(DE FSE) A fast spin echo sequence with application of a pulse, which sensitizes the sequence to variations in T2.

(FRFSE, FR-FSE) The fast relaxation fast spin echo sequence provides high signal intensity of fluids even with short repetition times, and can be used with parallel imaging techniques for short breath hold imaging or respiratory gating for free-breathing, high isotropic resolution MR imaging. After signal decay at the end of the echo train, a negative 90° pulse align spins with long T2 from the transverse plane to the longitudinal plane, leading to a much faster recovery of tissues with long T2 time to the equilibrium and thus better contrast between tissues with long and short T2.
Fast relaxation FSE has advantages also for volumetric imaging as the TR can be substantially reduced and thus the scan time. The sequence can be post processed with maximum intensity projection, surface or volume rendering algorithms to visualize anatomical details in brain or spine MRI. Cerebro spinal fluid pulsation artifacts, often problematic in the cervical or thoracic spine may be reduced by radial sampling, in particular when combined with acquisitions of the PROPELLER type.

See also Fast spin echo, Driven Equilibrium.

(FSE) In the pulse sequence timing diagram, a fast spin echo sequence with an echo train length of 3 is illustrated. This sequence is characterized by a series of rapidly applied 180° rephasing pulses and multiple echoes, changing the phase encoding gradient for each echo.
The echo time TE may vary from echo to echo in the echo train. The echoes in the center of the K-space (in the case of linear k-space acquisition) mainly produce the type of image contrast, whereas the periphery of K-space determines the spatial resolution. For example, in the middle of K-space the late echoes of T2 weighted images are encoded. T1 or PD contrast is produced from the early echoes.
The benefit of this technique is that the scan duration with, e.g. a turbo spin echo turbo factor / echo train length of 9, is one ninth of the time. In T1 weighted and proton density weighted sequences, there is a limit to how large the ETL can be (e.g. a usual ETL for T1 weighted images is between 3 and 7). The use of large echo train lengths with short TE results in blurring and loss of contrast. For this reason, T2 weighted imaging profits most from this technique.
In T2 weighted FSE images, both water and fat are hyperintense. This is because the succession of 180° RF pulses reduces the spin spin interactions in fat and increases its T2 decay time. Fast spin echo (FSE) sequences have replaced conventional T2 weighted spin echo sequences for most clinical applications. Fast spin echo allows reduced acquisition times and enables T2 weighted breath hold imaging, e.g. for applications in the upper abdomen.
In case of the acquisition of 2 echoes this type of a sequence is named double fast spin echo / dual echo sequence, the first echo is usually density and the second echo is T2 weighted image. Fast spin echo images are more T2 weighted, which makes it difficult to obtain true proton density weighted images. For dual echo imaging with density weighting, the TR should be kept between 2000 - 2400 msec with a short ETL (e.g., 4).
Other terms for this technique are:
Turbo Spin Echo
Rapid Imaging Spin Echo,
Rapid Spin Echo,
Rapid Acquisition Spin Echo,
Rapid Acquisition with Refocused Echoes

Knee and shoulder MRI exams are the most commonly requested musculoskeletal MRI scans. Other MR imaging of the extremities includes hips, ankles, elbows, and wrists. Orthopedic imaging requires very high spatial resolution for reliable small structure definition and therefore places extremely high demands on SNR.
Exact presentation of joint pathology expects robust and reliable fat suppression, often under difficult conditions like off-center FOV, imaging at the edge of the field homogeneity or in regions with complex magnetic susceptibility.
MR examinations can evaluate meniscal dislocations, muscle fiber tears, tendon disruptions, tendinitis, and diagnose bone tumors and soft tissue masses. MR can also demonstrate acute fractures that are radiographically impossible to see. Evaluation of articular cartilage for traumatic injury or assessment of degenerative disease represents an imaging challenge, which can be overcome by high field MRI applications. Currently, fat-suppressed 3D spoiled gradient echo sequences and density weighted fast spin echo sequences are the gold-standard techniques used to assess articular cartilage.
Open MRI procedures allow the kinematic imaging of joints, which provides added value to any musculoskeletal MRI practice. This technique demonstrates the actual functional impingements or positional subluxations of joints. In knee MRI examinations, the kinematical patellar study can show patellofemoral joint abnormalities.

See also Open MRI, Knee MRI, Low Field MRI.

Multi echo imaging sequences use a series of echoes acquired as a train following after a single excitation pulse. Multiple symmetrical or asymmetrical echoes can be acquired, typically T2 weighted. In spin echo imaging, each echo is formed by a 180° pulse, but also a FSE (TSE, RARE) or EPI sequence can be used. As a difference to a normal fast spin echo sequence, in multi echo imaging, separate images are produced from each echo of the train with different T2 weightings. The signal height reduces with transverse relaxation. This drop in signal can be used to calculate a pure T2 image.

See also Fast Spin Echo.