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Šprláková-Puková A, Štouračová A, Repko M, Koriťáková E, Tintěra J, Dostál M, Otaševič T. Prospective Multiparametric Magnetic Resonance Monitoring of Changes in Lesions of Hyaline Cartilage of the Knee Joint After Treatment by Microfractures and Implantation of Biological Collagen Type I Matrix Implants . Acad Radiol 2021; 28:1133-1141. [PMID: 32620530 DOI: 10.1016/j.acra.2020.05.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/12/2020] [Accepted: 05/20/2020] [Indexed: 11/27/2022]
Abstract
RATIONALE AND OBJECTIVES This study's aims were to depict changes in cartilage quality after surgical intervention using magnetic resonance (MR) examination and in content of glycosaminoglycans chains (GAGs) after two types of surgeries - chondral defect treatment by microfractures and scaffold implantation in combination with microfractures. MATERIALS AND METHODS Twenty-five patients were studied: 14 with implants, 11 with microfractures. MR examination was made before surgery and 6, 12, and 18 months thereafter. Qualitative changes in cartilage were observed by means of delayed gadolinium enhanced magnetic resonance imaging of cartilage sequence using Gd-DTPA2- and Gd-DOTA. In each examination, GAGs content was determined at three locations: the defect, its surroundings, and a non-load-bearing reference area. RESULTS Measured indices showed no statistically significant differences in changes within the defect area when comparing the two treatment types at individual time points of 6, 12, and 18 months. In the case of microfracture treatment, more substantial decrease in GAGs concentration occurred at month 6, whereas the greatest decline occurred at month 12 when using an implant. Change in GAGs content and decline in cartilage quality were substantial also in the reference area and close surroundings. CONCLUSIONS Hyaline cartilage behaves as a unified whole, and change in GAGs content was marked also in locations with no morphological damage. Over the monitored period, no statistically significant difference between treatment types was noted as measured by GAGs content in the defect or its close surroundings. dGEMRIC is suitable for monitoring cartilage quality even if use of Gd-DTPA2- is not possible, because comparable results were achieved using Gd-DOTA.
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Eder J, Szomolanyi P, Schmid-Schwap M, Bristela M, Skolka A, Pittschieler E, Piehslinger E, Trattnig S. Early diagnosis of degenerative changes in the articular/fibrocartilaginous disc of the temporomandibular joint in patients with temporomandibular disorders using delayed gadolinium-enhanced MRI at 3 Tesla - preliminary results. Magn Reson Imaging 2019; 67:24-27. [PMID: 31843417 DOI: 10.1016/j.mri.2019.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 12/04/2019] [Accepted: 12/05/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Delayed gadolinium enhanced MRI of cartilage (dGEMRIC) is a quantitative method for assessment of glycosaminoglycan content in connective tissues. We hypothesize that the early diagnosis of degenerative changes in the temporomandibular joint could be diagnosed using dGEMRIC technique. PURPOSE To test the compositional MRI technique, dGEMRIC, at 3 Tesla to diagnosis early the degenerative changes in the fibrocartilaginous disc of the temporomandibular joint (TMJ) in patients with temporomandibular disorders (TMD) and to compare the dGEMRIC index of patients to the healthy volunteers. METHODS Six volunteers (two men, four women; 20.8÷28.1 years) and eleven patients (22 TMJs, seven women, four men; 24÷54 years) were recruited for this prospective trial. Only patients with no morphological abnormality on MRI and without disc dislocations were included. Volunteers were used as a control group. The PD-weighted FSE sequence and the 3D GRE (DESS) sequence protocols were performed for morphological assessment. The Inversion recovery (IR) sequence was performed for T1 relaxation time measurements and intra-venous (IV) contrast agent administration was used according to the dGEMRIC protocol. T1 maps were calculated offline and ROIs were drawn on TMJ discs by a specialist trained in TMD disorders. Statistical evaluation was performed by ANOVA and correlations were calculated. RESULTS The difference between the dGEMRIC values in the TMJ articular discs of the patients and the volunteers was statistically significant (P = .019). After contrast agent administration the T1 values dropped in both groups. In patient group was the T1 drop stronger (-54% from initial pre-contrast value), while in control group was the T1 drop less pronounced (-46% from initial pre-contrast value). CONCLUSIONS dGEMRIC seems to be a useful, compositional, quantitative method, suitable also for small joints, such as the articular disc of the TMJ. The results of the dGEMRIC index in the articular disc of the TMJ imply a lower GAG content in patients with TMJ disorders.
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Affiliation(s)
- Jaryna Eder
- Division of Prosthodontics, University Clinic of Dentistry Vienna, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria.
| | - Pavol Szomolanyi
- High-Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria; Department of Imaging Methods, Institute of Measurement Science, Slovak Academy of Sciences, Dubravska cesta 9, 84219 Bratislava, Slovakia
| | - Martina Schmid-Schwap
- Division of Prosthodontics, University Clinic of Dentistry Vienna, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria
| | - Margit Bristela
- Division of Prosthodontics, University Clinic of Dentistry Vienna, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria
| | - Astrid Skolka
- Division of Prosthodontics, University Clinic of Dentistry Vienna, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria
| | - Elisabeth Pittschieler
- Private practice for orthodontics and craniomandibular disorders, Reichsratsstraße 5/4a1010, Vienna, Austria
| | - Eva Piehslinger
- Division of Prosthodontics, University Clinic of Dentistry Vienna, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria
| | - Siegfried Trattnig
- High-Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria; CD Laboratory for Molecular Clinical MR Imaging, Vienna, Austria; Austrian Cluster for Tissue Regeneration, Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Vienna, Austria
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Tjörnstrand J, Neuman P, Svensson J, Lundin B, Dahlberg LE, Tiderius CJ. Osteoarthritis development related to cartilage quality-the prognostic value of dGEMRIC after anterior cruciate ligament injury. Osteoarthritis Cartilage 2019; 27:1647-1652. [PMID: 31279937 DOI: 10.1016/j.joca.2019.06.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 05/22/2019] [Accepted: 06/13/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Rupture of the anterior cruciate ligament (ACL) increases the risk of developing osteoarthritis (OA). Delayed Gadolinium enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) investigates cartilage integrity through T1-analysis after intravenous contrast injection. A high dGEMRIC index represents good cartilage quality. The main purpose of this prospective cohort study was to investigate the prognostic value of the dGEMRIC index regarding future knee OA. METHOD 31 patients with ACL injury (mean age 27 ± 6.7 (±SD) years, 19 males) were examined after 2 years with 1.5T dGEMRIC of femoral cartilage. Re-examination 14 years post-injury included weight-bearing knee radiographs, Lysholm and Knee Osteoarthritis Outcome Score (KOOS). RESULTS At the 14-year follow up radiographic OA (ROA) was present in 68% and OA symptoms (SOA) in 42% of the injured knees. The dGEMRIC index of the medial compartment was lower in knees that developed medial ROA, 325 ± 68 (ms±SD) vs 376 ± 47 (51 (7-94)) (difference of means (95% confidence interval (CI))), in patients that developed symptomatic OA (SOA), 327 ± 61 vs 399 ± 42 (52 (11-93)), and poor knee function 337 ± 54 vs 381 ± 52 (48 (7-89)) compared to those that did not develop ROA, SOA or poor function. The dGEMRIC index correlated negatively with the OARSI osteophyte score in medial (r = -0.44, P = 0.01) and lateral (r = -0.38, P = 0.03) compartments. CONCLUSION The associations between a low dGEMRIC index and future ROA, as well as SOA, are in agreement with previous studies and indicate that dGEMRIC has a prognostic value for future knee OA.
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Affiliation(s)
- J Tjörnstrand
- Orthopedics, Department of Clinical Sciences, Lund University, Skåne University Hospital, SE-221 85 Lund, Sweden.
| | - P Neuman
- Department of Orthopedics, Clinical Sciences, Lund University, Skåne University Hospital, SE-205 02 Malmö, Sweden
| | - J Svensson
- Department of Medical Imaging and Physiology, Skåne University Hospital, SE-221 85 Lund, Sweden; Medical Radiation Physics, Department of Translational Medicine, Lund University, SE-205 02 Malmö, Sweden
| | - B Lundin
- Department of Medical Imaging and Physiology, Skåne University Hospital, SE-221 85 Lund, Sweden
| | - L E Dahlberg
- Orthopedics, Department of Clinical Sciences, Lund University, Skåne University Hospital, SE-221 85 Lund, Sweden
| | - C J Tiderius
- Orthopedics, Department of Clinical Sciences, Lund University, Skåne University Hospital, SE-221 85 Lund, Sweden
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[Magnetic resonance imaging following cartilage repair of focal chondral lesions]. Radiologe 2019; 59:722-731. [PMID: 31168773 DOI: 10.1007/s00117-019-0552-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Focal cartilage lesions are common pathologies of weight-bearing joints. Clinical presentation ranges from asymptomatic patients to severe, pain-related movement deficits. Moreover, focal chondral lesions are risk factors for the development of osteoarthritis. There are various treatment options involving both surgical and nonsurgical treatments. Musculoskeletal radiologists should be aware of the various surgical options as well as the postsurgical imaging characteristics to depict whether the encountered imaging findings reflect the normal postoperative course or are indicative of a treatment failure. OBJECTIVES We aim to describe the most common surgical procedures for the repair of focal cartilage lesions and their typical postsurgical appearance on MRI studies. MATERIALS AND METHODS The literature in PubMed was searched with the terms "focal articular cartilage lesions", "chondral lesions", "MOCART", "Microfracture", "Osteochondral Autograft Transfer", "mosaicplasty", "Osteochondral Allograft Transplantation", "OATS", "OCT", "Autologous Chondrocyte Implantation", "ACI", "Matrix-Assisted Chondrocyte Implantation", "Autologous Matrix-induced Chondrogenesis". RESULTS Surgical methods for the treatment of focal cartilage lesions as well as the MR imaging features are explained.
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Rehnitz C, Do T, Klaan B, Burkholder I, Barié A, Wuennemann F, Kauczor H, Weber M. Feasibility of using half‐dose Gd‐BOPTA for delayed gadolinium‐enhanced MRI of cartilage (dGEMRIC) at the knee, compared with standard‐dose Gd‐DTPA. J Magn Reson Imaging 2019; 51:144-154. [DOI: 10.1002/jmri.26816] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 05/21/2019] [Indexed: 11/06/2022] Open
Affiliation(s)
- Christoph Rehnitz
- Department of Diagnostic and Interventional RadiologyUniversity Hospital Heidelberg Heidelberg Germany
| | - Thuy Do
- Department of Diagnostic and Interventional RadiologyUniversity Hospital Heidelberg Heidelberg Germany
| | - Bastian Klaan
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and NeuroradiologyUniversity Medicine Rostock Rostock Germany
| | - Iris Burkholder
- Department of Nursing and HealthUniversity of Applied Sciences of the Saarland Saarbruecken Germany
| | - Alexander Barié
- Department of Orthopedics and Trauma SurgeryUniversity Hospital Heidelberg Heidelberg Germany
| | - Felix Wuennemann
- Department of Diagnostic and Interventional RadiologyUniversity Hospital Heidelberg Heidelberg Germany
| | - Hans‐Ulrich Kauczor
- Department of Diagnostic and Interventional RadiologyUniversity Hospital Heidelberg Heidelberg Germany
| | - Marc‐André Weber
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and NeuroradiologyUniversity Medicine Rostock Rostock Germany
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Fujimori M, Nakamura S, Hasegawa K, Ikeno K, Ichikawa S, Sutherland K, Kamishima T. Cartilage quantification using contrast-enhanced MRI in the wrist of rheumatoid arthritis: cartilage loss is associated with bone marrow edema. Br J Radiol 2017; 90:20170167. [PMID: 28707530 DOI: 10.1259/bjr.20170167] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE To quantify wrist cartilage using contrast MRI and compare with the extent of adjacent synovitis and bone marrow edema (BME) in patients with rheumatoid arthritis (RA). METHODS 18 patients with RA underwent post-contrast fat-suppressed T1weighted coronal imaging. Cartilage area at the centre of the scaphoid-capitate and radius-scaphoid joints was measured by in-house developed software. We defined cartilage as the pixels with signal intensity between two thresholds (lower: 0.4, 0.5 and 0.6 times the muscle signal, upper: 0.9, 1.0, 1.1, 1.2 and 1.3 times the muscle signal). We investigated the association of cartilage loss with synovitis and BME score derived from RA MRI scoring system. RESULTS Cartilage area was correlated with BME score when thresholds were adequately set with lower threshold at 0.6 times the muscle signal and upper threshold at 1.2 times the muscle signal for both SC (rs=-0.469, p < 0.05) and RS (rs=-0.486, p < 0.05) joints, while it showed no significant correlation with synovitis score at any thresholds. CONCLUSION Our software can accurately quantify cartilage in the wrist and BME associated with cartilage loss in patients with RA. Advances in knowledge: Our software can quantify cartilage using conventional MR images of the wrist. BME is associated with cartilage loss in RA patients.
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Affiliation(s)
- Motoshi Fujimori
- 1 Department of Health Sciences, Hokkaido University , Sapporo , Japan
| | - Satoko Nakamura
- 2 Department of Rheumatology, Sapporo Yamanoue Hospital , Sapporo , Japan
| | - Kiminori Hasegawa
- 2 Department of Rheumatology, Sapporo Yamanoue Hospital , Sapporo , Japan
| | - Kunihiro Ikeno
- 3 Department of Radiology, Sapporo Yamanoue Hospital , Sapporo , Japan
| | - Shota Ichikawa
- 4 Department of Radiological Technology, Kurashiki Central Hospital , Kurashiki , Japan
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