Considerations in high resolution skeletal muscle DTI using single-shot EPI with stimulated echo preparation and SENSE

Previous studies have shown that skeletal muscle diffusion tensor imaging (DTI) can non-invasively probe changes in the muscle fiber architecture and microstructure in diseased and damaged muscles. However, DTI fiber reconstruction in small muscles and in muscle regions close to aponeuroses and tendons remains challenging because of partial volume effects. Increasing the spatial resolution of skeletal muscle single-shot diffusion weighted (DW)-EPI can be hindered by the inherently low SNR of muscle DW-EPI due to the short muscle T2 and the high sensitivity of single-shot EPI to off-resonance effects and T2* blurring. In the present work, eddy-current compensated diffusion-weighted stimulated echo preparation is combined with sensitivity encoding (SENSE) to maintain good SNR properties and reduce the sensitivity to distortions and T2* blurring in high resolution skeletal muscle single-shot DW-EPI. An analytical framework is developed for optimizing the reduction factor and diffusion weighting time to achieve maximum SNR. Arguments for the selection of the experimental parameters are then presented considering the compromise between SNR, B0-induced distortions, T2* blurring effects and tissue incoherent motion effects. Based on the selected parameters in a high resolution skeletal muscle single-shot DW-EPI protocol, imaging protocols at lower acquisition matrix sizes are defined with matched bandwidth in the phase-encoding direction and SNR. In vivo results show that high resolution skeletal muscle DTI with minimized sensitivity to geometric distortions and T2* blurring is feasible using the proposed methodology. In particular, a significant benefit is demonstrated from reducing partial volume effects on resolving multi-pennate muscles and muscles with small cross sections in calf muscle DTI.