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Wu W, Kang Z, Mu D, Zhao H, Yang F. T2 mapping for quantitative assessment of ankle cartilage of weightlifters. Sci Rep 2023; 13:19160. [PMID: 37932324 PMCID: PMC10628267 DOI: 10.1038/s41598-023-46259-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 10/30/2023] [Indexed: 11/08/2023] Open
Abstract
The research into the prevention of sports injuries among the population, particularly juveniles, has become crucial due to the increasing participation in physical exercises like fitness. To assess the difference in T2 values of ankle talar cartilage between weightlifters and healthy volunteers using quantitative magnetic resonance imaging (MRI) technique T2 mapping. Study design: Prospective. Prospective evaluation of T2 values of ankle cartilage of 50 weightlifters (30 adults and 20 juveniles) and 100 healthy volunteers (80 adults and 20 juveniles) using Siemens 3.0 T MRI with PDWI, T1WI, and T2 mapping sequences. Three physicians manually divided the talar cartilage of the ankle joint into six regions of interest. Three physicians utilized the anterior and posterior cut edges of the tibial cartilage as markers to identify the corresponding anterior and posterior cut edges of the talar cartilage on the sagittal MRI images. The medial and lateral sides were defined as half of the talar articular surface on the coronal plane. Differences in T2 values in each cartilage region were compared using independent sample T test or Mann-Whitney U test. The T2 values of talar cartilage were significantly increased in the athlete group relative to the volunteer group (35.11 and 31.99, P < 0.001), with the most significant difference observed in the juvenile athlete group compared to the volunteer group (34.42 and 28.73, P < 0.001). There was a significant difference in the T2 value of ankle talar cartilage between weightlifters and healthy volunteers, and juveniles may be more vulnerable to overuse sports injuries. This study contributes to understanding the cartilage health of juvenile athletes and the prevention of sports injuries.
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Affiliation(s)
- Weibiao Wu
- Radiology Department, Central Hospital Affiliated to Shenyang Medical College, No.5 NanQiXi Road, TieXi District, Shenyang, Liaoning, 110024, People's Republic of China
| | - Zhuanzhuan Kang
- Radiology Department, Central Hospital Affiliated to Shenyang Medical College, No.5 NanQiXi Road, TieXi District, Shenyang, Liaoning, 110024, People's Republic of China
| | - Di Mu
- Radiology Department, Central Hospital Affiliated to Shenyang Medical College, No.5 NanQiXi Road, TieXi District, Shenyang, Liaoning, 110024, People's Republic of China
| | - Huiyu Zhao
- Radiology Department, Central Hospital Affiliated to Shenyang Medical College, No.5 NanQiXi Road, TieXi District, Shenyang, Liaoning, 110024, People's Republic of China
| | - Feng Yang
- Radiology Department, Central Hospital Affiliated to Shenyang Medical College, No.5 NanQiXi Road, TieXi District, Shenyang, Liaoning, 110024, People's Republic of China.
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Brakel BA, Sussman MS, Majeed H, Teitel J, Man C, Rayner T, Weiss R, Moineddin R, Blanchette V, Doria AS. T2 mapping magnetic resonance imaging of cartilage in hemophilia. Res Pract Thromb Haemost 2023; 7:102182. [PMID: 37767061 PMCID: PMC10520564 DOI: 10.1016/j.rpth.2023.102182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 06/16/2023] [Accepted: 06/17/2023] [Indexed: 09/29/2023] Open
Abstract
Background In hemophilia, recurrent hemarthrosis may lead to irreversible arthropathy. T2 mapping MRI may reflect cartilage changes at an earlier reversible stage of arthropathy as opposed to structural MRI. Objectives To evaluate interval changes of T2 mapping compared with the International Prophylaxis Study Group (IPSG) structural MRI scores of ankle cartilage in boys with hemophilia receiving prophylaxis. Methods Eight boys with hemophilia A (median age, 13; range, 9-17 years), 7 age- and sex-matched healthy boys (controls, median age, 15; range, 7-16 years). A multiecho spin-echo T2-weighted MRI sequence at 3.0T was used to obtain T2 maps of cartilage of boys with hemophilia and controls. Structural joint status was evaluated using the IPSG MRI score. Results T2 relaxation times of ankle cartilage increased significantly over time in both persons with hemophilia and controls (P = .002 and P = .00009, respectively). Changes in T2 relaxation time strongly correlated with changes in IPSG cartilage scores (rs = 0.93 to rs = 0.78 [P = .0007 to P = .023]), but not with changes in age (P = .304 to P = .840). Responsiveness of T2 relaxation times were higher than that of IPSG cartilage scores, with standardized response means >1.4 for T2 mapping in all regions-of-interest compared with 0.84 for IPSG cartilage scores. Baseline T2 relaxation time strongly correlated with timepoint 2 IPSG cartilage score (rs = 0.93 to rs = 0.82 [P = .001 to P = .012]) and T2 relaxation time (rs = 0.98 to rs = 0.88 [P = .00003 to P = .004]) changes in most regions-of-interest. Conclusion T2 mapping shows sensitivity to biochemical changes in cartilage prior to detectable damage using conventional MRI, offering potential for early detection of bleed-related cartilage damage in boys with hemophilia.
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Affiliation(s)
- Benjamin A. Brakel
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Marshall S. Sussman
- Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Haris Majeed
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Jerry Teitel
- Division of Hematology/Oncology, St Michael’s Hospital, Toronto, ON, Canada
| | - Carina Man
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Tammy Rayner
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Ruth Weiss
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Rahim Moineddin
- Division of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Victor Blanchette
- Department of Pediatrics, University of Toronto, Toronto, ON, Canada
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Andrea S. Doria
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
- Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Ontario, Canada
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Lindner D, Chechik Y, Beer Y, Tal S, Lysyy O, Blumenfeld-Katzir T, Ben-Eliezer N, Agar G. T2 Mapping Values in Postmeniscectomy Knee Articular Cartilage after Running: Early Signs of Osteoarthritis? J Knee Surg 2022; 35:739-749. [PMID: 33111272 DOI: 10.1055/s-0040-1718596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Loading on the joints during running may have a deleterious effect on post-partial meniscectomy knee cartilage, leading to osteoarthritis. Utilizing T2-mapping measurements before and after running may enable the observation of changes in the articular cartilage of the postmeniscectomy knees compared with healthy knees. After medial partial meniscectomy, 12 volunteers underwent magnetic resonance imaging (MRI) of the both knees, before and immediately after 30 minutes of running. Quantitative assessment of articular cartilage was performed using a T2-mapping technique. In the medial compartment of the operated knees, significantly lower T2 values were found in anterior tibial plateau (pre- vs. postrun: 33.85 vs. 30.45 ms; p = 0.003) and central tibial plateau (33.33 vs. 30.63 ms; p = 0.007). Similar differences were found in lateral regions of central femur (post- vs. prerun: 35.86 vs. 40.35 ms; p = 0.015), posterior femur (34.89 vs. 37.73 ms; p = 0.001), and anterior tibia (24.66 vs. 28.70 ms, p = 0.0004). In lateral compartment, postrun values were significantly lower in operated compared with healthy knees, in central femur (34.89 vs. 37.59 ms; p = 0.043), posterior femoral (36.88 vs. 39.36 ms; p = 0.017), anterior tibia (24.66 vs. 30.20 ms; p = 0.009), and posterior tibia (28.84 vs. 33.17 ms; p = 0.006). No statistical difference was found while comparing postrun to prerun healthy knees. Lower T2 values were found in operated knees after 30 minutes of running. These changes were seen in medial and lateral compartments. We suspect that running may subject the articular cartilage to excessive loads in the post-partial meniscectomy knee, loads that in healthy knee do not cause any changes.
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Affiliation(s)
- Dror Lindner
- Department of Orthopedics, Shamir Medical Center, Zerifin, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yigal Chechik
- Department of Orthopedics, Shamir Medical Center, Zerifin, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yiftah Beer
- Department of Orthopedics, Shamir Medical Center, Zerifin, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sigal Tal
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Radiology, Shamir Medical Center, Zerifin, Israel
| | - Oleg Lysyy
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Radiology, Shamir Medical Center, Zerifin, Israel
| | | | - Noam Ben-Eliezer
- Department of Biomedical Engineering, Tel-Aviv University, Tel Aviv, Israel
| | - Gabriel Agar
- Department of Orthopedics, Shamir Medical Center, Zerifin, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Strickland CD, Ho CK, Merkle AN, Vidal AF. MR Imaging of Knee Cartilage Injury and Repair Surgeries. Magn Reson Imaging Clin N Am 2022; 30:227-239. [DOI: 10.1016/j.mric.2021.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kasar S, Ozturk M, Polat AV. Quantitative T2 mapping of the sacroiliac joint cartilage at 3T in patients with axial spondyloarthropathies. Eur Radiol 2021; 32:1395-1403. [PMID: 34797385 DOI: 10.1007/s00330-021-08357-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/25/2021] [Accepted: 09/28/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To evaluate the diagnostic value of T2 mapping of sacroiliac joint cartilage in patients with axial spondyloarthropathies (SpA). METHODS Thirty-seven SpA patients and 43 controls (mean age: 36.5 ± 8.2; 20 men) prospectively underwent conventional MRI and T2 mapping of the sacroiliac joints at 3 T. SpA patients and their sacroiliac joints were categorized into active and inactive based on the presence of bone marrow edema on the conventional MRI. T2-relaxation times were measured by drawing six manual ROIs on the cartilaginous part of the joints. T2 values of the bilateral iliac and sacral joint cartilages for each patient (T2subject), iliac and sacral cartilages for each sacroiliac joint (T2joint), iliac cartilage (T2iliac), and sacral cartilage (T2sacral) were calculated and compared between SpA patients and controls, and active and inactive joints. RESULTS The T2subject of SpA patients (50.48 ± 5.32 ms) was significantly higher than the T2subject of the controls (46.33 ± 3.30 ms, p < 0.001). Selecting an optimal T2subject cut-off value of 48.77 to differentiate SpA patients from controls revealed a sensitivity and a specificity of 62.2% and 81.4% respectively (AUC = 0.739). In SpA patients, T2joint, T2iliac, and T2sacral values of the inactive joints were not significantly different from those of the active joints (p = 0.088, p = 0.179, and p = 0.069). T2joint, T2iliac, and T2sacral values of the inactive joints of SpA patients were significantly higher than those of the controls (p = 0.012, p = 0.029, and p = 0.016). CONCLUSIONS T2 values of both active and inactive sacroiliac joint cartilages of SpA patients were increased. Thus, T2 mapping may be used in the diagnosis of SpA. KEY POINTS • Sacroiliac cartilage T2 values of SpA patients increase compared to those of the non-SpA controls. • Sacroiliac cartilage T2 values of active and inactive joints of SpA patients increase compared to those of the non-SpA controls. • Sacroiliac cartilage T2 values of active and inactive joints of SpA patients do not show statistically significant difference.
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Affiliation(s)
- Suleyman Kasar
- Department of Radiology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey
| | - Mesut Ozturk
- Radiology Clinic, Samsun Gazi State Hospital, Samsun, Turkey.
| | - Ahmet Veysel Polat
- Department of Radiology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey
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Huang Y, Wei J, Han D, Jiang Y, Zhang J, Zhang Z, He B. Muscular blood oxygen level-dependent MRI is beneficial to evaluate effectiveness of an exercise prescription. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:470. [PMID: 33850867 PMCID: PMC8039708 DOI: 10.21037/atm-21-279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background To determine the feasibility and validity of using blood oxygen level-dependent (BOLD) magnetic resonance imaging (MRI) to evaluate the effects of back extension exercise on core lumbar paraspinal muscle strength. Methods In this prospective study, R2* and T2 mapping of paraspinal muscles of 100 healthy volunteers were performed before and after back extension exercises in different recovery sessions (session I, II, III or IV). Volunteers use the Roman chair to complete the back extension exercises. The cross-sectional area (CSA), R2* and T2 values were measured and analyzed in 3 muscles (iliocostalis, longissimus, and multifidus muscles) of the lower back before and after exercise. Results The CSA and T2 values of iliocostalis, longissimus, and multifidus muscles at L3 and L4 levels were higher in recovery sessions I and II than in the resting-state (P<0.05); however, compared to that in the resting-state, the R2* value was significantly reduced in session I but increased in sessions II–IV (P<0.05). Furthermore, the CSA and T2 values in recovery session I were higher than those in the resting-state, whereas the R2* value was lower (P<0.05). After exercise, the recovery tendency of R2* and T2 value was consistent in both males and females, but a significant sex difference in R2* value was observed between recovery sessions III and IV (P<0.05). Conclusions R2* mapping and T2 mapping are effective and feasible for assessment of the effects of back extension exercises on lumbar paraspinal muscle strength.
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Affiliation(s)
- Yilong Huang
- Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jialu Wei
- Department of Radiology, The 3rd People's Hospital of Kunming, Kunming, China
| | - Dan Han
- Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yuanming Jiang
- Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jia Zhang
- Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Zhenguang Zhang
- Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Bo He
- Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming, China
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Liu P, Luo B, Chen L, Wang QX, Yuan G, Jiang GH, Zhang J. Baseline Volumetric T2 Relaxation Time Histogram Analysis: Can It Be Used to Predict the Response to Intravenous Methylprednisolone Therapy in Patients With Thyroid-Associated Ophthalmopathy? Front Endocrinol (Lausanne) 2021; 12:614536. [PMID: 33716970 PMCID: PMC7947366 DOI: 10.3389/fendo.2021.614536] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 01/13/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Prediction of therapy response to intravenous methylprednisolone pulses (ivMP) is crucial for thyroid-associated ophthalmopathy (TAO). Image histograms may offer sensitive imaging biomarkers for therapy effect prediction. This study aimed to investigate whether pretherapeutic, multiparametric T2 relaxation time(T2RT) histogram features of extraocular muscles (EOMs) can be used to predict therapy response. MATERIALS AND METHODS Forty-five active and moderate-severe TAO patients, who were treated with standard ivMP and underwent orbital MRI before therapy, were retrospectively included in this study. The patients were divided into responsive (n = 24, 48 eyes) and unresponsive group(n = 21, 42 eyes) according to clinical evaluation. Baseline clinical features of patients and histogram-derived T2RT parameters of the EOMs were analyzed and compared. Logistic regression model was conducted to determine independent predictors, and a histogram features nomogram was formulated for personalized prediction. RESULTS Responsive group displayed lower values for 5th, 10th percentiles (P < 0.050, respectively), and higher values for 75th, 90th, and 95th percentiles, skewness, entropy, and inhomogeneity (P < 0.050, respectively) than unresponsive group. Multivariate logistic regression analysis showed that 95th percentile of >88.1 [odds ratio (OR) = 12.078; 95% confidence interval (CI) = 3.98-36.655, p < 0.001], skewness of >0.31 (OR = 3.935; 95% CI = 2.28-6.788, p < 0.001) and entropy of >3.41 (OR = 4.375; 95% CI = 2.604-7.351, p < 0.001) were independent predictors for favorable response. The nomogram integration of three independent predictors demonstrated optimal predictive efficiency, with a C-index of 0.792. CONCLUSIONS Pre-treatment volumetric T2RT histogram features of EOMs could function to predict the response to ivMP in patients with TAO. The nomogram based on histogram features facilitates the selection of patients who will derive maximal benefit from ivMP.
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Affiliation(s)
- Ping Liu
- Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Ban Luo
- Department of Ophthalmology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Lang Chen
- Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Qiu-Xia Wang
- Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Gang Yuan
- Department of Endocrinology and Metabolism, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Gui-hua Jiang
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Jing Zhang
- Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
- *Correspondence: Jing Zhang,
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Yu F, He B, Chen L, Wang F, Zhu H, Dong Y, Pan S. Intermuscular Fat Content in Young Chinese Men With Newly Diagnosed Type 2 Diabetes: Based on MR mDIXON-Quant Quantitative Technique. Front Endocrinol (Lausanne) 2021; 12:536018. [PMID: 33868161 PMCID: PMC8044767 DOI: 10.3389/fendo.2021.536018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 03/12/2021] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Skeletal muscle fat content is one of the important contributors to insulin resistance (IR), but its diagnostic value remains unknown, especially in the Chinese population. Therefore, we aimed to analyze differences in skeletal muscle fat content and various functional MRI parameters between diabetic patients and control subjects to evaluate the early indicators of diabetes. In addition, we aimed to investigate the associations among skeletal muscle fat content, magnetic resonance parameters of skeletal muscle function and IR in type 2 diabetic patients and control subjects. METHODS We enrolled 12 patients (age:29-38 years, BMI: 25-28 kg/m2) who were newly diagnosed with type 2 diabetes (intravenous plasma glucose concentration≥11.1mmol/l or fasting blood glucose concentration≥7.0mmol/l) together with 12 control subjects as the control group (age: 26-33 years, BMI: 21-28 kg/m2). Fasting blood samples were collected for the measurement of glucose, insulin, 2-hour postprandial blood glucose (PBG2h), and glycated hemoglobin (HbAlc). The magnetic resonance scan of the lower extremity and abdomen was performed, which can evaluate visceral fat content as well as skeletal muscle metabolism and function through transverse relaxation times (T2), fraction anisotropy (FA) and apparent diffusion coefficient (ADC) values. RESULTS We found a significant difference in intermuscular fat (IMAT) between the diabetes group and the control group (p<0.05), the ratio of IMAT in thigh muscles of diabetes group was higher than that of control group. In the entire cohort, IMAT was positively correlated with HOMA-IR, HbAlc, T2, and FA, and the T2 value was correlated with HOMA-IR, PBG2h and HbAlc (p<0.05). There were also significant differences in T2 and FA values between the diabetes group and the control group (p<0.05). According to the ROC, assuming 8.85% of IMAT as the cutoff value, the sensitivity and specificity of IMAT were 100% and 83.3%, respectively. Assuming 39.25ms as the cutoff value, the sensitivity and specificity of T2 value were 66.7% and 91.7%, respectively. All the statistical analyses were adjusted for age, BMI and visceral fat content. CONCLUSION Deposition of IMAT in skeletal muscles seems to be an important determinant for IR in type 2 diabetes. The skeletal muscle IMAT value greater than 8.85% and the T2 value greater than 39.25ms are suggestive of IR.
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Affiliation(s)
- Fuyao Yu
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Bing He
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Li Chen
- Department of Medicine, Medical College of Georgia, Georgia Prevention Institute, Augusta, GA, United States
| | - Fengzhe Wang
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Haidong Zhu
- Department of Medicine, Medical College of Georgia, Georgia Prevention Institute, Augusta, GA, United States
| | - Yanbin Dong
- Department of Medicine, Medical College of Georgia, Georgia Prevention Institute, Augusta, GA, United States
| | - Shinong Pan
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
- *Correspondence: Shinong Pan,
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Dong X, Li C, Liu J, Huang P, Jiang G, Zhang M, Zhang W, Zhang X. The effect of running on knee joint cartilage: A systematic review and meta-analysis. Phys Ther Sport 2020; 47:147-155. [PMID: 33279802 DOI: 10.1016/j.ptsp.2020.11.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 11/15/2020] [Accepted: 11/18/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Although running causes inevitable stress to the joints, data regarding its effect on the cartilage of the knee are conflicting. This systematic review and meta-analysis aimed to evaluate the effect of running on knee joint cartilage. METHODS PubMed, EMBASE, SportDiscus, and Cochrane Library databases were searched to identify randomized controlled trials (RCTs) and cohort studies. The outcome indicators were cartilage oligomeric matrix protein (COMP), cartilage volume and thickness, and T2. RESULTS A total of two RCTs and 13 cohort studies were included. There was no significant difference in cartilage volume between the running and control groups (MD, -115.88 U/I; 95% CI, -320.03 to 88.27; p = 0.27). However, running would decrease cartilage thickness (MD, -0.09 mm; 95%CI, -0.18 to -0.01; p = 0.03) and T2 (MD, -2.78 ms; 95% CI, -4.12 to -1.45; p < 0.001). Subgroup analysis demonstrated that COMP immediately or at 0.5 h after running was significantly increased, but there were no significant changes at 1 h or 2 h. CONCLUSIONS Running has advantages in promoting nutrition penetrating into the cartilage as well as squeezing out the metabolic substance, such as water. Our study found that running had a short-term adverse effect on COMP and did not affect cartilage volume or thickness.
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Affiliation(s)
- Xueping Dong
- Department of Sports Medicine and Rehabilitation, National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
| | - Canfeng Li
- Department of Sports Medicine and Rehabilitation, National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
| | - Jiyi Liu
- Department of Sports Medicine and Rehabilitation, National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
| | - Pengzhou Huang
- Department of Sports Medicine and Rehabilitation, National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
| | - Guanwei Jiang
- Department of Sports Medicine and Rehabilitation, National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
| | - Mengdi Zhang
- Department of Sports Medicine and Rehabilitation, National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
| | - Wentao Zhang
- Department of Sports Medicine and Rehabilitation, National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China
| | - Xintao Zhang
- Department of Sports Medicine and Rehabilitation, National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, PR China.
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Wang N, Badar F, Xia Y. Resolution-dependent influences of compressed sensing in quantitative T2 mapping of articular cartilage. NMR IN BIOMEDICINE 2020; 33:e4260. [PMID: 32040226 PMCID: PMC7415577 DOI: 10.1002/nbm.4260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 12/18/2019] [Accepted: 12/29/2019] [Indexed: 06/10/2023]
Abstract
This study evaluates the resolution-dependent influences of compressed sensing (CS) in MRI quantification of T2 mapping in articular cartilage with osteoarthritis (OA). T2-weighed 2D experiments of healthy and OA cartilage were fully sampled in k-space with five echo times at both 17.6 μm and 195.3 μm in-plane resolutions; termed as microscopic MRI (μMRI) and macroscopic MRI (mMRI) respectively. These fully sampled k-space data were under-sampled at various 2D CS accelerating factors (AF = 4-32). The under-sampled data were reconstructed individually into 2D images using nonlinear reconstruction, which were used to calculate the T2 maps. The bulk and zonal variations of T2 values in cartilage were evaluated at different AFs. The study finds that the T2 images at AFs up to 8 preserved major visual information and produced negligible artifacts for μMRI. The T2 values remained accurate for different sub-tissue zones at various AFs. The absolute difference between the CS (AF up to 32) and the Ground Truth (i.e., using 100% of the k-space data) of the mean T2 values through the whole tissue depth was higher in mMRI versus μMRI. For mMRI (where the resolution mimics the clinical MRI of human cartilage), the quantitative T2 mapping at AFs up to 4 showed negligible variations. This study demonstrates that both clinical MRI and μMRI can benefit from the use of CS in image acquisition, and μMRI benefits more from the use of CS by acquiring much less data, without losing significant accuracy in the quantification of T2 maps in osteoarthritic cartilage.
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Affiliation(s)
- Nian Wang
- Center for In Vivo Microscopy, Duke University School of Medicine, Durham, North Carolina, USA
- Department of Radiology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Farid Badar
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, MI 48309
| | - Yang Xia
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, MI 48309
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Chen W, Hu H, Chen HH, Su GY, Yang T, Xu XQ, Wu FY. Utility of T2 mapping in the staging of thyroid-associated ophthalmopathy: efficiency of region of interest selection methods. Acta Radiol 2020; 61:1512-1519. [PMID: 32053002 DOI: 10.1177/0284185120905032] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Discriminating the stage of thyroid-associated ophthalmopathy (TAO) is crucial for the treatment strategy and prognosis prediction. Utility of conventional magnetic resonance imaging in the disease staging is limited. PURPOSE To investigate the performance of T2 mapping based on different region of interest (ROI) selection methods in the staging of TAO. MATERIAL AND METHODS Thirty-two patients with TAO were retrospectively enrolled. Two radiologists independently measured the T2 relaxation time (T2RT) of extraocular muscles using two different ROIs (hotspot [ROIHS]: T2RT-hot; single-slice [ROISS]: T2RT-mean, T2RT-max, T2RT-min). Independent-samples t test, Wilcoxon signed rank test, Spearman correlation analysis, receiver operating characteristic (ROC) curves analyses, multiple ROC comparisons, and intra-class correlation coefficient (ICC) were used for statistical analyses. RESULTS No significant difference was found in the measuring time between ROIHS and ROISS methods (P = 0.066). T2RT-mean demonstrated the highest ICC for measurement, followed by T2RT-max and T2RT-min, and T2RT-hot showed the poorest reproducibility. Active TAOs showed significantly higher values for all the T2RTs than inactive mimics (all P < 0.001). Significant positive correlations were found between T2RTs and CAS (all P < 0.005). T2RT-hot and T2RT-max showed significantly higher areas under the curve than that of T2RT-mean (P = 0.013 and 0.024, respectively), while the difference between T2RT-hot and T2RT-max was not significant (P = 0.970). CONCLUSION The T2RTs derived from both ROI selection methods could be useful for the staging of TAO. The results of measuring time, reproducibility, and diagnostic performance suggest that T2RT-max would be the optimal indicator for staging.
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Affiliation(s)
- Wen Chen
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Hao Hu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Huan-Huan Chen
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Guo-Yi Su
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Tao Yang
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Xiao-Quan Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Fei-Yun Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
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Hu H, Chen HH, Chen W, Wu Q, Chen L, Zhu H, Xu XQ, Shi HB, Wu FY. T2 mapping histogram at extraocular muscles for predicting the response to glucocorticoid therapy in patients with thyroid-associated ophthalmopathy. Clin Radiol 2020; 76:159.e1-159.e8. [PMID: 33010933 DOI: 10.1016/j.crad.2020.09.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 09/02/2020] [Indexed: 02/06/2023]
Abstract
AIM To evaluate the performance of T2 mapping histograms at the extraocular muscles (EOMs) in predicting the response to glucocorticoid therapy in the patients with active and moderate-severe thyroid-associated ophthalmopathy (TAO). MATERIALS AND METHODS Thirty active and moderate-severe TAO patients (responsive group, n=20; unresponsive group, n=10) were enrolled, and evaluated using T2 mapping before treatment. Histogram parameters (mean, median, max, min, 10th, 90th percentiles, skewness, and kurtosis) of T2 relaxation time (T2RT) at the EOMs for each orbit, and clinical variables (age, sex, disease duration, anti-thyroid treatment, smoking habit, pre-treatment thyroid function, thyrotrophin receptor antibody, diplopia presence, activity and severity scores) were collected and compared between groups. Logistic regression and receiver operating characteristic (ROC) curve analyses were used to assess the predictive value of identified independent variables for treatment response. RESULTS The responsive group showed significantly shorter disease duration (p=0.003), while higher T2RTmin than unresponsive group (p<0.001). Multivariate analysis showed that T2RTmin and disease duration were independent predictors for responsive TAOs. ROC curve analyses indicated that setting a cut-off value of ≥54.3 for T2RTmin demonstrated the optimal predicting specificity for responsive TAOs (100%), while a combination of T2RTmin ≥54.3 and disease duration ≤4.5 showed optimal predicting efficiency and sensitivity (area under the curve, 0.820; sensitivity, 65%). CONCLUSIONS Histogram analysis can help to exhibit the heterogeneity of T2RT at the EOMs. T2RTmin, together with disease duration may be the promising marker for predicting response to glucocorticoid therapy in the patients with active and moderate-severe TAO.
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Affiliation(s)
- H Hu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - H-H Chen
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - W Chen
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Q Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - L Chen
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - H Zhu
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - X-Q Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - H-B Shi
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| | - F-Y Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
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T2 mapping of the sacroiliac joints in patients with axial spondyloarthritis. Eur J Radiol 2020; 131:109246. [PMID: 32911127 DOI: 10.1016/j.ejrad.2020.109246] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 08/01/2020] [Accepted: 08/20/2020] [Indexed: 01/08/2023]
Abstract
PURPOSE To test whether T2 mapping of the sacro-iliac joints (SIJs) might help identifying patients with spondyloarthritis. METHOD This study included 20 biologic-naive patients with axial spondyloarthritis (10 females; mean age: 38 ± 9years; range, 19-47) and 27 controls (16 males; mean age = 39 ± 13years; range = 28-71) who prospectively underwent SIJs MRI at 1.5 T, including a multislice multiecho spin-echo sequence. Standard MRIs were reviewed to assess the SIJs according to the Assessment of SpondyloArthritis International Society (ASAS) criteria and SPondyloArthritis Research Consortium of Canada (SPARCC) MRI index. T2 maps obtained from multiecho sequences were used to draw regions of interests in the cartilaginous part of the SIJs. Disease activity was assessed using BASDAI questionnaire. Bland-Altman method, ROC curve analysis, Chi square, Mann-Whitney U, Pearson's and Spearman's correlation coefficient were used for data analysis. RESULTS According to ASAS criteria, MRI was positive for sacroiliitis in 5/20 patients (25 %). Inter-observer reproducibility of T2 values was 87 % (coefficient of repeatability = 7.0; bias = 0.49; p < .001). Mean T2 values of patients (58.5 ± 4.4 ms, range: 52.6-68.2 ms) were significantly higher (p < .001) than those of controls (44.1 ± 6.6 ms, range: 33.6-67.2 ms). A T2 value of 52.51 ms yielded 100 % sensitivity and 91.7 % specificity to differentiate patients from controls. No statistically significant association/correlation was found between T2 values and BASDAI (r=-.026, p = .827), disease duration (r = .024, p = .871), SPARCC (r=-.004, p = .981), ASAS criteria (p = .476), HLA-B27-positivity (p = .139), age (r=-.2.53, p = .891), and gender (p = .404). CONCLUSIONS T2 relaxation times of the SIJs were significantly higher in patients than in healthy controls, making this tool potentially helpful to early identify patients with spondyloarthritis.
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Schütz U, Ehrhardt M, Göd S, Billich C, Beer M, Trattnig S. A mobile MRI field study of the biochemical cartilage reaction of the knee joint during a 4,486 km transcontinental multistage ultra-marathon using T2* mapping. Sci Rep 2020; 10:8157. [PMID: 32424133 PMCID: PMC7235258 DOI: 10.1038/s41598-020-64994-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 04/21/2020] [Indexed: 02/08/2023] Open
Abstract
Nearly nothing is known about the consequences of ultra-long-distance running on knee cartilage. In this mobile MRI field study, we analysed the biochemical effects of a 4,486 km transcontinental multistage ultra-marathon on femorotibial joint (FTJ) cartilage. Serial MRI data were acquired from 22 subjects (20 male, 18 finisher) using a 1.5 T MR scanner mounted on a 38-ton trailer, travelling with the participants of the TransEurope FootRace (TEFR) day by day over 64 stages. The statistical analyses focused on intrachondral T2* behaviour during the course of the TEFR as the main outcome variable of interest. T2* mapping (sagittal FLASH T2* weighted gradient echo) is a validated and highly accurate method for quantitative compositional cartilage analysis of specific weightbearing areas of the FTJ. T2* mapping is sensitive to changes in the equilibrium of free intrachondral water, which depends on the content and orientation of collagen and the proteoglycan content in the extracellular cartilage matrix. Within the first 1,100 km, a significant running load-induced T2* increase occurred in all joint regions: 44.0% femoral-lateral, 42.9% tibial-lateral, 34.9% femoral-medial, and 25.1% tibial-medial. Osteochondral lesions showed no relevant changes or new occurrence during the TEFR. The reasons for stopping the race were not associated with knee problems. As no further T2* elevation was found in the second half of the TEFR but a decreasing T2* trend (recovery) was observed after the 3,500 km run, we assume that no further softening of the cartilage occurs with ongoing running burden over ultra-long distances extending 4,500 km. Instead, we assume the ability of the FTJ cartilage matrix to reorganize and adapt to the load.
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Affiliation(s)
- Uwe Schütz
- Department of Diagnostic and Interventional Radiology, University Hospital of Ulm, Albert-Einstein-Allee 23, D-89081, Ulm, Germany.
| | - Martin Ehrhardt
- Department of Diagnostic and Interventional Radiology, University Hospital of Ulm, Albert-Einstein-Allee 23, D-89081, Ulm, Germany
| | - Sabine Göd
- MR Centre of Excellence- High Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, BT32, Lazarettgasse 14, 1090, Vienna, Austria
| | - Christian Billich
- Department of Diagnostic and Interventional Radiology, University Hospital of Ulm, Albert-Einstein-Allee 23, D-89081, Ulm, Germany
| | - Meinrad Beer
- Department of Diagnostic and Interventional Radiology, University Hospital of Ulm, Albert-Einstein-Allee 23, D-89081, Ulm, Germany
| | - Siegfried Trattnig
- MR Centre of Excellence- High Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, BT32, Lazarettgasse 14, 1090, Vienna, Austria
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Huang YL, Zhou JL, Jiang YM, Zhang ZG, Zhao W, Han D, He B. Assessment of lumbar paraspinal muscle activation using fMRI BOLD imaging and T2 mapping. Quant Imaging Med Surg 2020; 10:106-115. [PMID: 31956534 DOI: 10.21037/qims.2019.10.20] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background Our study aimed to investigate the feasibility of functional magnetic resonance imaging [blood oxygen level-dependent (BOLD) imaging and T2 mapping] in monitoring the activation of lumbar paraspinal muscles before and after exercise. Methods The ethics committee of the First Affiliated Hospital of Kunming Medical University approved our study. Both BOLD and T2 mapping of paraspinal muscles were performed in 50 healthy, young volunteers before and after upper-body extension exercises. The movement tasks included upper body flexion and extension using a simple Roman chair. Cross-sectional area (CSA), R2*, and T2 values were measured in various lower-back anatomical regions. The SPSS22.0 statistical software was used to analyze all the data. Results Post-exercise CSA and T2 values were higher than those recorded in the pre-exercise session for the three lower-back muscles that were evaluated (iliocostalis, longissimus, and multifidus) (P<0.01). However, R2* values of these muscles were significantly lower after exercise (P<0.01). A significant difference in the R2*, CSA, and T2 values of the iliocostalis occurred between males and females (P<0.05). No statistically significant differences were evident for R2*, CSA, and T2 of the lower-back muscles between L3 and L4 levels, or between the left and right sides. The total CSA of the iliocostalis was higher than that of the multifidus and longissimus (P<0.05). Conclusions BOLD and T2 mapping are feasible non-invasive indirect assessments of lumbar paraspinal muscle activation before and after exercise.
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Affiliation(s)
- Yi-Long Huang
- Department of Medical Imaging, The First Affiliated Hospital of Kunming Medical University Yunnan, Kunming 650032, China
| | - Jia-Long Zhou
- Department of Medical Imaging, The First Affiliated Hospital of Kunming Medical University Yunnan, Kunming 650032, China.,Department of Magnetic Resonance Imaging, The First People's Hospital of Yunnan Province, Kunming 650032, China
| | - Yuan-Ming Jiang
- Department of Medical Imaging, The First Affiliated Hospital of Kunming Medical University Yunnan, Kunming 650032, China
| | - Zhen-Guang Zhang
- Department of Medical Imaging, The First Affiliated Hospital of Kunming Medical University Yunnan, Kunming 650032, China
| | - Wei Zhao
- Department of Medical Imaging, The First Affiliated Hospital of Kunming Medical University Yunnan, Kunming 650032, China
| | - Dan Han
- Department of Medical Imaging, The First Affiliated Hospital of Kunming Medical University Yunnan, Kunming 650032, China
| | - Bo He
- Department of Medical Imaging, The First Affiliated Hospital of Kunming Medical University Yunnan, Kunming 650032, China
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Ke Z, Yan X, Min X, Cai W, Zhang P, You H, Fan C, Wang L. Validation of SE-EPI-based T2 mapping for characterization of prostate cancer: a new method compared with the traditional CPMG method. Abdom Radiol (NY) 2019; 44:3432-3440. [PMID: 31218387 DOI: 10.1007/s00261-019-02105-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE We aim to compare the results of spin echo-echo planar imaging (SE-EPI)-based T2 mapping with those of the conventional Carr-Purcell-Meiboom-Gill (CPMG) method and to investigate the potential validity of SE-EPI-T2 mapping for the characterization of prostate cancer (PCa). METHODS Our retrospective study included 42 PCa patients and 42 noncancer patients who underwent 3.0T MRI with b values ranging from 0 to 2000 s/mm2 and echo times (TEs) ranging from 32 to 100 ms before biopsies. Bland-Altman analysis was used to compare the agreement between the two methods. The correlations between CPMG-T2 values and SE-EPI-T2 values at different b values were determined by Spearman's rho analysis or Pearson analysis. The Mann-Whitney U test and two-sample t tests were used to analyze the differences between the cancerous and noncancerous groups. RESULTS Substantial agreement regarding the measurements was observed between the two methods. The average correlation between the CPMG-T2 values and SE-EPI-T2 values was moderate and positive, and the best correlations were found at b = 200 s/mm2 in the noncancer group (r = 0.557, P = 0.000) and at b = 100 s/mm2 in the cancer group (r = 0.537, P = 0.000). In addition, statistically significant differences were found between the noncancer and cancer groups in T2 values and ADC values (diff TEs) (P = 0.000). CONCLUSIONS Substantial agreement in the measurements was found between the SE-EPI method and CPMG method. SE-EPI-based T2 mapping has potential clinical value for the prostate and can be considered an alternative to the traditional CPMG-T2 mapping method.
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Affiliation(s)
- Zan Ke
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Road, Wuhan, 430030, Hubei, China
| | - Xu Yan
- MR Collaboration NE Asia, Siemens Healthcare, Shanghai, 201321, China
| | - Xiangde Min
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Road, Wuhan, 430030, Hubei, China
| | - Wei Cai
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Road, Wuhan, 430030, Hubei, China
| | - Peipei Zhang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Road, Wuhan, 430030, Hubei, China
| | - Huijuan You
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Road, Wuhan, 430030, Hubei, China
| | - Chanyuan Fan
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Road, Wuhan, 430030, Hubei, China
| | - Liang Wang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Road, Wuhan, 430030, Hubei, China.
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Waldenberg C, Hebelka H, Brisby H, Lagerstrand KM. Differences in IVD characteristics between low back pain patients and controls associated with HIZ as revealed with quantitative MRI. PLoS One 2019; 14:e0220952. [PMID: 31437172 PMCID: PMC6705856 DOI: 10.1371/journal.pone.0220952] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 07/27/2019] [Indexed: 11/18/2022] Open
Abstract
Background Magnetic resonance imaging (MRI) can provide objective continuous intervertebral disc (IVD) measures in low back pain (LBP) patients. However, there are limited studies comparing quantitative IVD measures of symptomatic and asymptomatic individuals. Purpose This study aimed to investigate possible differences in IVD tissue composition in patients with chronic LBP and controls using quantitative MRI and correlate IVD measures with the phenotype High-Intensity Zone (HIZ). Methods The lumbar spine of 25 LBP-patients (25-69y, mean 38y, 11 males) and 12 controls (25-59y, mean 38y, 7 males) was examined with T2-mapping on a 1.5T MRI scanner. The mean T2-map value and standard deviation were determined in three midsagittal IVD slices and five sub-regions dividing each IVD in the sagittal plane. The distribution of T2-map values over the IVD was also determined with histogram analysis (Δμ = distribution width). Results When compared to controls, patient IVDs displayed lower values for all metrics, with significant differences for the T2-map value, standard deviation (p = 0.026) and Δμ (p = 0.048). Significantly different T2-map values were found between cohorts in the region representing nucleus pulposus and the border zone between nucleus pulposus and posterior annulus fibrosus (p = 0.047–0.050). Excluding all IVDs with HIZs resulted in no significant difference between the cohorts for any of the analyzed metrics (p = 0.053–0.995). Additionally, the T2-map values were lower in patients with HIZ in comparison without HIZ. Conclusions Differences in IVD characteristics, measured with quantitative MRI, between LBP patients and controls were found. The T2-differences may reflect altered IVD function associated with HIZ. Future studies are recommended to explore IVD functionality in relation to HIZ and LBP.
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Affiliation(s)
- Christian Waldenberg
- Department of Medical Physics and Techniques, Sahlgrenska University Hospital, Gothenburg, Sweden
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- * E-mail:
| | - Hanna Hebelka
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Helena Brisby
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Kerstin Magdalena Lagerstrand
- Department of Medical Physics and Techniques, Sahlgrenska University Hospital, Gothenburg, Sweden
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Tang X, Cai F, Ding DX, Zhang LL, Cai XY, Fang Q. Magnetic resonance imaging relaxation time in Alzheimer's disease. Brain Res Bull 2018; 140:176-189. [PMID: 29738781 DOI: 10.1016/j.brainresbull.2018.05.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 04/18/2018] [Accepted: 05/04/2018] [Indexed: 12/26/2022]
Abstract
The magnetic resonance imaging (MRI) relaxation time constants, T1 and T2, are sensitive to changes in brain tissue microstructure integrity. Quantitative T1 and T2 relaxation times have been proposed to serve as non-invasive biomarkers of Alzheimer's disease (AD), in which alterations are believed to not only reflect AD-related neuropathology but also cognitive impairment. In this review, we summarize the applications and key findings of MRI techniques in the context of both AD subjects and AD transgenic mouse models. Furthermore, the possible mechanisms of relaxation time alterations in AD will be discussed. Future studies could focus on relaxation time alterations in the early stage of AD, and longitudinal studies are needed to further explore relaxation time alterations during disease progression.
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Affiliation(s)
- Xiang Tang
- Department of Neurology, The First Affiliated Hospital of Soochow University, No. 899, Pinghai Road, Suzhou, Jiangsu 215006, China
| | - Feng Cai
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, No. 899, Pinghai Road, Suzhou, Jiangsu 215006, China
| | - Dong-Xue Ding
- Department of Neurology, The First Affiliated Hospital of Soochow University, No. 899, Pinghai Road, Suzhou, Jiangsu 215006, China
| | - Lu-Lu Zhang
- Department of Neurology, The First Affiliated Hospital of Soochow University, No. 899, Pinghai Road, Suzhou, Jiangsu 215006, China
| | - Xiu-Ying Cai
- Department of Neurology, The First Affiliated Hospital of Soochow University, No. 899, Pinghai Road, Suzhou, Jiangsu 215006, China.
| | - Qi Fang
- Department of Neurology, The First Affiliated Hospital of Soochow University, No. 899, Pinghai Road, Suzhou, Jiangsu 215006, China.
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Kaipel M, Schreiner M, Kellner R, Klikovits J, Apprich S, Brix M, Boszotta H, Domayer S, Trattnig S. Beneficial clinical effects but limited tissue quality following osteochondral repair with a cell-free multilayered nano-composite scaffold in the talus. Foot Ankle Surg 2017; 23:302-306. [PMID: 29202992 DOI: 10.1016/j.fas.2016.09.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 08/22/2016] [Accepted: 09/19/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND The treatment of larger osteochondral lesions of the talus remains an operative challenge. In addition to micro fracturing and osteochondral transplantation one promising strategy could be the operative repair with a cell-free multilayered nano-composite scaffold with the potential to regenerate bone and cartilage in one treatment. METHODS In this prospective case series four consecutive patients who suffered from a single osteochondral lesion (≥1.5cm2) on the medial talus were enrolled. The repair potential of the implant was assessed using MRI based biochemical, compositional MR sequences (T2 mapping) as well as semi-quantitative morphological analyses (MOCART score) at 18 months follow-up after the surgery. The clinical outcome was determined at 6-, 12-, 18-, and 24 months follow-up by using the Ankle Disability Index and the AOFAS score. RESULTS At 18 months after the surgery, the clinical outcome was significantly improved compared to the preoperative baseline. Global T2 relaxation times of the repair tissue were significantly increased compared to the healthy control cartilage. CONCLUSIONS Osteochondral repair with a cell-free, biomimetic scaffold provides good clinical, short-term results. However, biochemical MR imaging provides strong evidence for limited repair tissue quality at 18 months after the implantation. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Martin Kaipel
- Department of Orthopaedic Surgery, Federal Hospital Güssing, Grazer Strasse 15, A-7540 Güssing, Austria.
| | - Markus Schreiner
- Centre of Excellence "High-field Magnetic Resonance (MR)", Medical University Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria; Department of Orthopaedics, Medical University Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
| | - Richard Kellner
- Department of Orthopedic and Trauma Surgery, St. John's Hospital Eisenstadt, Johannes von Gott-Platz 1, A-7000 Eisenstadt, Austria
| | - Joachim Klikovits
- Department of Orthopaedic Surgery, Federal Hospital Güssing, Grazer Strasse 15, A-7540 Güssing, Austria
| | - Sebastian Apprich
- Department of Orthopaedics, Medical University Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
| | - Martin Brix
- Department of Orthopaedic Surgery, Federal Hospital Güssing, Grazer Strasse 15, A-7540 Güssing, Austria
| | - Harald Boszotta
- Department of Orthopedic and Trauma Surgery, St. John's Hospital Eisenstadt, Johannes von Gott-Platz 1, A-7000 Eisenstadt, Austria
| | - Stephan Domayer
- Centre of Excellence "High-field Magnetic Resonance (MR)", Medical University Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
| | - Siegfried Trattnig
- Centre of Excellence "High-field Magnetic Resonance (MR)", Medical University Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
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Bae WC, Ruangchaijatuporn T, Chung CB. New Techniques in MR Imaging of the Ankle and Foot. Magn Reson Imaging Clin N Am 2017; 25:211-225. [PMID: 27888849 DOI: 10.1016/j.mric.2016.08.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Foot and ankle disorders are common in everyday clinical practice. MR imaging is frequently required for diagnosis given the variety and complexity of foot and ankle anatomy. Although conventional MR imaging plays a significant role in diagnosis, contemporary management increasingly relies on advanced imaging for monitoring therapeutic response. There is an expanding need for identification of biomarkers for musculoskeletal tissues. Advanced imaging techniques capable of imaging these tissue substrates will be increasingly used in routine clinical practice. Radiologists should therefore become familiar with these innovative MR techniques. Many such techniques are already widely used in other organ systems.
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Affiliation(s)
- Won C Bae
- Radiology Service, Veterans Affairs San Diego Healthcare System, 3350 La Jolla Village Drive, MC 114, San Diego, CA 92161, USA; Department of Radiology, UCSD MSK Imaging Research Lab, University of California, San Diego, 9427 Health Sciences Drive, La Jolla, CA 92093-0997, USA
| | - Thumanoon Ruangchaijatuporn
- Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchatewi, Bangkok 10400, Thailand
| | - Christine B Chung
- Radiology Service, Veterans Affairs San Diego Healthcare System, 3350 La Jolla Village Drive, MC 114, San Diego, CA 92161, USA; Department of Radiology, UCSD MSK Imaging Research Lab, University of California, San Diego, 9427 Health Sciences Drive, La Jolla, CA 92093-0997, USA.
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Wei Y, Wu S, Gao F, Sun T, Zheng D, Ning P, Zhao C, Li Z, Li X, Li L, Zhu S. Esophageal carcinoma: Ex vivo evaluation by high-spatial-resolution T 2 -mapping MRI compared with histopathological findings at 3.0T. J Magn Reson Imaging 2016; 45:1609-1616. [PMID: 27711986 DOI: 10.1002/jmri.25509] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 09/23/2016] [Indexed: 01/03/2023] Open
Abstract
PURPOSE To prospectively determine the feasibility of T2 -mapping magnetic resonance imaging (MRI) to quantitatively describe the signal characteristics of the normal esophageal wall and assess the depth of esophageal wall invasion by carcinoma at 3.0T. MATERIALS AND METHODS Thirty-two patient specimens, each having foci of carcinoma, were studied using 3.0T MR. Freehand regions of interest were placed to measure the T2 value of the normal esophageal layers and were compared with the regions of carcinoma. Three independent readers reviewed the MR images to evaluate the depth of carcinoma invasion; when the three radiologists could not fully agree with each other, the final stage was determined by consensus. The Games-Howell test was used to compare the difference between the normal esophageal layers and carcinoma. Spearman correlation coefficient analysis was used to compare the stage at MRI with that at histopathological analysis. The interobserver agreement was compared with Cohen's kappa. The sensitivity, specificity, and accuracy for detecting carcinoma invasion were calculated. RESULTS The T2 values between the carcinoma and normal esophageal layers were different (all P < 0.01), except for the inner circular muscle (P = 0.511). The T2 value of each layer of the normal esophageal wall was also different from that of the adjacent layer (all P < 0.01). In 29 of 32 lesions, the depth of the esophageal wall invasion determined by MR was consistent with the histopathological stage (r = 0.969, P < 0.001). The sensitivity, specificity, and accuracy were 80%, 96.3%, and 93.8%, respectively, for invasion into the mucosa; 77.8%, 95.7%, and 90.6%, respectively, for invasion into submucosa; 100%, 95.8%, and 96.9%, respectively, for invasion into muscularis propria; and 100%, 100%, and 100%, respectively, for invasion into the adventitia. CONCLUSION T2 -mapping MR images obtained using a 3.0T MR scanner can be used to depict the precise histopathological layers of the esophageal wall clearly and provide excellent diagnostic accuracy for assessing esophageal carcinoma invasion. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;45:1609-1616.
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Affiliation(s)
- Yi Wei
- Department of Radiology, Zhengzhou University People's Hospital, Zhengzhou, China.,Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Sen Wu
- Center of Thoracic Tumor, Henan Provincial People's Hospital, Zhengzhou, China
| | - Feifei Gao
- Department of Radiology, Zhengzhou University People's Hospital, Zhengzhou, China.,Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Tingyi Sun
- Department of Pathology, Henan Provincial People's Hospital, Zhengzhou, China
| | | | - Peigang Ning
- Department of Radiology, Zhengzhou University People's Hospital, Zhengzhou, China.,Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Cuihua Zhao
- Department of Radiology, Zhengzhou University People's Hospital, Zhengzhou, China.,Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Ziyuan Li
- Department of Radiology, Zhengzhou University People's Hospital, Zhengzhou, China.,Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Xiaodong Li
- Department of Radiology, Zhengzhou University People's Hospital, Zhengzhou, China.,Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Linlin Li
- Department of Radiology, Zhengzhou University People's Hospital, Zhengzhou, China.,Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Shaocheng Zhu
- Department of Radiology, Zhengzhou University People's Hospital, Zhengzhou, China.,Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China
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22
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Brix M, Kaipel M, Kellner R, Schreiner M, Apprich S, Boszotta H, Windhager R, Domayer S, Trattnig S. Successful osteoconduction but limited cartilage tissue quality following osteochondral repair by a cell-free multilayered nano-composite scaffold at the knee. INTERNATIONAL ORTHOPAEDICS 2016; 40:625-32. [PMID: 26803322 DOI: 10.1007/s00264-016-3118-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 01/11/2016] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The treatment of larger osteochondral lesions in the knee is still a clinical challenge. One promising strategy to overcome this problem could be surgical repair by using a cell-free multilayered nano-composite scaffold. METHOD In this prospective cohort study eight consecutive patients which suffered from a single osteochondral lesion (≥1.5 cm(2)) on the femoral condyle were enrolled. The repair potential of the implant was assessed by using MRI based biochemical MR sequences (T2 mapping) as well as semi-quantitative morphological analyses (MOCART score) at 18 months after the surgery. The clinical outcome was determined at six, 12, 18, and 24 month follow ups by using IKDC, Tegner-Lysholm, and Cincinnati knee scores. RESULTS Seven out of eight patients showed a complete integration of the scaffold into the border zone and five out of eight patients excellent or good subchondral ossification of the implant at 18 months following implantation. The surface of the repair tissue was found to be intact in all eight patients. T2 mapping data and the zonal T2 index significantly differed in the repair tissue compared to the healthy control cartilage (P < 0.001) which indicates a limited quality of the repair cartilage. The clinical outcome scores consistently improved during the follow up period without reaching statistical significance. CONCLUSIONS Osteochondral repair by implanting the MaioRegen® scaffold provides a successful osteoconduction and filling of the cartilage defect. However there is evidence for a limited repair cartilage tissue quality at 18 months after the surgery.
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Affiliation(s)
- Martin Brix
- Centre of Excellence "High-field Magnetic Resonance (MR)", Medical University Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria
| | - Martin Kaipel
- Department of Orthopaedic and Trauma Surgery, Barmherzige Brüder Hospital, Johannes von Gott-Platz 1, A-7000, Eisenstadt, Austria.
| | - Richard Kellner
- Department of Orthopaedic and Trauma Surgery, Barmherzige Brüder Hospital, Johannes von Gott-Platz 1, A-7000, Eisenstadt, Austria
| | - Markus Schreiner
- Centre of Excellence "High-field Magnetic Resonance (MR)", Medical University Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria
| | - Sebastian Apprich
- Department of Orthopaedics, Medical University Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria
| | - Harald Boszotta
- Department of Orthopaedic and Trauma Surgery, Barmherzige Brüder Hospital, Johannes von Gott-Platz 1, A-7000, Eisenstadt, Austria
| | - Reinhard Windhager
- Department of Orthopaedics, Medical University Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria
| | - Stephan Domayer
- Centre of Excellence "High-field Magnetic Resonance (MR)", Medical University Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria
| | - Siegfried Trattnig
- Centre of Excellence "High-field Magnetic Resonance (MR)", Medical University Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria
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23
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Li H, Qian J, Chen J, Zhong K, Chen S. Osteochondral repair with synovial membrane‑derived mesenchymal stem cells. Mol Med Rep 2016; 13:2071-7. [PMID: 26781689 PMCID: PMC4768977 DOI: 10.3892/mmr.2016.4795] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 11/10/2015] [Indexed: 12/25/2022] Open
Abstract
The aim of the present study was to analyze cartilage repair tissue quality following synovial membrane-derived mesenchymal stem cell (SMSC) transplantation in a rabbit osteochondral defect. A total of 15 New Zealand white rabbits were randomly distributed into three groups (n=5 in each group). In group 1, an osteochondral defect model was established in the right knee trochlea, prior to transplantation with SMSCs (SMSC group). In group 2, an osteochondral defect model was established without further treatment (control group). Group 3 did not undergo osteochondral defect model establishment and served as the sham control (normal group). All animals were sacrificed 12 weeks following the surgical procedures for magnetic resonance imaging and histological examination. No significant differences were observed between the control and SMSC group in the macroscopic score (P>0.05), the 2D magnetic resonance observation of cartilage repair tissue score (P>0.05) or the modified O'Driscoll scale (P>0.05). Compared with the control group, a significant improvement in tissue quality was observed in the SMSCs group postoperatively. The repair tissue of the SMSCs group had a shorter T2, compared with that of the control group, although no significant difference was detected (P>0.05). Furthermore, the apparent diffusion coefficient in the repair tissue of the SMSC group had a significantly lower value, compared with that of the control group (P=0.016). The results of the present study demonstrated that osteochondral repair using SMSCs facilitated the repair of appropriate tissue texture.
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Affiliation(s)
- Hong Li
- Department of Sports Medicine, Huashan Hospital, Shanghai 200040, P.R. China
| | - Junchao Qian
- High Magnetic Field Laboratory, Chinese Academy of Sciences, Hefei, Anhui 230031, P.R. China
| | - Jiwu Chen
- Department of Sports Medicine, Huashan Hospital, Shanghai 200040, P.R. China
| | - Kai Zhong
- High Magnetic Field Laboratory, Chinese Academy of Sciences, Hefei, Anhui 230031, P.R. China
| | - Shiyi Chen
- Department of Sports Medicine, Huashan Hospital, Shanghai 200040, P.R. China
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24
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Shen S, Wang H, Zhang J, Wang F, Liu SR. Diffusion Weighted Imaging, Diffusion Tensor Imaging, and T2* Mapping of Lumbar Intervertebral Disc in Young Healthy Adults. IRANIAN JOURNAL OF RADIOLOGY 2016; 13:e30069. [PMID: 27127578 PMCID: PMC4841898 DOI: 10.5812/iranjradiol.30069] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Revised: 06/14/2015] [Accepted: 07/03/2015] [Indexed: 11/16/2022]
Abstract
Background: Although conventional magnetic resonance imaging (MRI) could provide excellent detection of morphological changes in the diagnosis of lumbar disc degeneration (LDD), it has some difficulties in discriminating minimal changes associated with early LDD before morphological or clinical alterations. Therefore, newer MRI techniques have emerged for investigation of early LDD. Objectives: The aim of this study was to use diffusion weighted imaging (DWI), diffusion Tensor Imaging (DTI) and T2* mapping to detect lumbar discs in healthy young adults, to evaluate if they could depict the microstructural changes of early LDD. Patients and Methods: Apparent diffusion coefficient (ADC), fractional anisotropy (FA), and T2* images of the lumbar discs were obtained for 40 asymptomatic young subjects (19 males and 21 females; mean age of 24.3 years), using DWI, DTI and T2* mapping with a 1.5-T MRI scanner. ADC, FA, and T2* values were measured to compare five regions of interest (ROI) selected in each nucleus pulposus (NP) of the images. Results: The ADC, FA, and T2* values were different (P < 0.05) among different ROIs within the same disc or among corresponding ROIs in different level discs. While the average values of ADC increased regularly with the lowering of the anatomical location (P < 0.05), the average FA and T2* values also associated with the anatomic locations, showed an increase in L4-L5 and L5-S1 discs (P < 0.05). Conclusion: ADC, FA, and T2* values may quantitatively reflect the microstructural characteristics of NP, therefore they could be used to detect the minimal changes of early LDD.
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Affiliation(s)
- Si Shen
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
| | - Hao Wang
- Pain Clinic, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
- Corresponding author: Hao Wang, Pain Clinic, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China. Tel: +86-13430267880, Fax: +86-2038688416, E-mail:
| | - Jing Zhang
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
| | - Fei Wang
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
| | - Si-Run Liu
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
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25
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Novakofski KD, Pownder SL, Koff MF, Williams RM, Potter HG, Fortier LA. High-Resolution Methods for Diagnosing Cartilage Damage In Vivo. Cartilage 2016; 7:39-51. [PMID: 26958316 PMCID: PMC4749750 DOI: 10.1177/1947603515602307] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Advances in current clinical modalities, including magnetic resonance imaging and computed tomography, allow for earlier diagnoses of cartilage damage that could mitigate progression to osteoarthritis. However, current imaging modalities do not detect submicrometer damage. Developments in in vivo or arthroscopic techniques, including optical coherence tomography, ultrasonography, bioelectricity including streaming potential measurement, noninvasive electroarthrography, and multiphoton microscopy can detect damage at an earlier time point, but they are limited by a lack of penetration and the ability to assess an entire joint. This article reviews current advancements in clinical and developing modalities that can aid in the early diagnosis of cartilage injury and facilitate studies of interventional therapeutics.
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Affiliation(s)
| | | | - Matthew F. Koff
- MRI Laboratory, Hospital for Special Surgery, New York, NY, USA
| | | | | | - Lisa A. Fortier
- Department of Clinical Sciences, Cornell University, Ithaca, NY, USA,Lisa A. Fortier, Department of Clinical Sciences, Cornell University, VMC C3-181, Ithaca, NY 14853, USA. Email
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26
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Bergen CJAV, Gerards RM, Opdam KTM, Terra MP, Kerkhoffs GMMJ. Diagnosing, planning and evaluating osteochondral ankle defects with imaging modalities. World J Orthop 2015; 6:944-953. [PMID: 26716090 PMCID: PMC4686441 DOI: 10.5312/wjo.v6.i11.944] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 09/02/2015] [Accepted: 10/13/2015] [Indexed: 02/06/2023] Open
Abstract
This current concepts review outlines the role of different imaging modalities in the diagnosis, preoperative planning, and follow-up of osteochondral ankle defects. An osteochondral ankle defect involves the articular cartilage and subchondral bone (usually of the talus) and is mostly caused by an ankle supination trauma. Conventional radiographs are useful as an initial imaging tool in the diagnostic process, but have only moderate sensitivity for the detection of osteochondral defects. Computed tomography (CT) and magnetic resonance imaging (MRI) are more accurate imaging modalities. Recently, ultrasonography and single photon emission CT have been described for the evaluation of osteochondral talar defects. CT is the most valuable modality for assessing the exact location and size of bony lesions. Cartilage and subchondral bone damage can be visualized using MRI, but the defect size tends to be overestimated due to bone edema. CT with the ankle in full plantar flexion has been shown a reliable tool for preoperative planning of the surgical approach. Postoperative imaging is useful for objective assessment of repair tissue or degenerative changes of the ankle joint. Plain radiography, CT and MRI have been used in outcome studies, and different scoring systems are available.
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27
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Morphological and compositional monitoring of a new cell-free cartilage repair hydrogel technology - GelrinC by MR using semi-quantitative MOCART scoring and quantitative T2 index and new zonal T2 index calculation. Osteoarthritis Cartilage 2015; 23:2224-2232. [PMID: 26187572 DOI: 10.1016/j.joca.2015.07.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 06/24/2015] [Accepted: 07/07/2015] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate cartilage repair tissue (RT) using MOCART scoring for morphological and T2 mapping for biochemical assessment following implantation of GelrinC, a biosynthetic, biodegradable hydrogel implant. DESIGN MR imaging (1.5/3T) was performed on 21 patients at six sites. Standard protocols were used for MOCART evaluation at 1 week (baseline) 1, 3, 6, 12, 18 and 24 months. Multi-echo SE was used for T2 mapping. Global (T2 in RT divided by T2 in normal cartilage) and zonal T2 index (deep T2 divided by superficial T2) of RT were calculated. RESULTS Average MOCART score was 71.8 (95% CI 62.2 to 81.3) at six, 75.2 (95% CI 62.8 to 87.5) at twelve, 71.8 (95% CI 55.4 to 88.2) at eighteen and 84.4 (95% CI 77.7 to 91.0) at twenty-four months. The global T2 index ranged between 0.8 and 1.2 (normal healthy cartilage) in 1/11 (9%) patients at baseline, 8/12 (67%) at 12 months, 11/13 (85%) at 18 months and 13/16 (81%) at 24 months. The zonal T2 index for RT was <20% difference to the zonal T2 index for normal cartilage in: 6/12 patients (50%) at 12 months, 7/13 (53.8%) at 18 months and 10/16 (63.5%) at 24 months. The standard deviation for T2 showed a significant decrease over the study. CONCLUSIONS The increase of MOCART scores over follow-up indicates improving cartilage repair tissue. Global and zonal T2 repair values at 24 months reached normal cartilage in 81% and 63.5% of the patients respectively, reflecting collagen organization similar to hyaline cartilage.
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28
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Bittersohl B, Kircher J, Miese FR, Dekkers C, Habermeyer P, Fröbel J, Antoch G, Krauspe R, Zilkens C. T2* mapping and delayed gadolinium-enhanced magnetic resonance imaging in cartilage (dGEMRIC) of humeral articular cartilage--a histologically controlled study. J Shoulder Elbow Surg 2015; 24:1644-52. [PMID: 25958213 DOI: 10.1016/j.jse.2015.03.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 02/27/2015] [Accepted: 03/07/2015] [Indexed: 02/01/2023]
Abstract
BACKGROUND Cartilage biochemical imaging modalities that include the magnetic resonance imaging (MRI) techniques of T2* mapping (sensitive to water content and collagen fiber network) and delayed gadolinium-enhanced MRI of cartilage (dGEMRIC, sensitive to the glycosaminoglycan content) can be effective instruments for early diagnosis and reliable follow-up of cartilage damage. The purpose of this study was to provide T2* mapping and dGEMRIC values in various histologic grades of cartilage degeneration in humeral articular cartilage. METHODS A histologically controlled in vitro study was conducted that included human humeral head cartilage specimens with various histologic grades of cartilage degeneration. High-resolution, 3-dimensional (3D) T2* mapping and dGEMRIC were performed that enabled the correlation of MRI and histology data. Cartilage degeneration was graded according to the Mankin score, which evaluates surface morphology, cellularity, toluidine blue staining, and tidemark integrity. SPSS software was used for statistical analyses. RESULTS Both MRI mapping values decreased significantly (P < .001) with increasing cartilage degeneration. Spearman rank analysis revealed a significant correlation (correlation coefficients ranging from -0.315 to 0.784; P < .001) between the various histologic parameters and the T2* and T1Gd mapping values. CONCLUSION This study demonstrates the feasibility of 3D T2* and dGEMRIC to identify various histologic grades of cartilage damage of humeral articular cartilage. With regard to the advantages of these mapping techniques with high image resolution and the ability to accomplish a 3D biochemically sensitive imaging, we consider that these imaging techniques can make a positive contribution to the currently evolving science and practice of cartilage biochemical imaging.
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Affiliation(s)
- Bernd Bittersohl
- Medical Faculty, Department of Orthopaedics, University Düsseldorf, Düsseldorf, Germany
| | - Jörn Kircher
- Klinik Fleetinsel Hamburg, Clinic for Orthopedic Surgery, Hamburg, Germany.
| | - Falk R Miese
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Düsseldorf, Düsseldorf, Germany
| | - Christin Dekkers
- Medical Faculty, Department of Orthopaedics, University Düsseldorf, Düsseldorf, Germany
| | - Peter Habermeyer
- ATOS-Klinik Heidelberg, Department of Shoulder and Elbow Surgery, Heidelberg, Germany
| | - Julia Fröbel
- Medical Faculty, Department of Orthopaedics, University Düsseldorf, Düsseldorf, Germany
| | - Gerald Antoch
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Düsseldorf, Düsseldorf, Germany
| | - Rüdiger Krauspe
- Medical Faculty, Department of Orthopaedics, University Düsseldorf, Düsseldorf, Germany
| | - Christoph Zilkens
- Medical Faculty, Department of Orthopaedics, University Düsseldorf, Düsseldorf, Germany
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Cha JG, Yi JS, Han JK, Lee YK. Comparison of Quantitative Cartilage T2 Measurements and Qualitative MR Imaging between Professional Ballet Dancers and Healthy Volunteers. Radiology 2015; 276:199-206. [PMID: 25759971 DOI: 10.1148/radiol.15142021] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jang Gyu Cha
- From the Departments of Radiology (J.G.C., J.S.Y.) and Orthopedics (Y.K.L.), Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon, South Korea, 420-767; and Department of Radiology, Soonchunhyang University Cheonan Hospital, Cheonan, South Korea (J.K.H.)
| | - Ji Sook Yi
- From the Departments of Radiology (J.G.C., J.S.Y.) and Orthopedics (Y.K.L.), Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon, South Korea, 420-767; and Department of Radiology, Soonchunhyang University Cheonan Hospital, Cheonan, South Korea (J.K.H.)
| | - Jong Kyu Han
- From the Departments of Radiology (J.G.C., J.S.Y.) and Orthopedics (Y.K.L.), Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon, South Korea, 420-767; and Department of Radiology, Soonchunhyang University Cheonan Hospital, Cheonan, South Korea (J.K.H.)
| | - Young Koo Lee
- From the Departments of Radiology (J.G.C., J.S.Y.) and Orthopedics (Y.K.L.), Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon, South Korea, 420-767; and Department of Radiology, Soonchunhyang University Cheonan Hospital, Cheonan, South Korea (J.K.H.)
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30
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Tao H, Li H, Hua Y, Chen Z, Feng X, Chen S. Quantitative magnetic resonance imaging (MRI) evaluation of cartilage repair after microfracture treatment for full-thickness cartilage defect models in rabbit knee joints: correlations with histological findings. Skeletal Radiol 2015; 44:393-402. [PMID: 25425345 DOI: 10.1007/s00256-014-2062-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 09/04/2014] [Accepted: 11/11/2014] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate repair tissue (RT) after microfracture treatment for full-thickness cartilage defect models using quantitative MRI and investigate the correlations between MRI and histological findings. MATERIALS AND METHODS The animal experiment was approved by the Animal Care and Use Committee of our college. Thirty-six full-thickness cartilage defect models in rabbit knee joints were assigned to the microfracture or joint debridement group (as control). Each group consisted of 3-week, 5-week, and 7-week subgroups. MR imaging, including a three-dimensional double-echo steady-state sequence (3D-DESS), and T2 mapping were performed at 3, 5, and 7 weeks postoperatively. The thickness and T2 indices of RT were calculated. After MRI scans at each time point, operation sites were removed to make hematoxylin-eosin (H&E)-stained sections. Histological results were evaluated using the modified O'Driscoll score system. Comparisons were made between the two groups with respect to the MRI and histological findings, and correlation analysis was performed within each group. RESULTS The thickness index and histological O'Driscoll score of RT in the two groups increased over time, while the T2 index decreased. The thickness index and histological O'Driscoll score of the microfracture group were higher than in the joint debridement group at each time point. The T2 index of the microfracture group was lower than in the joint debridement group at 3 weeks (P = 0.006), while it was higher than in the joint debridement group at 5 and 7 weeks (P = 0.025 and 0.025). The thickness index was positively correlated with the histological O'Driscoll score in both groups (microfracture: r s = 0.745, P < 0.001; joint debridement: r s = 0.680, P = 0.002). The T2 index was negatively correlated with the histological O'Driscoll score in both groups (microfracture: r s = -0.715, P = 0.002; joint debridement: r s = -0.826, P < 0.001). CONCLUSION Significant improvement over time after microfracture can be expected on the basis of the quantitative MRI finding and histological O'Driscoll score. MRI was correlated with the histological O'Driscoll score, which indicated that quantitative MRI 3D-DESS and T2 mapping could evaluate cartilage repair after microfracture as an effective noninvasive tool.
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Affiliation(s)
- Hongyue Tao
- Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqizhong Road, 200040, Shanghai, China
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31
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Bittersohl B, Hosalkar HS, Miese FR, Schibensky J, König DP, Herten M, Antoch G, Krauspe R, Zilkens C. Zonal T2* and T1Gd assessment of knee joint cartilage in various histological grades of cartilage degeneration: an observational in vitro study. BMJ Open 2015; 5:e006895. [PMID: 25667150 PMCID: PMC4322206 DOI: 10.1136/bmjopen-2014-006895] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Accurate assessment of cartilage status is increasingly becoming important to clinicians for offering joint preservation surgeries versus joint replacements. The goal of this study was to evaluate the validity of three-dimensional (3D), gradient-echo (GRE)-based T2* and T1Gd mapping for the assessment of various histological severities of degeneration in knee joint cartilage with potential implications for clinical management. METHODS MRI and histological assessment were conducted in 36 ex vivo lateral femoral condyle specimens. The MRI protocol included a 3D GRE multiecho data image combination sequence in order to assess the T2* decay, a 3D double-echo steady-state sequence for assessment of cartilage morphology, and a dual flip angle 3D GRE sequence with volumetric interpolated breathhold examination for the T1Gd assessment. The histological sample analysis was performed according to the Mankin system. The data were then analysed statistically and correlated. RESULTS We observed a significant decrease in the T2* and T1Gd values with increasing grades of cartilage degeneration (p<0.001) and a moderate correlation between T2* (r=0.514)/T1Gd (r=0.556) and the histological grading of cartilage degeneration (p<0.001). In addition, we noted a zonal variation in the T2* and T1Gd values reflecting characteristic zonal differences in the biochemical composition of hyaline cartilage. CONCLUSIONS This study outlines the potential of GRE-based T2* and T1Gd mapping to identify various grades of cartilage damage. Early changes in specific zones may assist clinicians in identifying methods of early intervention involving the targeted joint preservation approach versus moving forward with unicompartmental, bicompartmental or tricompartmental joint replacement procedures. TRIAL REGISTRATION NUMBER DRKS00000729.
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Affiliation(s)
- Bernd Bittersohl
- Medical Faculty, Department of Orthopaedics, University Düsseldorf, Düsseldorf, Germany
| | - Harish S Hosalkar
- Center of Hip Preservation and Children's Orthopaedics, San Diego, California, USA
| | - Falk R Miese
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Düsseldorf, Düsseldorf, Germany
| | - Jonas Schibensky
- Medical Faculty, Department of Orthopaedics, University Düsseldorf, Düsseldorf, Germany
| | | | - Monika Herten
- Medical Faculty, Clinic for Vascular and Endovascular Surgery, University Münster, Münster, Germany
| | - Gerald Antoch
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Düsseldorf, Düsseldorf, Germany
| | - Rüdiger Krauspe
- Medical Faculty, Department of Orthopaedics, University Düsseldorf, Düsseldorf, Germany
| | - Christoph Zilkens
- Medical Faculty, Department of Orthopaedics, University Düsseldorf, Düsseldorf, Germany
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Hesper T, Miese FR, Hosalkar HS, Behringer M, Zilkens C, Antoch G, Krauspe R, Bittersohl B. Quantitative T2* assessment of knee joint cartilage after running a marathon. Eur J Radiol 2015; 84:284-9. [DOI: 10.1016/j.ejrad.2014.11.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 10/27/2014] [Accepted: 11/17/2014] [Indexed: 11/16/2022]
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Hesper T, Hosalkar HS, Bittersohl D, Welsch GH, Krauspe R, Zilkens C, Bittersohl B. T2* mapping for articular cartilage assessment: principles, current applications, and future prospects. Skeletal Radiol 2014; 43:1429-45. [PMID: 24643762 DOI: 10.1007/s00256-014-1852-3] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 02/08/2014] [Accepted: 02/17/2014] [Indexed: 02/02/2023]
Abstract
With advances in joint preservation surgery that are intended to alter the course of osteoarthritis by early intervention, accurate and reliable assessment of the cartilage status is critical. Biochemically sensitive MRI techniques can add robust biomarkers for disease onset and progression, and therefore, could be meaningful assessment tools for the diagnosis and follow-up of cartilage abnormalities. T2* mapping could be a good alternative because it would combine the benefits of biochemical cartilage evaluation with remarkable features including short imaging time and the ability of high-resolution three-dimensional cartilage evaluation-without the need for contrast media administration or special hardware. Several in vitro and in vivo studies, which have elaborated on the potential of cartilage T2* assessment in various cartilage disease patterns and grades of degeneration, have been reported. However, much remains to be understood and certain unresolved questions have become apparent with these studies that are crucial to the further application of this technique. This review summarizes the principles of the technique and current applications of T2* mapping for articular cartilage assessment. Limitations of recent studies are discussed and the potential implications for patient care are presented.
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Affiliation(s)
- Tobias Hesper
- Department of Orthopaedics Medical Faculty, University Düsseldorf, Düsseldorf, Germany
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Ronga M, Angeretti G, Ferraro S, DE Falco G, Genovese EA, Cherubino P. Imaging of articular cartilage: current concepts. JOINTS 2014; 2:137-40. [PMID: 25606557 DOI: 10.11138/jts/2014.2.3.137] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Magnetic resonance imaging (MRI) is the gold standard method for non-invasive assessment of joint cartilage, providing information on the structure, morphology and molecular composition of this tissue. There are certain minimum requirements for a MRI study of cartilage tissue: machines with a high magnetic field (> 1.5 Tesla); the use of surface coils; and the use of T2-weighted, proton density-weighted fast-spin echo (T2 FSE-DP) and 3D fat-suppressed T1-weighted gradient echo (3D-FS T1W GRE) sequences. For better contrast between the different joint structures, MR arthography is a method that can highlight minimal fibrillation or fractures of the articular surface and allow evaluation of the integrity of the native cartilage-repair tissue interface. To assess the biochemical composition of cartilage and cartilage repair tissue, various techniques have been proposed for studying proteoglycans [dGEMRIC, T1rho mapping, sodium (23Na) imaging MRI, etc.], collagen, and water distribution [T2 mapping, "magnetisation transfer contrast", diffusion-weighted imaging (DWI), and so on]. Several MRI classifications have been proposed for evaluating the processes of joint degeneration (WORMS, BLOKS, ICRS) and post-surgical maturation of repair tissue (MOCART, 3D MOCART). In the future, isotropic 3D sequences set to improve image quality and facilitate the diagnosis of disorders of articular structures adjacent to cartilage.
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Affiliation(s)
- Mario Ronga
- Orthopaedics and Traumatology, Department of Biotechnology and Life Sciences (DBSV), University of Insubria, Varese, Italy
| | - Gloria Angeretti
- Radiology Unit, Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy
| | - Sergio Ferraro
- Orthopaedics and Traumatology, Department of Biotechnology and Life Sciences (DBSV), University of Insubria, Varese, Italy
| | - Giovanni DE Falco
- Orthopaedics and Traumatology, Department of Biotechnology and Life Sciences (DBSV), University of Insubria, Varese, Italy
| | | | - Paolo Cherubino
- Orthopaedics and Traumatology, Department of Biotechnology and Life Sciences (DBSV), University of Insubria, Varese, Italy
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Cartilage imaging in children: current indications, magnetic resonance imaging techniques, and imaging findings. Radiol Clin North Am 2013; 51:689-702. [PMID: 23830793 DOI: 10.1016/j.rcl.2013.04.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Evaluation of hyaline cartilage in pediatric patients requires in-depth understanding of normal physiologic changes in the developing skeleton. Magnetic resonance (MR) imaging is a powerful tool for morphologic and functional imaging of the cartilage. In this review article, current imaging indications for cartilage evaluation pertinent to the pediatric population are described. In particular, novel surgical techniques for cartilage repair and MR classification of cartilage injuries are summarized. The authors also provide a review of the normal anatomy and a concise description of the advances in quantitative cartilage imaging (ie, T2 mapping, delayed gadolinium-enhanced MR imaging of cartilage, and T1rho).
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Cha JG, Lee JC, Kim HJ, Han JK, Lee EH, Kim YD, Jeon CH. Comparison of MRI T2 relaxation changes of knee articular cartilage before and after running between young and old amateur athletes. Korean J Radiol 2012; 13:594-601. [PMID: 22977327 PMCID: PMC3435857 DOI: 10.3348/kjr.2012.13.5.594] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2011] [Accepted: 03/07/2012] [Indexed: 11/30/2022] Open
Abstract
Objective To compare changes in T2 relaxation on magnetic resonance (MR) images of knee articular cartilage in younger and older amateur athletes before and after running. Materials and Methods By using a 3.0-T MR imager, quantitative T2 maps of weight-bearing femoral and tibial articular cartilages in 10 younger and 10 older amateur athletes were acquired before, immediately after, and 2 hours after 30 minutes of running. Changes in global cartilage T2 signals of the medial and lateral condyles of the femur and tibia and regional cartilage T2 signals in the medial condyles of femoral and tibia in response to exercise were compared between the two age groups. Results Changes in global cartilage T2 values after running did not differ significantly between the age groups. In terms of the depth variation, relatively higher T2 values in the older group than in the younger group were observed mainly in the superficial layers of the femoral and tibial cartilage (p < 0.05). Conclusion Age-related cartilage changes may occur mainly in the superficial layer of cartilage where collagen matrix degeneration is primarily initiated. However, no trend is observed regarding a global T2 changes between the younger and older age groups in response to exercise.
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Affiliation(s)
- Jang Gyu Cha
- Department of Radiology, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon 420-767, Korea.
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Domayer SE, Apprich S, Stelzeneder D, Hirschfeld C, Sokolowski M, Kronnerwetter C, Chiari C, Windhager R, Trattnig S. Cartilage repair of the ankle: first results of T2 mapping at 7.0 T after microfracture and matrix associated autologous cartilage transplantation. Osteoarthritis Cartilage 2012; 20:829-36. [PMID: 22542632 DOI: 10.1016/j.joca.2012.04.015] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Revised: 04/11/2012] [Accepted: 04/19/2012] [Indexed: 02/02/2023]
Abstract
BACKGROUND Both microfracture (MFX) and matrix associated autologous cartilage transplantation (MACT) are currently used to treat cartilage defects of the talus. T2 mapping of the ankle at 7 T has the potential to assess the collagen fibril network organization of the native hyaline cartilage and of the repair tissue (RT). This study provides first results regarding the properties of cartilage RT after MFX (mean follow-up: 113.8 months) and MACT (65.4 months). METHODS A multi-echo spin-echo sequence was used at 7 T to assess T2 maps in 10 volunteer cases, and in 10 cases after MFX and MACT each. Proton weighted morphological images and clinical data were used to ensure comparable baseline criteria. RESULTS A significant zonal variation of T2 was found in the volunteers. T2 of the superficial and the deep layer was 39.3 ± 5.9 ms and 21.1 ± 3.1 ms (zonal T2 index calculated by superficial T2/deep T2: 1.87 ± 0.2, P < 0.001). In MFX, T2 of the reference cartilage was 37.4 ± 5.0 ms and 25.3 ± 3.5 ms (1.51 ± 0.3, P < 0.001). In the RT, T2 was 43.4 ± 10.5 ms and 36.3 ± 7.7 ms (1.20 ± 0.2, P = 0.009). In MACT, T2 of the reference cartilage was 39.0 ± 9.1 ms and 27.1 ± 6.6 ms (1.45 ± 0.2, P < 0.001). In the RT, T2 was 44.6 ± 10.4 ms and 38.6 ± 7.3 ms (1.15 ± 0.1, P = 0.003). The zonal RT T2 variation differed significantly from the reference cartilage in both techniques (MFX: P = 0.004, MACT: P = 0.001). CONCLUSION T2 mapping at 7 T allows for the quantitative assessment of the collagen network organization of the talus. MACT and MFX yielded RT with comparable T2 properties.
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Affiliation(s)
- S E Domayer
- Department of Orthopedics, Medical University of Vienna, Austria.
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MONAHAN PAULE, DORIA ANDREAS, LJUNG ROLF, JIMÉNEZ-YUSTE VICTOR. Optimizing joint function: new knowledge and novel tools and treatments. Haemophilia 2012; 18 Suppl 5:17-26. [DOI: 10.1111/j.1365-2516.2012.02888.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Assessment of cartilage repair after chondrocyte transplantation with a fibrin-hyaluronan matrix – Correlation of morphological MRI, biochemical T2 mapping and clinical outcome. Eur J Radiol 2012; 81:1216-23. [DOI: 10.1016/j.ejrad.2011.03.031] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Accepted: 03/07/2011] [Indexed: 11/19/2022]
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Staroswiecki E, Granlund KL, Alley MT, Gold GE, Hargreaves BA. Simultaneous estimation of T(2) and apparent diffusion coefficient in human articular cartilage in vivo with a modified three-dimensional double echo steady state (DESS) sequence at 3 T. Magn Reson Med 2011; 67:1086-96. [PMID: 22179942 DOI: 10.1002/mrm.23090] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Revised: 06/11/2011] [Accepted: 06/19/2011] [Indexed: 11/12/2022]
Abstract
T(2) mapping and diffusion-weighted imaging complement morphological imaging for assessing cartilage disease and injury. The double echo steady state sequence has been used for morphological imaging and generates two echoes with markedly different T(2) and diffusion weighting. Modifying the spoiler gradient area and flip angle of the double echo steady state sequence allows greater control of the diffusion weighting of both echoes. Data from two acquisitions with different spoiler gradient areas and flip angles are used to simultaneously estimate the T(2) and apparent diffusion coefficient of each voxel. This method is verified in phantoms and validated in vivo in the knee; estimates from different regions of interest in the phantoms and cartilage are compared to those obtained using standard spin-echo methods. The Pearson correlations were 0.984 for T(2) (∼2% relative difference between spin-echo and double echo steady state estimates) and 0.997 for apparent diffusion coefficient (˜1% relative difference between spin-echo and double echo steady state estimates) for the phantom study and 0.989 for T(2) and 0.987 for apparent diffusion coefficient in regions of interest in the human knee in vivo. High accuracy for simultaneous three-dimensional T(2) and apparent diffusion coefficient measurements are demonstrated, while also providing morphologic three-dimensional images without blurring or distortion in reasonable scan times.
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Winalski CS, Rajiah P. The evolution of articular cartilage imaging and its impact on clinical practice. Skeletal Radiol 2011; 40:1197-222. [PMID: 21847750 DOI: 10.1007/s00256-011-1226-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Accepted: 06/27/2011] [Indexed: 02/02/2023]
Abstract
Over the past four decades, articular cartilage imaging has developed rapidly. Imaging now plays a critical role not only in clinical practice and therapeutic decisions but also in the basic research probing our understanding of cartilage physiology and biomechanics.
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Affiliation(s)
- Carl S Winalski
- Imaging Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
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Huang C, Graff CG, Clarkson EW, Bilgin A, Altbach MI. T2 mapping from highly undersampled data by reconstruction of principal component coefficient maps using compressed sensing. Magn Reson Med 2011; 67:1355-66. [PMID: 22190358 DOI: 10.1002/mrm.23128] [Citation(s) in RCA: 121] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Revised: 06/14/2011] [Accepted: 07/08/2011] [Indexed: 12/30/2022]
Abstract
Recently, there has been an increased interest in quantitative MR parameters to improve diagnosis and treatment. Parameter mapping requires multiple images acquired with different timings usually resulting in long acquisition times. While acquisition time can be reduced by acquiring undersampled data, obtaining accurate estimates of parameters from undersampled data is a challenging problem, in particular for structures with high spatial frequency content. In this work, principal component analysis is combined with a model-based algorithm to reconstruct maps of selected principal component coefficients from highly undersampled radial MRI data. This novel approach linearizes the cost function of the optimization problem yielding a more accurate and reliable estimation of MR parameter maps. The proposed algorithm--reconstruction of principal component coefficient maps using compressed sensing--is demonstrated in phantoms and in vivo and compared with two other algorithms previously developed for undersampled data.
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Affiliation(s)
- Chuan Huang
- Department of Mathematics, University of Arizona, Tucson, Arizona 85724, USA
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Xu J, Xie G, Di Y, Bai M, Zhao X. Value of T2-mapping and DWI in the diagnosis of early knee cartilage injury. J Radiol Case Rep 2011; 5:13-8. [PMID: 22470777 DOI: 10.3941/jrcr.v5i2.515] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To study the value of T2-mapping and diffusion weighted imaging (DWI) in the diagnosis of early injury of knee cartilage. METHODS Seventy-two subjects, including healthy group (n=30) and early cartilage injury group (n=42), were tested on MR scans with T2-mapping and DWI. T2 and apparent diffusion coefficient (ADC) values of cartilage were measured after being processed at the workstation, and the differences were statistically analyzed between the two groups. RESULTS The mean T2 and ADC values of cartilage in early injury group and health group were respectively 51.58±4.15 ms and 1.78±0.35 ×10(-3) mm(2)/s, 39.54±4.02 ms and 1.44±0.17 ×10(-3) mm(2)/s. There was significant difference between the values of T2 and ADC. CONCLUSION T2 and ADC values in early cartilage injury have obviously increased. T2-mapping and DWI have high clinical value in the diagnosis of early articular cartilage injury.
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Affiliation(s)
- Jinfa Xu
- Department of Radiology, Liaocheng People's Hospital, Taishan Medical University, Liaocheng, Shandong, China.
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Ording Müller LS, Avenarius D, Olsen OE. High signal in bone marrow at diffusion-weighted imaging with body background suppression (DWIBS) in healthy children. Pediatr Radiol 2011; 41:221-6. [PMID: 20652234 DOI: 10.1007/s00247-010-1774-8] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2009] [Revised: 05/28/2010] [Accepted: 05/30/2010] [Indexed: 12/29/2022]
Abstract
BACKGROUND In our experience, diffusion-weighted imaging with body background suppression (DWIBS) is hard to interpret in children who commonly have foci of restricted diffusion in their skeletons unrelated to pathology, sometimes in an asymmetrical pattern. This raises serious concern about the accuracy of DWIBS in cancer staging in children. OBJECTIVE To describe the signal distribution at DWIBS in the normal developing lumbar spine and pelvic skeleton. MATERIALS AND METHODS Forty-two healthy children underwent an MR DWIBS sequence of the abdomen and pelvis. An axial short-tau inversion-recovery (STIR) echo-planar imaging (EPI) pulse sequence was used. Two radiologists did a primary review of the images and based on these preliminary observations, separate scoring systems for the lumbar spine, pelvis and proximal femoral epiphyses/femoral heads were devised. Visual evaluation of the images was then performed by the two radiologists in consensus. The scoring was repeated separately 2 months later by a third radiologist. Restricted diffusion was defined as areas of high signal compared to the background. Coronal maximum intensity projection (MIP) reformats were used to assess the vertebral bodies. For the pelvis, the extension of high signal for each bone was given a score of 0 to 4. Cohen's Kappa interobserver agreement coefficients of signal distribution and asymmetry were calculated. RESULTS All children had areas of high signal, both within the lumbar vertebral bodies and within the pelvic skeleton. Three patterns of signal distribution were seen in the lumbar spine, but no specific pattern was seen in the pelvis. There was a tendency toward a reduction of relative area of high signal within each bone with age, but also a widespread interindividual variation. CONCLUSION Restricted diffusion is a normal finding in the pelvic skeleton and lumbar spine in children with an asymmetrical distribution seen in 48% of normal children in this study. DWIBS should be used with caution for cancer staging in children as this could lead to high numbers of false positive findings or even unjustified upstaging.
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Trattnig S, Winalski CS, Marlovits S, Jurvelin JS, Welsch GH, Potter HG. Magnetic Resonance Imaging of Cartilage Repair: A Review. Cartilage 2011; 2:5-26. [PMID: 26069565 PMCID: PMC4300792 DOI: 10.1177/1947603509360209] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Articular cartilage lesions are a common pathology of the knee joint, and many patients may benefit from cartilage repair surgeries that offer the chance to avoid the development of osteoarthritis or delay its progression. Cartilage repair surgery, no matter the technique, requires a noninvasive, standardized, and high-quality longitudinal method to assess the structure of the repair tissue. This goal is best fulfilled by magnetic resonance imaging (MRI). The present article provides an overview of the current state of the art of MRI of cartilage repair. In the first 2 sections, preclinical and clinical MRI of cartilage repair tissue are described with a focus on morphological depiction of cartilage and the use of functional (biochemical) MR methodologies for the visualization of the ultrastructure of cartilage repair. In the third section, a short overview is provided on the regulatory issues of the United States Food and Drug Administration (FDA) and the European Medicines Agency (EMEA) regarding MR follow-up studies of patients after cartilage repair surgeries.
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Affiliation(s)
- Siegfried Trattnig
- MR Centre - High Field MR, Department of Radiology, Medical University of Vienna, Vienna, Austria,Siegfried Trattnig, MR Centre - High Field MR, Department of Radiology, Medical University of Vienna, Lazarettgasse 14, A-1090 Vienna, Austria
| | | | - Stephan Marlovits
- Trauma Surgery Department, Medical University of Vienna, Vienna, Austria
| | - Jukka S. Jurvelin
- Department of Physics and Mathematics, University of Eastern Finland, Kuopio, Finland
| | - Goetz H. Welsch
- MR Centre - High Field MR, Department of Radiology, Medical University of Vienna, Vienna, Austria,Department of Trauma Surgery, University Hospital of Erlangen, Erlangen, Germany
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Lee KT, Choi YS, Lee YK, Kim JS, Young KW, Kim JH. Comparison of MRI and arthroscopy after autologous chondrocyte implantation in patients with osteochondral lesion of the talus. Orthopedics 2010; 33. [PMID: 20704107 DOI: 10.3928/01477447-20100625-12] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
No reported postoperative evaluation method is accurately correlated with the clinical outcome of repaired cartilage after autologous chondrocyte implantation. This study investigated the correlation of follow-up magnetic resonance imaging (MRI) evaluation and arthroscopic findings to the clinical outcome of surgically repaired osteochondral lesion of the talus with autologous chondrocyte implantation using the modified magnetic resonance observation of cartilage repair tissue (MOCART) scoring system.The study group comprised 21 consecutive patients with an osteochondral lesion of the talus who underwent autologous chondrocyte implantation. One year postoperatively, a follow-up MRI was obtained and a second-look arthroscopy was performed. Although the arthroscopic findings of the repaired osteochondral lesion of the talus showed better correlation with the clinical outcome when used with the modified MOCART scoring system, the higher correlation occurred only within a statistical error range, thus making the correlation not significantly different from the one determined on MRI. Therefore, a second-look arthroscopy is not necessary to evaluate the repaired talar cartilage after an autologous chondrocyte implantation. Magnetic resonance imaging is a useful method for long-term follow-up of patients with osteochondral lesions of the talus.
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Affiliation(s)
- Kyung Tai Lee
- Foot and Ankle Service, Department of Orthopedic Surgery, Eulji Hospital, Eulji University School of Medicine, Seoul, Korea
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DORIA AS. State-of-the-art imaging techniques for the evaluation of haemophilic arthropathy: present and future. Haemophilia 2010; 16 Suppl 5:107-14. [DOI: 10.1111/j.1365-2516.2010.02307.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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48
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Bittersohl B, Hosalkar HS, Kim YJ, Werlen S, Trattnig S, Siebenrock KA, Mamisch TC. T1 assessment of hip joint cartilage following intra-articular gadolinium injection: A pilot study. Magn Reson Med 2010; 64:1200-7. [DOI: 10.1002/mrm.22472] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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49
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Abstract
The cartilage of the lower limb joints is exposed to high levels of mechanical stress and therefore is a frequent site of degenerative and traumatic lesions. Magnetic resonance imaging (MRI) is the modality of choice for the assessment of these cartilage lesions. To date, clinically available sequences have focused on morphological defects and cartilage loss. Efforts have been made in recent years to depict cartilage lesions at an earlier stage, with new quantitative sequences focusing on the biochemical assessment of tissue.After a brief review of the hyaline cartilage structure, we review the current morphological imaging methods and the biochemical MRI techniques to assess the cartilage. We then illustrate the application of these MRI sequences for the most common degenerative and traumatic disorders affecting lower limb cartilage.
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50
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Mamisch TC, Trattnig S, Quirbach S, Marlovits S, White LM, Welsch GH. Quantitative T2 Mapping of Knee Cartilage: Differentiation of Healthy Control Cartilage and Cartilage Repair Tissue in the Knee with Unloading—Initial Results. Radiology 2010; 254:818-826. [DOI: 10.1148/radiol.09090335] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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