The Dixon technique is a MRI method used for fat suppression and/or fat quantification. The difference in magnetic resonance frequencies between fat and water-bound protons allows the separation of water and fat images based on the chemical shift effect.
This imaging technique is named after Dixon, who published in 1984 the basic idea to use phase differences to calculate water and fat components in postprocessing. Dixon's method relies on acquiring an image when fat and water are 'in phase', and another in 'opposed phase' (out of phase). These images are then added together to get water-only images, and subtracted to get fat-only images. Therefore, this sequence type can deliver up to 4 contrasts in one measurement: in phase, opposed phase, water and fat images. An additional benefit of Dixon imaging is that source images and fat images are also available to the diagnosing physician.
The original two point Dixon sequence (number of points means the number of images acquired at different TE) had limited possibilities to optimize the echo time, spatial resolution, slice thickness, and scan time; but Dixon based fat suppression can be very effective in areas of high magnetic susceptibility, where other techniques fail. This insensitivity to magnetic field inhomogeneity and the possibility of direct image-based water and fat quantification have currently generated high research interests and improvements to the basic method (three point Dixon).
The combination of Dixon with gradient echo sequences allows for example liver imaging with 4 image types in one breath hold. With Dixon TSE/FSE an excellent fat suppression with high resolution can be achieved, particularly useful in imaging of the extremities.
For low bandwidth imaging, chemical shift correction of fat images can be made before recombination with water images to produce images free of chemical shift displacement artifacts. The need to acquire more echoes lengthens the minimum scan time, but the lack of fat saturation pulses extends the maximum slice coverage resulting in comparable scan time.

Knee MRI, with its high soft tissue contrast is one of the main imaging tools to depict knee joint pathology. MRI allows accurate imaging of intra-articular structures such as ligaments, cartilage, menisci, bone marrow, synovium, and adjacent soft tissue.
Knee exams require a dedicated extremity coil, providing a homogenous imaging volume and high SNR to ensure best signal coverage. A complete knee MR examination includes for example sagittal and coronal T1 weighted, and proton density weighted pulse sequences +/- fat saturation, or STIR sequences. For high spatial resolution, maximal 4 mm thick slices with at least an in plane resolution of 0.75 mm and small gap are recommended. To depict the anterior cruciate ligament clearly, the sagittal plane has to be rotated 10 - 20° externally (parallel to the medial border of the femoral condyle). Retropatellar cartilage can bee seen for example in axial T2 weighted gradient echo sequences with Fatsat. However, the choice of the pulse sequences is depended of the diagnostic question, the used scanner, and preference of the operator.
Diagnostic quality in knee imaging is possible with field strengths ranging from 0.2 to 3T. With low field strengths more signal averages must be measured, resulting in increased scan times to provide equivalent quality as high field strengths.
More diagnostic information of meniscal tears and chondral defects can be obtained by direct magnetic resonance arthrography, which is done by introducing a dilute solution of gadolinium in saline (1:1000) into the joint capsule. The knee is then scanned in all three planes using T1W sequences with fat suppression. For indirect arthrography, the contrast is given i.v. and similar scans are started 20 min. after injection and exercise of the knee.
Frequent indications of MRI scans in musculoskeletal knee diseases are:
e.g., meniscal degeneration and tears, ligament injuries, osteochondral fractures, osteochondritis dissecans, avascular bone necrosis and rheumatoid arthritis.

See also Imaging of the Extremities and STIR.

From ONI Medical Systems, Inc.;
MSK-Extremeâ„¢MRI system is a dedicated high field extremity imaging device, designed to provide orthopedic surgeons and other physicians with detailed diagnostic images of the foot, ankle, knee, hand, wrist and elbow, all with the clinical confidence and advantages derived from high field, whole body MRI units. The light weight (less than 650 kg) of the OrthOne System performs rapid patient studies, is easy to operate, has a patient friendly open environment and can be installed in a practice office or hospital, all at a cost similar to a low field extremity machine.
New features include a more powerful operating system that offers increased scan speed as well as a 160-mm knee coil with higher signal to noise ratio, and the option of a CD burner.

A pulse is a rapid change in the amplitude of a RF signal or in some characteristic a RF signal, e.g., phase or frequency, from a baseline value to a higher or lower value, followed by a rapid return to the baseline value. For radio frequencies near the Larmor frequency, it will result in rotation of the macroscopic magnetization vector. The amount of rotation will depend on the strength and duration of the RF pulse; commonly used examples are 90° (p/2) and 180° (p) pulses.
RF pulses are used in the spin preparation phase of a pulse sequence, which prepare the spin system for the ensuing measurements. In many sequences, RF pulses are also applied to the volumes outside the one to be measured. This is the case when spatial presaturation techniques are used to suppress artifacts. Many preparation pulses are required in MR spectroscopy to suppress signal from unwanted spins. The simplest preparation pulse making use of spectroscopic properties is a fat saturation pulse, which specifically irradiates the patient at the fat resonant frequency, so that the magnetization coming from fat protons is tilted into the xy-plane where it is subsequently destroyed by a strong dephasing gradient.
The frequency spectrum of RF pulses is critical as it determines the spatial extension and homogeneity over which the spin magnetization is influenced while a gradient field is applied.

In MR, saturation is a nonequilibrium state with no net magnetization. The same amount of nuclear spins is aligned against and with the magnetic field. Saturation methods like FatSat, SPIR etc., work with a frequency selective saturation pulse for a specific chemical shift applied before the actual sequence starts. This saturation pulse adjusts the magnetization from tissue components to zero. The hydrogen nuclei of fat and water resonate at different frequencies, which makes it possible to excite just the fat with repeatedly applying RF pulses at the Larmor frequency with interpulse times compared to T1. The resulting signal is then destroyed with a gradient pulse (Spoiler Gradient Pulse). Fat is the chemical compound to be saturated at a fat saturation sequence. When the actual sequence follows, (e.g., a spin echo sequence) the unwanted suppressed component will not resonate.

See also Saturation Recovery.