Learning objectives

To detail the existing utility of T1 weighted images in musculoskeletal MR scans. 

To learn the additional or unrecognized importance of T1 weighted sequences in the interpretation of Musculoskeletal MR scans.

Background

Fluid sensitive sequences like FSPD (fat saturated Proton Density) and STIR are given more importance by many readers while interpreting musculoskeletal MRI. T1 weighted sequences are usually ignored as the images are considered as "anatomy weighted". In this review, we discuss the importance of T1 weighted sequences in detecting different pathologies of the musculoskeletal system. 

From Known to Unknown- utility of T1 weighted images. 

Broad concepts On T1W- What is known :

1.  View the "Dark side" with suspicion

If marrow lesions are darker than muscle, they are likely pathological, either due to marrow infiltration or infection. 

Bright signal of bone marrow often seen on fluid-sensitive sequences like STIR and FSPD, and appears brighter than muscle are not pathological. Two examples shown are hematopoietic / red marrow and increased microvascularity due to prior trauma.

Findings and procedure details

Unknown ( or lesser known) concepts On T1W:

1.  View the "Dark side" with suspicion

Dark soft tissue, not seen on fluid sensitive images, is likely due to fibrotic lesions. Examples include De Quervain's tenosynovitis and capsular scarring in the axillary recess.

Conclusion

This review summarises the importance of T1 Weighted sequences in the interpretation of musculoskeletal pathologies. The well-known concepts are first reviewed followed by lesser-known concepts about T1 weighted sequences. In general, apart of excellent anatomic detail on T1 Weighted sequences, there is a wealth of information to diagnose many pathologies.

Link to complete publication here: https://scholar.google.com/citations?view_op=view_citation&hl=en&user=dqpMNRUAAAAJ&cstart=20&pagesize=80&citation_for_view=dqpMNRUAAAAJ:LkGwnXOMwfcC