Zero Echo Time MRI for Osseous Assessment of Sports-Related Pathology in Athletes: A Pictorial Essay

David F. Hanff; Filip M. Vanhoenacker; Edwin H.G. Oei

doi:10.5334/jbsr.4198

Zero Echo Time MRI for Osseous Assessment of Sports-Related Pathology in Athletes: A Pictorial Essay

David F. Hanff^*
, Filip M. Vanhoenacker
, Edwin H.G. Oei

^*Corresponding author for this work

Radiology & Nuclear Medicine

AZ St Maarten

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Assessment of cortical bone and mineralized tissue in athletes traditionally relied on radiographs and CT, as conventional MRI provides limited/no signal from cortical bone. Recent advances, particularly zero echo time (ZTE) MRI, enable CT-like visualization of osseous structures within routine MRI protocols. This pictorial essay highlights the added value of ZTE in sports imaging, illustrating its role in the evaluation of stress injuries, occult fractures, osteoid osteoma, osteochondral lesions, calcified tendon pathology, hip and groin pathologies, and relevant differential diagnosis. ZTE complements conventional MRI by improving the depiction of cortical and mineralized abnormalities relevant to athletic populations.

Original language	English
Article number	17
Journal	Journal of the Belgian Society of Radiology
Volume	110
Issue number	1
DOIs	https://doi.org/10.5334/jbsr.4198
Publication status	Published - 2026

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© 2026 The Author(s).

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Zero Echo Time MRI for Osseous Assessment of Sports-Related Pathology in AthletesFinal published version, 5.63 MBLicence: CC BY

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title = "Zero Echo Time MRI for Osseous Assessment of Sports-Related Pathology in Athletes: A Pictorial Essay",

abstract = "Assessment of cortical bone and mineralized tissue in athletes traditionally relied on radiographs and CT, as conventional MRI provides limited/no signal from cortical bone. Recent advances, particularly zero echo time (ZTE) MRI, enable CT-like visualization of osseous structures within routine MRI protocols. This pictorial essay highlights the added value of ZTE in sports imaging, illustrating its role in the evaluation of stress injuries, occult fractures, osteoid osteoma, osteochondral lesions, calcified tendon pathology, hip and groin pathologies, and relevant differential diagnosis. ZTE complements conventional MRI by improving the depiction of cortical and mineralized abnormalities relevant to athletic populations.",

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AB - Assessment of cortical bone and mineralized tissue in athletes traditionally relied on radiographs and CT, as conventional MRI provides limited/no signal from cortical bone. Recent advances, particularly zero echo time (ZTE) MRI, enable CT-like visualization of osseous structures within routine MRI protocols. This pictorial essay highlights the added value of ZTE in sports imaging, illustrating its role in the evaluation of stress injuries, occult fractures, osteoid osteoma, osteochondral lesions, calcified tendon pathology, hip and groin pathologies, and relevant differential diagnosis. ZTE complements conventional MRI by improving the depiction of cortical and mineralized abnormalities relevant to athletic populations.

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Zero Echo Time MRI for Osseous Assessment of Sports-Related Pathology in Athletes: A Pictorial Essay

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