{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T10:37:53Z","timestamp":1785494273438,"version":"3.56.0"},"reference-count":25,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Musculoskelet Radiol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Zero echo time magnetic resonance imaging is an ultrashort echo time technique that enables computed tomography\u2013like visualization of cortical and trabecular bone while preserving the ionizing radiation-free, multiplanar, and soft tissue advantages of conventional magnetic resonance imaging. This narrative review outlines the technical foundations of spinal zero echo time imaging, such as sequence design, key optimization parameters, advanced deep learning\u2013based reconstruction strategies, and common interpretive pitfalls like gas mimicking calcification, metal-related artifacts, and limited spatial resolution. Clinical applications are detailed across traumatic, degenerative, inflammatory, neoplastic, infectious, and developmental spinal conditions, emphasizing how zero echo time complements standard magnetic resonance imaging sequences and often approaches computed tomography in depicting cortical disruption, osteophytes, erosions, sclerosis, and heterotopic ossification.<\/jats:p>\n                  <jats:p>I also highlight emerging roles for zero echo time in pediatric and fetal spine assessment and in magnetic resonance imaging\u2013only surgical planning workflows, where accurate computed tomography\u2013like bone contrast is required but ionizing radiation avoidance is paramount. Collectively, current evidence positions zero echo time as a versatile adjunct that can streamline imaging algorithms, reduce dependence on computed tomography, and support ionizing radiation-sparing magnetic resonance imaging focused pathways for diagnosis, treatment planning, and follow-up in spine disease.<\/jats:p>","DOI":"10.1055\/a-2803-1958","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T23:49:31Z","timestamp":1773704971000},"page":"327-338","source":"Crossref","is-referenced-by-count":1,"title":["Zero Echo Time Magnetic Resonance Imaging of the Spine"],"prefix":"10.1055","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4325-847X","authenticated-orcid":false,"given":"\u00dcst\u00fcn","family":"Ayd\u0131ng\u00f6z","sequence":"additional","affiliation":[{"name":"Department of Radiology, Hacettepe University Hospitals, Ankara, T\u00fcrkiye"},{"name":"Department of Radiology, SSM Health Saint Louis University Hospital, Saint Louis, Missouri, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.1148\/rg.220029","article-title":"Zero echo time musculoskeletal MRI: technique, optimization, applications, and pitfalls","volume":"42","author":"\u00dc Ayd\u0131ng\u00f6z","year":"2022","journal-title":"Radiographics"},{"issue":"11","key":"ref3","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1007\/s11604-023-01449-4","article-title":"Magnetic resonance bone imaging: applications to vertebral lesions","volume":"41","author":"K Tsuchiya","year":"2023","journal-title":"Jpn J Radiol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"266","DOI":"10.2152\/jmi.72.266","article-title":"Zero-echo time (ZTE) and fast field echo resembling a CT using restricted echo-spacing (FRACTURE) on 3-T MRI for the cervical spine","volume":"72","author":"T Okazaki","year":"2025","journal-title":"J Med Invest"},{"key":"ref5","first-page":"112310","article-title":"Zero echo time MRI for preoperative cervical spine assessment: deep learning reconstruction improves image quality and reduces acquisition time","volume":"191","author":"L Peng","year":"2025","journal-title":"Eur J Radiol"},{"issue":"08","key":"ref6","doi-asserted-by":"crossref","first-page":"1705","DOI":"10.1007\/s00256-020-03659-7","article-title":"Fast field echo resembling a CT using restricted echo-spacing (FRACTURE): a novel MRI technique with superior bone contrast","volume":"50","author":"B Johnson","year":"2021","journal-title":"Skeletal Radiol"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"1421876","DOI":"10.3389\/fendo.2024.1421876","article-title":"Bone injury imaging in knee and ankle joints using fast-field-echo resembling a CT using restricted echo-spacing MRI: a feasibility study","volume":"15","author":"N Wang","year":"2024","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"1088","key":"ref8","doi-asserted-by":"crossref","first-page":"20170815","DOI":"10.1259\/bjr.20170815","article-title":"VIBE MRI: an alternative to CT in the imaging of sports-related osseous pathology?","volume":"91","author":"E Koh","year":"2018","journal-title":"Br J Radiol"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s13244-025-01902-0","article-title":"Deep learning reconstruction of zero-echo time sequences to improve visualization of osseous structures and associated pathologies in MRI of cervical spine","volume":"16","author":"M Kaniewska","year":"2025","journal-title":"Insights Imaging"},{"issue":"01","key":"ref10","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1007\/s00590-024-04116-0","article-title":"Diagnosis and evaluation of cervical ossification of the posterior longitudinal ligament on zero-echo time magnetic resonance imaging: an illustrative case series","volume":"35","author":"T Caffard","year":"2024","journal-title":"Eur J Orthop Surg Traumatol"},{"issue":"05","key":"ref11","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.2214\/AJR.21.26239","article-title":"Ossification of the posterior longitudinal ligament on zero-TE MRI with CT-like contrast","volume":"217","author":"Y J Ma","year":"2021","journal-title":"AJR Am J Roentgenol"},{"issue":"07","key":"ref12","doi-asserted-by":"crossref","first-page":"4680","DOI":"10.1007\/s00330-020-07597-9","article-title":"CT-like images based on T1 spoiled gradient-echo and ultra-short echo time MRI sequences for the assessment of vertebral fractures and degenerative bone changes of the spine","volume":"31","author":"B J Schwaiger","year":"2021","journal-title":"Eur Radiol"},{"issue":"05","key":"ref13","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1007\/s00256-023-04507-0","article-title":"Utility of zero-echo time sequence as an adjunct for MR evaluation of degenerative disease in the cervical spine","volume":"53","author":"C V Tran","year":"2024","journal-title":"Skeletal Radiol"},{"issue":"03","key":"ref14","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1007\/s00586-021-07099-2","article-title":"Evaluation of the degenerative lumbar osseous morphology using zero echo time magnetic resonance imaging (ZTE-MRI)","volume":"31","author":"B Hou","year":"2022","journal-title":"Eur Spine J"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"111743","DOI":"10.1016\/j.ejrad.2024.111743","article-title":"Bone assessment of the sacroiliac joint in ankylosing spondylitis: Comparison between computed tomography and zero echo time MRI","volume":"181","author":"Z Zhang","year":"2024","journal-title":"Eur J Radiol"},{"issue":"06","key":"ref16","doi-asserted-by":"crossref","first-page":"3963","DOI":"10.1007\/s00330-021-08513-5","article-title":"Comparison of zero echo time MRI with T1-weighted fast spin echo for the recognition of sacroiliac joint structural lesions using CT as the reference standard","volume":"32","author":"Y Li","year":"2022","journal-title":"Eur Radiol"},{"issue":"12","key":"ref17","doi-asserted-by":"crossref","first-page":"2307","DOI":"10.1007\/s00256-022-04097-3","article-title":"Detailed bone assessment of the sacroiliac joint in a prospective imaging study: comparison between computed tomography, zero echo time, and black bone magnetic resonance imaging","volume":"51","author":"L Wolharn","year":"2022","journal-title":"Skeletal Radiol"},{"issue":"08","key":"ref18","doi-asserted-by":"crossref","first-page":"4979","DOI":"10.1007\/s00330-023-10558-7","article-title":"Preferential involvement of the pelvis and hips along with active sacroiliitis in chronic nonbacterial osteomyelitis: MRI of 97 patients from a single tertiary referral center","volume":"34","author":"\u00dc Ayd\u0131ng\u00f6z","year":"2024","journal-title":"Eur Radiol"},{"issue":"01","key":"ref19","doi-asserted-by":"crossref","first-page":"e231817","DOI":"10.1148\/radiol.231817","article-title":"MRI-based zero echo time and black bone pseudo-CT compared with whole-body CT to detect osteolytic lesions in multiple myeloma","volume":"313","author":"F E Lecouvet","year":"2024","journal-title":"Radiology"},{"issue":"13","key":"ref20","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1097\/BRS.0000000000002462","article-title":"Diagnostic accuracy of zero-echo time MRI for the evaluation of cervical neural foraminal stenosis","volume":"43","author":"E C Argentieri","year":"2018","journal-title":"Spine"},{"issue":"18","key":"ref21","doi-asserted-by":"crossref","first-page":"e25800","DOI":"10.1097\/MD.0000000000025800","article-title":"Clinical feasibility of MR-generated synthetic CT images of the cervical spine: diagnostic performance for detection of OPLL and comparison of CT number","volume":"100","author":"H S Jeong","year":"2021","journal-title":"Medicine (Baltimore)"},{"issue":"02","key":"ref22","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1148\/radiol.2019181695","article-title":"Criteria for early-phase diffuse idiopathic skeletal hyperostosis: development and validation","volume":"291","author":"J S Kuperus","year":"2019","journal-title":"Radiology"},{"issue":"04","key":"ref23","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1093\/rheumatology\/kead362","article-title":"Prevalence of diffuse idiopathic skeletal hyperostosis (DISH) and early-phase DISH across the lifespan of an American population","volume":"63","author":"D E Fournier","year":"2024","journal-title":"Rheumatology (Oxford)"},{"issue":"18","key":"ref24","doi-asserted-by":"crossref","first-page":"4137","DOI":"10.3390\/jcm10184137","article-title":"Associations between clinical findings and severity of diffuse idiopathic skeletal hyperostosis in patients with ossification of the posterior longitudinal ligament","volume":"10","author":"T Hirai","year":"2021","journal-title":"J Clin Med"},{"issue":"02","key":"ref25","doi-asserted-by":"crossref","first-page":"461","DOI":"10.2214\/ajr.177.2.1770461","article-title":"Arachnoiditis ossificans: MR imaging features in five patients","volume":"177","author":"B Frizzell","year":"2001","journal-title":"AJR Am J Roentgenol"},{"issue":"02","key":"ref26","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1177\/21925682241232328","article-title":"Robot-assisted lumbar pedicle screw placement based on 3D magnetic resonance imaging","volume":"15","author":"F CS Altorfer","year":"2025","journal-title":"Global Spine J"}],"container-title":["Seminars in Musculoskeletal Radiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2803-1958.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T22:32:39Z","timestamp":1779489159000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2803-1958"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,16]]},"references-count":25,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2026,5,22]]},"published-print":{"date-parts":[[2026,6]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2803-1958","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1089-7860","1098-898X"],"issn-type":[{"value":"1089-7860","type":"print"},{"value":"1098-898X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,16]]}}}