Perfusion Imaging of the Musculoskeletal System

Perfusion is essential to the metabolism all viable tissues and is an extremely useful measure of tissue activity. The most vascularized musculoskeletal tissues are the hematopoietic bone marrow and the synovium. Perfusion can be evaluated with DCE-MR imaging, IVIM, and to a lesser degree ASL. As outlined in this review, it has a lot of potential clinical musculoskeletal applications, though is generally underused currently. The standardization of data acquisition and a more automated approach to data analysis, using artificial intelligence to consolidate the various perfusion factors into a few perfusion indices will, no doubt, lead to more widespread clinical usage.