IDEAL imaging of the musculoskeletal system: Robust water-fat separation for uniform fat suppression, marrow evaluation, and cartilage imaging

OBJECTIVE. The objective of this article is to discuss the acquisition of high-quality MR images of the musculoskeletal system with uniform fat suppression using iterative decomposition of water and fat with echo asymmetry and least-squares estimation ( IDEAL). IDEAL is a three-point water-fat separation method that provides robust fat suppression even in the complex magnetic environments commonly encountered during clinical musculoskeletal imaging. CONCLUSION. The IDEAL technique provides uniform fat saturation even in complex magnetic environments and simultaneously produces in-phase and opposed-phase images that may be useful for characterization of osseous lesions. The IDEAL water-fat separation method is highly versatile and has been successfully combined with T1-weighted, T2-weighted, steady-state free precession, and spoiled gradient-recalled echo techniques to produce highquality MR images in clinically acceptable scanning times.