Editorial Commentary: Real-Time Dynamic Magnetic Resonance Imaging of the Patellofemoral Joint: Ready for Prime Time?

Development of Real-Time Kinematic Magnetic Resonance Imaging (kMRI) Techniques for Studying the Kinematics of the Spine and Joints in Dogs-Preliminary Study on Cadavers

Simple Summary

Many orthopedic and neurological pathologic conditions can potentially lead to or be affected by joint instability. Standard magnetic resonance imaging, as a static technique that examine joints and body parts in functional rest, can underestimate or overlook key diagnostic findings. As a result, kinematic magnetic resonance imaging techniques were developed to evaluate joints and body parts under stress and load conditions or during movement. In human medicine, the real-time acquisition technique is one of the modalities for acquiring kinematic magnetic resonance imaging, and has gained popularity in recent years. This proof-of-concept study was designed to test the feasibility of real-time acquisition techniques in veterinary medicine for the first time. Based on the results of this preliminary cadaveric study, real-time kinematic magnetic resonance imaging may be a feasible and valuable procedure to be applied to the canine cervical spine and stifle joints. Moreover, given the ease of execution and the concise duration of acquisitions, it could be applied in a regular standard protocol MRI with little additional effort, risk, and cost. In this proof-of-concept study, a good visualization of the canine cervical spine and stifle joint was achieved, showing the potential of real-time acquisition techniques for clinical and research applications.

Abstract

Kinematic MRI (kMRI) is a novel human imaging technique that couples the excellent soft tissue contrast and multiplanar capabilities of traditional MRI with kinematic potential. The study’s goals are: (1) testing the feasibility of spinal cord and joints real-time kMRI; and (2) evaluating the quality of these kinematic studies as a new diagnostic option in veterinary medicine. Standard and real-time kinematic MRI were performed on cervical spine, elbow, and stifle joints of seven cadavers. Studies were repeated after a surgical insult aimed to create a certain degree of joint instability. A total of 56 MRI were performed—7 cervical spinal tracts, 3 elbow joints, and 4 stifle joints were examined. The technique was feasible in all the three regions examined. The images were considered of excellent quality for the stifle joint, good to fair for the cervical spine, whereas two of three elbow studies were considered to have unacceptable image quality. Additionally, real-time kMRI provided good to excellent information about stifle instability. Therefore we consider kMRI a promising technique in veterinary medicine. Further studies and an in vivo setting are needed to increase the quality of the kMRI images, and to fully evaluate clinical usefulness.