration. In the animals with extended radiation damage, large hypo-intense regions appeared due to USPIO, which might be attributed to blood spinal cord barrier breakdown, but the involvement of blood-derived iron-loaded macrophages could not be excluded.     

Characterization and detection of experimental rat gliomas using magnetic resonance imaging

Two different experimental rat brain tumours (F98 glioma and 9L glioma) were characterized using T1 and T2, apparent diffusion coefficient (ADC) and magnetization transfer ratio (MTR). Even though both tumours appeared homogenous at the early stage of growth, significant differences were measured for all parametric images between tumours and normal brain tissue. Irrespective of the sequence used, tumour lesion/normal parenchyma contrast for the non-infiltrative 9L was twice that of the infiltrative F98 glioma. The use of spin preparation via an inversion pulse in a fast spin echo sequence increases contrast by a factor of 20–30.     

Breath-hold spin-echo MR imaging for evaluation of dynamic enhancement of native and treated hepatocellular carcinoma after intravenous Gd-DTPA administration

Using a simple modification of a standard spin-echo sequence which enables acquisition of three breath-hold images in 15 s, dynamic enhancement of 30 histologically proven hepatocellular carcinomas (17 native tumors, 6 completely necrotic tumors after nonsurgical treatments, and 7 tumors with viable and necrotic portions) after intravenous injection of gadolinium-DTPA was evaluated. Native hepatocellular carcinomas and viable portions in treated nodules showed elective enhancement in images obtained 40 s after contrast injection. Contrast between these lesions and the normal liver decreased thereafter. No contrast uptake was seen in entirely necrotic nodules and necrotic portions of treated nodules. Because of the capability to demonstrate the elective arterial blood supply typical of hepatocellular carcinoma, breath-holdT ₁-weighted spin-echo sequence should replace conventionalT ₁-weighted images for the evaluation of intravenously administered gadolinium-DTPA enhancement of this tumor before and after nonsurgical treatments.     

A double-blind study to evaluate the efficacy and tolerability of a higher dose (0.3 mmol per kg bw) of gadodiamide injection as a contrast medium for MRI

Gadodiamide injection was administered intravenously to 48 patients with known or suspected central nervous system (CNS) lesions undergoing magnetic resonance imaging (MRI). Two parallel groups were examined to evaluate the efficacy and safety of single doses of 0.1 and 0.3mmol per kg bw. The principal measures of efficacy were diagnostic yield of MR images, the overall contrast enhancement and the contrast index (CI). Adverse events and serum bilirubin level were the main safety parameters. Nineteen patients in each dose group displayed contrast enhancement of the MR image (1.5 T Siemens Gyroscan MR unit;T ₁ TR/TE=560–650/15–25 ms;T ₂:TR/TE=2200–3100/22–90 ms). The CI increased by 47.3% in the 0.1 mmol/kg bw group and by 86.5% in the 0.3 mmol per kg bw group compared to the pre-contrast scan. Four patients in the 0.1 mmol per kg bw group and seven in the 0.3 mmol per kg bw group had their management changed by new information from the post-contrast scan and four patients in each dose group had their diagnosis altered following the post-contrast scan. Two patients in the 0.3 mmol per kg bw group experienced injection-associated discomfort. There were no other adverse events reported during the 24 h follow-up period. No clinically significant changes in serum bilirubin or other parameters of blood chemistry or haematology were observed. The study demonstrates that the safety profile of gadodiamide injection 0.3 mmol per kg bw is similar to that of 0.1 mmol per kg bw and that, at both doses, gadodiamide injection is a safe and effective contrast medium for use in patients undergoing MRI on the CNS. Slightly more patients had an improvement in diagnostic yield with the 0.3 mmol per kg bw dose and the CI was increased to a greater extent in this group, showing that when greater contrast is required the higher dose of gadodiamide injection may be considered. Further studies in selected patient groups, and with the use of different doses in the same patient are necessary to evaluate the diagnostic value of higher doses.     

Post-processing water-fat imaging technique for fat suppression in a low-field MR imaging system,evaluation in patients with rheumatoid arthritis

Purpose: To evaluate the feasibility of the phase difference-based post-processing water-fat imaging method for fat suppression at low-field in imaging of arthritic joints.Materials and methods: Thirty joints (wrist, 10; elbow, 10; knee, 10) in 30 patients with rheumatoid arthritis were imaged using a 0.23TMRI unit. Contrast-enhanced Tl-weighted (Tlw) three-dimensional (3D) gradient-echo (GRE) images with and without fat suppression along with short inversion time inversion-recovery (STIR) images were evaluated by two radiologists. Contrast-enhanced Tlw 3D GRE images and corresponding post-processed fat-suppressed images were scored for conspicuity and delineation of enhancing synovial hypertrophy. The uniformity of fat suppression was evaluated between Tlw 3D GRE fat-suppressed images and STIR images, and general image quality was estimated for all of the three techniques by consensus. For a quantitative analysis, the enhancing synovial hypertrophy-to-fat contrast-to-noise (CNR) values for the T1W 3D GRE images with and without fat suppression were measured. For comparison, synovial bright signal-to-fat CNR values for the STIR images were measured.Results: The post-processing water-fat imaging technique for fat suppression was successfully applied in all examinations. Conspicuity and delineation of enhancing tissue were superior in fat-suppressed Tlw 3D GRE images compared to non-fat-suppressed images (P < 0.0001). As expected, the enhancing synovial hypertrophy tissue-to-fat CNRs were significantly higher in fat-suppressed Tlw 3D GRE images compared to non-fat-suppressed images (P < 0.0001). General image quality was assessed to be best in non-fat-suppressed images, and the difference was significant compared to fat-suppressed images (P < 0.05) and STIR images (P < 0.05).Conclusion: The phase difference-based post-processing water-fat imaging technique for fat suppression can be successfully used at low-field, and it provides high-quality fat suppression images in imaging of arthritic joints.