1
|
Bayer T, Bächter L, Lutter C, Janka R, Uder M, Schöffel V, Roemer FW, Nagel AM, Heiss R. Comparison of 3T and 7T magnetic resonance imaging for direct visualization of finger flexor pulley rupture: an ex-vivo study. Skeletal Radiol 2024; 53:2469-2476. [PMID: 38607418 PMCID: PMC11410841 DOI: 10.1007/s00256-024-04671-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/22/2024] [Accepted: 03/30/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVE To compare image quality and diagnostic performance of 3T and 7T magnetic resonance imaging (MRI) for direct depiction of finger flexor pulleys A2, A3 and A4 before and after artificial pulley rupture in an ex-vivo model using anatomic preparation as reference. MATERIALS AND METHODS 30 fingers from 10 human cadavers were examined at 3T and 7T before and after being subjected to iatrogenic pulley rupture. MRI protocols were comparable in duration, both lasting less than 22 min. Two experienced radiologists evaluated the MRIs. Image quality was graded according to a 4-point Likert scale. Anatomic preparation was used as gold standard. RESULTS In comparison, 7T versus 3T had a sensitivity and specificity for the detection of A2, A3 and A4 pulley lesions with 100% vs. 95%, respectively 98% vs. 100%. In the assessment of A3 pulley lesions sensitivity of 7T was superior to 3T MRI (100% vs. 83%), whereas specificity was lower (95% vs. 100%). Image quality assessed before and after iatrogenic rupture was comparable with 2.74 for 7T and 2.61 for 3T. Visualization of the A3 finger flexor pulley before rupture creation was significantly better for 7 T (p < 0.001). Interobserver variability showed substantial agreement at 3T (κ = 0.80) and almost perfect agreement at 7T (κ = 0.90). CONCLUSION MRI at 3T allows a comparable diagnostic performance to 7T for direct visualization and characterization of finger flexor pulleys before and after rupture, with superiority of 7T MRI in the visualization of the normal A3 pulley.
Collapse
Affiliation(s)
- Thomas Bayer
- Institue of Radiology, Universitätsklinikum & Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
- Klinikum Fürth, Institute of Neuroradiology and Radiology, Fürth, Germany.
| | - Lilly Bächter
- Institue of Radiology, Universitätsklinikum & Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Christoph Lutter
- Department of Orthopedics, University Medical Center, Rostock, Germany
- School of Health, Leeds Becket University, Leeds, UK
| | - Rolf Janka
- Institue of Radiology, Universitätsklinikum & Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Michael Uder
- Institue of Radiology, Universitätsklinikum & Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Völker Schöffel
- Department of Sports Orthopaedics, Sports Medicine, Sports Traumatology, Klinikum Bamberg, Bamberg, Germany
- Department of Orthopedic and Trauma Surgery, Friedrich Alexander Universität Erlangen-Nürnberg, FRG, Erlangen, Germany
- Section of Wilderness Medicine, Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USA
- School of Health, Leeds Becket University, Leeds, UK
| | - Frank W Roemer
- Institue of Radiology, Universitätsklinikum & Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- School of Medicine, Chobanian & Avedisian Boston University, Boston, MA, USA
| | - Armin M Nagel
- Institue of Radiology, Universitätsklinikum & Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Division of Medical Physics in Radiology, German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Rafael Heiss
- Institue of Radiology, Universitätsklinikum & Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| |
Collapse
|
2
|
Cheng KY, Jerban S, Bae WC, Fliszar E, Chung CB. High-Field MRI Advantages and Applications in Rheumatology. Radiol Clin North Am 2024; 62:837-847. [PMID: 39059975 DOI: 10.1016/j.rcl.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2024]
Abstract
Imaging of rheumatologic diseases has historically been performed using conventional radiography. MRI offers an opportunity for detection of altered marrow signal in early disease that is not visible on other imaging modalities such as radiography, computed tomography, or sonography. This review describes the advantages of current MRI techniques in the diagnosis and treatment monitoring of rheumatologic diseases. In addition, this review discusses novel MRI techniques at high-field magnetic strength which may be deployed in the future to allow for improved imaging resolution and quantitative assessment of both axial and peripheral joints.
Collapse
Affiliation(s)
- Karen Y Cheng
- Department of Radiology, University of California, San Diego, 200 W Arbor Drive, San Diego, CA 92103, USA
| | - Saeed Jerban
- Department of Radiology, University of California, San Diego, 200 W Arbor Drive, San Diego, CA 92103, USA; Department of Orthopedic Surgery, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; Department of Radiology and Research Service, Veterans Affairs San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, USA
| | - Won C Bae
- Department of Radiology, University of California, San Diego, 200 W Arbor Drive, San Diego, CA 92103, USA
| | - Evelyne Fliszar
- Department of Radiology, University of California, San Diego, 200 W Arbor Drive, San Diego, CA 92103, USA
| | - Christine B Chung
- Department of Radiology, University of California, San Diego, 200 W Arbor Drive, San Diego, CA 92103, USA; Department of Radiology and Research Service, Veterans Affairs San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, USA.
| |
Collapse
|
3
|
Pachowsky ML, Söllner S, Gelse K, Sambale J, Nagel AM, Schett G, Saake M, Uder M, Roemer FW, Heiss R. Primary anterior cruciate ligament repair-morphological and quantitative assessment by 7-T MRI and clinical outcome after 1.5 years. Eur Radiol 2024; 34:5007-5015. [PMID: 38345606 PMCID: PMC11255066 DOI: 10.1007/s00330-024-10603-z] [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: 07/27/2023] [Revised: 12/07/2023] [Accepted: 12/19/2023] [Indexed: 07/18/2024]
Abstract
OBJECTIVES The purpose of this study was to assess morphological and quantitative changes of the anterior cruciate ligament (ACL) and cartilage after ACL repair. METHODS 7T MRI of the knee was acquired in 31 patients 1.5 years after ACL repair and in 13 controls. Proton density-weighted images with fat saturation (PD-fs) were acquired to assess ACL width, signal intensity, elongation, and fraying. T2/T2* mapping was performed for assessment of ACL and cartilage. Segmentation of the ACL, femoral, and tibial cartilage was carried out at 12 ROIs. The outcome evaluation consisted of the Lysholm Knee Score and International Knee Documentation Committee (IKDC) subjective score and clinical examination. RESULTS ACL showed a normal signal intensity in 96.8% and an increased width in 76.5% after repair. Fraying occurred in 22.6% without having an impact on the clinical outcome (Lysholm score: 90.39 ± 9.75, p = 0.76 compared to controls). T2 analysis of the ACL revealed no difference between patients and controls (p = 0.74). Compared to controls, assessment of the femoral and tibial cartilage showed a significant increase of T2* times in all ROIs, except at the posterolateral femur. Patients presented a good outcome in clinical examination with a Lysholm score of 87.19 ± 14.89 and IKDC of 80.23 ± 16.84. CONCLUSION T2 mapping results suggest that the tissue composition of the ACL after repair is similar to that of a native ACL after surgery, whereas the ACL exhibits an increased width. Fraying of the ACL can occur without having any impact on functional outcomes. T2* analysis revealed early degradation at the cartilage. CLINICAL RELEVANCE STATEMENT MRI represents a noninvasive diagnostic tool for the morphological and compositional assessment of the anterior cruciate ligament after repair, whereas knowledge about post-surgical alterations is crucial for adequate imaging interpretation. KEY POINTS • There has been renewed interest in repairing the anterior cruciate ligament with a proximally torn ligament. • T2 times of the anterior cruciate ligament do not differ between anterior cruciate ligament repair patients and controls. • T2 mapping may serve as a surrogate for the evaluation of the anterior cruciate ligament after repair.
Collapse
Affiliation(s)
- Milena L Pachowsky
- Department of Internal Medicine 3 - Rheumatology and Immunology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Ulmenweg 18, 91054, Erlangen, Germany.
- Department of Orthopaedic and Trauma Surgery, Waldkrankenhaus St. Marien, Erlangen, Germany.
| | - Stefan Söllner
- Department of Trauma and Orthopaedic Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Kolja Gelse
- Department of Trauma and Orthopaedic Surgery, Klinikum Traunstein, Traunstein, Germany
| | - Jannik Sambale
- Department of Internal Medicine 3 - Rheumatology and Immunology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Ulmenweg 18, 91054, Erlangen, Germany
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Armin M Nagel
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Georg Schett
- Department of Internal Medicine 3 - Rheumatology and Immunology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Ulmenweg 18, 91054, Erlangen, Germany
| | - Marc Saake
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Uder
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Frank W Roemer
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Quantitative Imaging Center (QIC), School of Medicine, Boston University, Chobanian & Avedisian, Boston, MA, USA
| | - Rafael Heiss
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| |
Collapse
|
4
|
Marth AA, von Deuster C, Sommer S, Feuerriegel GC, Goller SS, Sutter R, Nanz D. Accelerated High-Resolution Deep Learning Reconstruction Turbo Spin Echo MRI of the Knee at 7 T. Invest Radiol 2024:00004424-990000000-00230. [PMID: 38960863 DOI: 10.1097/rli.0000000000001095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2024]
Abstract
OBJECTIVES The aim of this study was to compare the image quality of 7 T turbo spin echo (TSE) knee images acquired with varying factors of parallel-imaging acceleration reconstructed with deep learning (DL)-based and conventional algorithms. MATERIALS AND METHODS This was a prospective single-center study. Twenty-three healthy volunteers underwent 7 T knee magnetic resonance imaging. Two-, 3-, and 4-fold accelerated high-resolution fat-signal-suppressing proton density (PD-fs) and T1-weighted coronal 2D TSE acquisitions with an encoded voxel volume of 0.31 × 0.31 × 1.5 mm3 were acquired. Each set of raw data was reconstructed with a DL-based and a conventional Generalized Autocalibrating Partially Parallel Acquisition (GRAPPA) algorithm. Three readers rated image contrast, sharpness, artifacts, noise, and overall quality. Friedman analysis of variance and the Wilcoxon signed rank test were used for comparison of image quality criteria. RESULTS The mean age of the participants was 32.0 ± 8.1 years (15 male, 8 female). Acquisition times at 4-fold acceleration were 4 minutes 15 seconds (PD-fs, Supplemental Video is available at http://links.lww.com/RLI/A938) and 3 minutes 9 seconds (T1, Supplemental Video available at http://links.lww.com/RLI/A939). At 4-fold acceleration, image contrast, sharpness, noise, and overall quality of images reconstructed with the DL-based algorithm were significantly better rated than the corresponding GRAPPA reconstructions (P < 0.001). Four-fold accelerated DL-reconstructed images scored significantly better than 2- to 3-fold GRAPPA-reconstructed images with regards to image contrast, sharpness, noise, and overall quality (P ≤ 0.031). Image contrast of PD-fs images at 2-fold acceleration (P = 0.087), image noise of T1-weighted images at 2-fold acceleration (P = 0.180), and image artifacts for both sequences at 2- and 3-fold acceleration (P ≥ 0.102) of GRAPPA reconstructions were not rated differently than those of 4-fold accelerated DL-reconstructed images. Furthermore, no significant difference was observed for all image quality measures among 2-fold, 3-fold, and 4-fold accelerated DL reconstructions (P ≥ 0.082). CONCLUSIONS This study explored the technical potential of DL-based image reconstruction in accelerated 2D TSE acquisitions of the knee at 7 T. DL reconstruction significantly improved a variety of image quality measures of high-resolution TSE images acquired with a 4-fold parallel-imaging acceleration compared with a conventional reconstruction algorithm.
Collapse
Affiliation(s)
- Adrian Alexander Marth
- From the Swiss Center for Musculoskeletal Imaging, Balgrist Campus AG, Zurich, Switzerland (A.A.M., C.v.D., S.S., D.N.); Department of Radiology, Balgrist University Hospital, Zurich, Switzerland (A.A.M., G.C.F., S.S.G., R.S.); Advanced Clinical Imaging Technology, Siemens Healthineers International AG, Zurich, Switzerland (C.v.D., S.S.); and Medical Faculty, University of Zurich, Zurich, Switzerland (R.S., D.N.)
| | | | | | | | | | | | | |
Collapse
|
5
|
Heiss R, Höger SA, Uder M, Hotfiel T, Hanspach J, Laun FB, Nagel AM, Roemer FW. Early functional and morphological changes of calf muscles in delayed onset muscle soreness (DOMS) assessed with 7T MRI. Ann Anat 2024; 251:152181. [PMID: 37871829 DOI: 10.1016/j.aanat.2023.152181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 09/24/2023] [Accepted: 10/19/2023] [Indexed: 10/25/2023]
Abstract
BACKGROUND To assess morphological and functional alterations of the skeletal muscle in exercise-induced delayed onset muscle soreness (DOMS) using 7 Tesla (T) magnetic resonance imaging (MRI). METHODS DOMS was induced in 16 volunteers performing an eccentric exercise protocol of the calf muscles of one randomized leg. 7 T MRI including T1w- (0.18×0.18×1mm3), T2w-images (0.2×0.2×2mm3), T2-maps (0.5×0.5×5mm3), and susceptibility weighted imaging (SWI, 0.7×0.7×0.7 mm3) were acquired at baseline, directly (t1) and 60 hours (t2) after the exercise. T2 signal intensity (SI), T2 values [ms], T1 SI and SWI were assessed in the medial (MG) and lateral gastrocnemius muscle (LG) and in the soleus muscle (SM). In addition, the serum creatine kinase (CK) activity, range of motion (ROM) of the ankle, calf circumference, and muscle soreness were assessed at each time point. RESULTS Directly after exercise (t1), T2 SI (p=0.04) and T2 values (p=0.03) increased significantly in the LG. No changes of SI and T2 values for MG and SM were present at t1. At t2, T2 SI and T2 values of LG (p=0.001, p=0.02) and MG (p=0.04, p=0.03) increased significantly compared to baseline. T1 SI did not change in any muscle at any time point. In SWI, no signs of intramuscular signal drop could be detected. Clinical parameters confirmed the induction of DOMS, with a significant increase of CK (p=0.03), muscle soreness (p<0.001), calf circumference (p=0.001), and respective a decrease of ROM (p=0.04). CONCLUSIONS 7 T MRI has the potential to visualize microstructural muscle damage immediately after an exercise that induces DOMS. No changes in susceptibility which could, for example, reflect micro-hemorrhage, could be detected with SWI immediately after exercise or in DOMS. Ultra-high field MRI may potentially be used in sports medicine to monitor intramuscular structural changes, allowing for modification of training intensity or to implement appropriate therapeutic strategies.
Collapse
Affiliation(s)
- Rafael Heiss
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität (FAU), Erlangen-Nürnberg, Maximiliansplatz 3, Erlangen 91054, Germany.
| | - Svenja A Höger
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität (FAU), Erlangen-Nürnberg, Maximiliansplatz 3, Erlangen 91054, Germany; Department of Sports Orthopaedics, Technical University of Munich, Ismaninger Str. 22, Munich 81675, Germany
| | - Michael Uder
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität (FAU), Erlangen-Nürnberg, Maximiliansplatz 3, Erlangen 91054, Germany
| | - Thilo Hotfiel
- Department of Orthopedic Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität (FAU), Erlangen-Nürnberg, Krankenhausstr. 12, Erlangen 91054, Germany; Center for Muskuloskeletal Surgery Osnabrück (OZMC), Klinikum Osnabrück GmbH, Klinikum Osnabrück, Am Finkenhügel 1, Osnabrück 49076, Germany
| | - Jannis Hanspach
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität (FAU), Erlangen-Nürnberg, Maximiliansplatz 3, Erlangen 91054, Germany
| | - Frederik B Laun
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität (FAU), Erlangen-Nürnberg, Maximiliansplatz 3, Erlangen 91054, Germany
| | - Armin M Nagel
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität (FAU), Erlangen-Nürnberg, Maximiliansplatz 3, Erlangen 91054, Germany
| | - Frank W Roemer
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität (FAU), Erlangen-Nürnberg, Maximiliansplatz 3, Erlangen 91054, Germany; Boston University Chobanian & Avedisian School of Medicine, 820 Harrison Ave, Boston, MA 02118, USA
| |
Collapse
|
6
|
Heiss R, Weber MA, Balbach EL, Hinsen M, Geissler F, Nagel AM, Ladd ME, Arkudas A, Horch RE, Gall C, Uder M, Roemer FW. Variation in cartilage T2 and T2* mapping of the wrist: a comparison between 3- and 7-T MRI. Eur Radiol Exp 2023; 7:80. [PMID: 38093075 PMCID: PMC10719234 DOI: 10.1186/s41747-023-00394-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/30/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND To analyze regional variations in T2 and T2* relaxation times in wrist joint cartilage and the triangular fibrocartilage complex (TFCC) at 3 and 7 T and to compare values between field strengths. METHODS Twenty-five healthy controls and 25 patients with chronic wrist pain were examined at 3 and 7 T on the same day using T2- and T2*-weighted sequences. Six different regions of interest (ROIs) were evaluated for cartilage and 3 ROIs were evaluated at the TFCC based on manual segmentation. Paired t-tests were used to compare T2 and T2* values between field strengths and between different ROIs. Spearman's rank correlation was calculated to assess correlations between T2 and T2* time values at 3 and 7 T. RESULTS T2 and T2* time values of the cartilage differed significantly between 3 and 7 T for all ROIs (p ≤ 0.045), with one exception: at the distal lunate, no significant differences in T2 values were observed between field strengths. T2* values differed significantly between 3 and 7 T for all ROIs of the TFCC (p ≤ 0.001). Spearman's rank correlation between 3 and 7 T ranged from 0.03 to 0.62 for T2 values and from 0.01 to 0.48 for T2* values. T2 and T2* values for cartilage varied across anatomic locations in healthy controls at both 3 and 7 T. CONCLUSION Quantitative results of T2 and T2* mapping at the wrist differ between field strengths, with poor correlation between 3 and 7 T. Local variations in cartilage T2 and T2* values are observed in healthy individuals. RELEVANCE STATEMENT T2 and T2* mapping are feasible for compositional imaging of the TFCC and the cartilage at the wrist at both 3 and 7 T, but the clinical interpretation remains challenging due to differences between field strengths and variations between anatomic locations. KEY POINTS •Field strength and anatomic locations influence T2 and T2* values at the wrist. •T2 and T2* values have a poor correlation between 3 and 7 T. •Local reference values are needed for each anatomic location for reliable interpretation.
Collapse
Affiliation(s)
- Rafael Heiss
- Department of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054, Erlangen, Germany.
| | - Marc-André Weber
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Schillingallee 35, 18057, Rostock, Germany
| | - Eva L Balbach
- Department of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054, Erlangen, Germany
| | - Maximilian Hinsen
- Department of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054, Erlangen, Germany
| | - Frederik Geissler
- Department of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054, Erlangen, Germany
| | - Armin M Nagel
- Department of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054, Erlangen, Germany
- Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - Mark E Ladd
- Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
- Faculty of Medicine and Faculty of Physics and Astronomy, Heidelberg University, Im Neuenheimer Feld 226, 69120, Heidelberg, Germany
| | - Andreas Arkudas
- Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Krankenhausstraße 12, 91054, Erlangen, Germany
| | - Raymund E Horch
- Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Krankenhausstraße 12, 91054, Erlangen, Germany
| | - Christine Gall
- Institute for Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Waldstraße 6, 91054, Erlangen, Germany
| | - Michael Uder
- Department of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054, Erlangen, Germany
| | - Frank W Roemer
- Department of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054, Erlangen, Germany
- Boston University School of Medicine, 72 E Concord St, Boston, MA, 02118, USA
| |
Collapse
|
7
|
He T, Pang Z, Yin Y, Xue H, Pang Y, Song H, Li J, Bai R, Qin A, Kong X. Micron-resolution Imaging of Cortical Bone under 14 T Ultrahigh Magnetic Field. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2300959. [PMID: 37339792 PMCID: PMC10460861 DOI: 10.1002/advs.202300959] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 05/11/2023] [Indexed: 06/22/2023]
Abstract
Compact, mineralized cortical bone tissues are often concealed on magnetic resonance (MR) images. Recent development of MR instruments and pulse techniques has yielded significant advances in acquiring anatomical and physiological information from cortical bone despite its poor 1 H signals. This work demonstrates the first MR research on cortical bones under an ultrahigh magnetic field of 14 T. The 1 H signals of different mammalian species exhibit multi-exponential decays of three characteristic T2 or T2 * values: 0.1-0.5 ms, 1-4 ms, and 4-8 ms. Systematic sample comparisons attribute these T2 /T2 * value ranges to collagen-bound water, pore water, and lipids, respectively. Ultrashort echo time (UTE) imaging under 14 T yielded spatial resolutions of 20-80 microns, which resolves the 3D anatomy of the Haversian canals. The T2 * relaxation characteristics further allow spatial classifications of collagen, pore water and lipids in human specimens. The study achieves a record of the spatial resolution for MR imaging in bone and shows that ultrahigh-field MR has the unique ability to differentiate the soft and organic compartments in bone tissues.
Collapse
Affiliation(s)
- Tian He
- Department of ChemistryZhejiang UniversityHangzhou310027China
| | - Zhenfeng Pang
- Department of ChemistryZhejiang UniversityHangzhou310027China
| | - Yu Yin
- Department of ChemistryZhejiang UniversityHangzhou310027China
| | - Huadong Xue
- Department of ChemistryZhejiang UniversityHangzhou310027China
- Department of RehabilitationSir Run Run Shaw HospitalCollege of MedicineZhejiang UniversityHangzhou310016China
| | - Yichuan Pang
- Shanghai Key Laboratory of Orthopedic ImplantsDepartment of OrthopaedicsShanghai Ninth People's HospitalShanghai Jiao Tong University School of MedicineShanghai200011China
| | - Haixin Song
- Department of RehabilitationSir Run Run Shaw HospitalCollege of MedicineZhejiang UniversityHangzhou310016China
| | - Jianhua Li
- Department of RehabilitationSir Run Run Shaw HospitalCollege of MedicineZhejiang UniversityHangzhou310016China
| | - Ruiliang Bai
- Interdisciplinary Institute of Neuroscience and Technology (ZIINT)College of Biomedical Engineering and Instrument ScienceZhejiang UniversityHangzhou310027China
- School of MedicineZhejiang UniversityHangzhou310058China
| | - An Qin
- Shanghai Key Laboratory of Orthopedic ImplantsDepartment of OrthopaedicsShanghai Ninth People's HospitalShanghai Jiao Tong University School of MedicineShanghai200011China
| | - Xueqian Kong
- Department of ChemistryZhejiang UniversityHangzhou310027China
- Department of RehabilitationSir Run Run Shaw HospitalCollege of MedicineZhejiang UniversityHangzhou310016China
- Institute of Translational MedicineShanghai Jiaotong UniversityShanghai200240China
| |
Collapse
|
8
|
Heiss R, Weber MA, Balbach E, Schmitt R, Rehnitz C, Laqmani A, Sternberg A, Ellermann JJ, Nagel AM, Ladd ME, Englbrecht M, Arkudas A, Horch R, Guermazi A, Uder M, Roemer FW. Clinical Application of Ultrahigh-Field-Strength Wrist MRI: A Multireader 3-T and 7-T Comparison Study. Radiology 2023; 307:e220753. [PMID: 36625744 DOI: 10.1148/radiol.220753] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Background Ultrahigh-field-strength MRI at 7 T may permit superior visualization of noninflammatory wrist pathologic conditions, particularly due to its high signal-to-noise ratio compared with the clinical standard of 3 T, but direct comparison studies are lacking. Purpose To compare the subjective image quality of 3-T and 7-T ultrahigh-field-strength wrist MRI through semiquantitative scoring of multiple joint tissues in a multireader study. Materials and Methods In this prospective study, healthy controls and participants with chronic wrist pain underwent 3-T and 7-T MRI (coronal T1-weighted turbo spin-echo [TSE], coronal fat-suppressed proton-density [PD]-weighted TSE, transversal T2-weighted TSE) on the same day, from July 2018 to June 2019. Images were scored by seven musculoskeletal radiologists. The overall image quality, presence of artifacts, homogeneity of fat suppression, and visualization of cartilage, the triangular fibrocartilage complex (TFCC), and scapholunate and lunotriquetral ligaments were semiquantitatively assessed. Pairwise differences between 3 T and 7 T were assessed using the Wilcoxon signed-rank test. Interreader reliability was determined using the Fleiss kappa. Results In total, 25 healthy controls (mean age, 25 years ± 4 [SD]; 13 women) and 25 participants with chronic wrist pain (mean age, 39 years ± 16; 14 men) were included. Overall image quality (P = .002) and less presence of artifacts at PD-weighted fat-suppressed MRI were superior at 7 T. T1- and T2-weighted MRI were superior at 3 T (both P < .001), as was fat suppression (P < .001). Visualization of cartilage was superior at 7 T (P < .001), while visualization of the TFCC (P < .001) and scapholunate (P = .048) and lunotriquetral (P = .04) ligaments was superior at 3 T. Interreader reliability showed slight to substantial agreement for the detected pathologic conditions (κ = 0.20-0.64). Conclusion A 7-T MRI of the wrist had potential advantages over 3-T MRI, particularly in cartilage assessment. However, superiority was not shown for all parameters; for example, visualization of the triangular fibrocartilage complex and wrist ligaments was superior at 3 T. © RSNA, 2023 Supplemental material is available for this article.
Collapse
Affiliation(s)
- Rafael Heiss
- Department of Radiology (R. Heiss, E.B., A.M.N., M.U., F.W.R.) and Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine (A.A., R. Horch), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054 Erlangen, Germany; Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany (M.A.W.); Department of Radiology, Ludwig Maximilian University of Munich, Munich, Germany (R.S.); Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (C.R.); Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (A.L.); Medizinisches Versorgungszentrum am Rotes Kreuz Krankenhaus, Bremen, Germany (A.S.); University of Minnesota Medical School, Minneapolis, Minnesota (J.J.E.); Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.M.N., M.E.L.); Statscoach, Eckental, Germany (M.E.); VA Boston Healthcare System, West Roxbury, Mass (A.G.); and Boston University School of Medicine, Boston, Mass (M.U., F.W.R.)
| | - Marc-André Weber
- Department of Radiology (R. Heiss, E.B., A.M.N., M.U., F.W.R.) and Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine (A.A., R. Horch), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054 Erlangen, Germany; Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany (M.A.W.); Department of Radiology, Ludwig Maximilian University of Munich, Munich, Germany (R.S.); Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (C.R.); Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (A.L.); Medizinisches Versorgungszentrum am Rotes Kreuz Krankenhaus, Bremen, Germany (A.S.); University of Minnesota Medical School, Minneapolis, Minnesota (J.J.E.); Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.M.N., M.E.L.); Statscoach, Eckental, Germany (M.E.); VA Boston Healthcare System, West Roxbury, Mass (A.G.); and Boston University School of Medicine, Boston, Mass (M.U., F.W.R.)
| | - Eva Balbach
- Department of Radiology (R. Heiss, E.B., A.M.N., M.U., F.W.R.) and Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine (A.A., R. Horch), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054 Erlangen, Germany; Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany (M.A.W.); Department of Radiology, Ludwig Maximilian University of Munich, Munich, Germany (R.S.); Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (C.R.); Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (A.L.); Medizinisches Versorgungszentrum am Rotes Kreuz Krankenhaus, Bremen, Germany (A.S.); University of Minnesota Medical School, Minneapolis, Minnesota (J.J.E.); Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.M.N., M.E.L.); Statscoach, Eckental, Germany (M.E.); VA Boston Healthcare System, West Roxbury, Mass (A.G.); and Boston University School of Medicine, Boston, Mass (M.U., F.W.R.)
| | - Rainer Schmitt
- Department of Radiology (R. Heiss, E.B., A.M.N., M.U., F.W.R.) and Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine (A.A., R. Horch), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054 Erlangen, Germany; Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany (M.A.W.); Department of Radiology, Ludwig Maximilian University of Munich, Munich, Germany (R.S.); Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (C.R.); Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (A.L.); Medizinisches Versorgungszentrum am Rotes Kreuz Krankenhaus, Bremen, Germany (A.S.); University of Minnesota Medical School, Minneapolis, Minnesota (J.J.E.); Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.M.N., M.E.L.); Statscoach, Eckental, Germany (M.E.); VA Boston Healthcare System, West Roxbury, Mass (A.G.); and Boston University School of Medicine, Boston, Mass (M.U., F.W.R.)
| | - Christoph Rehnitz
- Department of Radiology (R. Heiss, E.B., A.M.N., M.U., F.W.R.) and Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine (A.A., R. Horch), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054 Erlangen, Germany; Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany (M.A.W.); Department of Radiology, Ludwig Maximilian University of Munich, Munich, Germany (R.S.); Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (C.R.); Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (A.L.); Medizinisches Versorgungszentrum am Rotes Kreuz Krankenhaus, Bremen, Germany (A.S.); University of Minnesota Medical School, Minneapolis, Minnesota (J.J.E.); Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.M.N., M.E.L.); Statscoach, Eckental, Germany (M.E.); VA Boston Healthcare System, West Roxbury, Mass (A.G.); and Boston University School of Medicine, Boston, Mass (M.U., F.W.R.)
| | - Azien Laqmani
- Department of Radiology (R. Heiss, E.B., A.M.N., M.U., F.W.R.) and Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine (A.A., R. Horch), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054 Erlangen, Germany; Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany (M.A.W.); Department of Radiology, Ludwig Maximilian University of Munich, Munich, Germany (R.S.); Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (C.R.); Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (A.L.); Medizinisches Versorgungszentrum am Rotes Kreuz Krankenhaus, Bremen, Germany (A.S.); University of Minnesota Medical School, Minneapolis, Minnesota (J.J.E.); Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.M.N., M.E.L.); Statscoach, Eckental, Germany (M.E.); VA Boston Healthcare System, West Roxbury, Mass (A.G.); and Boston University School of Medicine, Boston, Mass (M.U., F.W.R.)
| | - Andreas Sternberg
- Department of Radiology (R. Heiss, E.B., A.M.N., M.U., F.W.R.) and Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine (A.A., R. Horch), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054 Erlangen, Germany; Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany (M.A.W.); Department of Radiology, Ludwig Maximilian University of Munich, Munich, Germany (R.S.); Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (C.R.); Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (A.L.); Medizinisches Versorgungszentrum am Rotes Kreuz Krankenhaus, Bremen, Germany (A.S.); University of Minnesota Medical School, Minneapolis, Minnesota (J.J.E.); Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.M.N., M.E.L.); Statscoach, Eckental, Germany (M.E.); VA Boston Healthcare System, West Roxbury, Mass (A.G.); and Boston University School of Medicine, Boston, Mass (M.U., F.W.R.)
| | - Jutta J Ellermann
- Department of Radiology (R. Heiss, E.B., A.M.N., M.U., F.W.R.) and Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine (A.A., R. Horch), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054 Erlangen, Germany; Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany (M.A.W.); Department of Radiology, Ludwig Maximilian University of Munich, Munich, Germany (R.S.); Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (C.R.); Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (A.L.); Medizinisches Versorgungszentrum am Rotes Kreuz Krankenhaus, Bremen, Germany (A.S.); University of Minnesota Medical School, Minneapolis, Minnesota (J.J.E.); Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.M.N., M.E.L.); Statscoach, Eckental, Germany (M.E.); VA Boston Healthcare System, West Roxbury, Mass (A.G.); and Boston University School of Medicine, Boston, Mass (M.U., F.W.R.)
| | - Armin M Nagel
- Department of Radiology (R. Heiss, E.B., A.M.N., M.U., F.W.R.) and Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine (A.A., R. Horch), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054 Erlangen, Germany; Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany (M.A.W.); Department of Radiology, Ludwig Maximilian University of Munich, Munich, Germany (R.S.); Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (C.R.); Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (A.L.); Medizinisches Versorgungszentrum am Rotes Kreuz Krankenhaus, Bremen, Germany (A.S.); University of Minnesota Medical School, Minneapolis, Minnesota (J.J.E.); Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.M.N., M.E.L.); Statscoach, Eckental, Germany (M.E.); VA Boston Healthcare System, West Roxbury, Mass (A.G.); and Boston University School of Medicine, Boston, Mass (M.U., F.W.R.)
| | - Mark E Ladd
- Department of Radiology (R. Heiss, E.B., A.M.N., M.U., F.W.R.) and Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine (A.A., R. Horch), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054 Erlangen, Germany; Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany (M.A.W.); Department of Radiology, Ludwig Maximilian University of Munich, Munich, Germany (R.S.); Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (C.R.); Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (A.L.); Medizinisches Versorgungszentrum am Rotes Kreuz Krankenhaus, Bremen, Germany (A.S.); University of Minnesota Medical School, Minneapolis, Minnesota (J.J.E.); Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.M.N., M.E.L.); Statscoach, Eckental, Germany (M.E.); VA Boston Healthcare System, West Roxbury, Mass (A.G.); and Boston University School of Medicine, Boston, Mass (M.U., F.W.R.)
| | - Matthias Englbrecht
- Department of Radiology (R. Heiss, E.B., A.M.N., M.U., F.W.R.) and Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine (A.A., R. Horch), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054 Erlangen, Germany; Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany (M.A.W.); Department of Radiology, Ludwig Maximilian University of Munich, Munich, Germany (R.S.); Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (C.R.); Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (A.L.); Medizinisches Versorgungszentrum am Rotes Kreuz Krankenhaus, Bremen, Germany (A.S.); University of Minnesota Medical School, Minneapolis, Minnesota (J.J.E.); Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.M.N., M.E.L.); Statscoach, Eckental, Germany (M.E.); VA Boston Healthcare System, West Roxbury, Mass (A.G.); and Boston University School of Medicine, Boston, Mass (M.U., F.W.R.)
| | - Andreas Arkudas
- Department of Radiology (R. Heiss, E.B., A.M.N., M.U., F.W.R.) and Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine (A.A., R. Horch), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054 Erlangen, Germany; Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany (M.A.W.); Department of Radiology, Ludwig Maximilian University of Munich, Munich, Germany (R.S.); Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (C.R.); Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (A.L.); Medizinisches Versorgungszentrum am Rotes Kreuz Krankenhaus, Bremen, Germany (A.S.); University of Minnesota Medical School, Minneapolis, Minnesota (J.J.E.); Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.M.N., M.E.L.); Statscoach, Eckental, Germany (M.E.); VA Boston Healthcare System, West Roxbury, Mass (A.G.); and Boston University School of Medicine, Boston, Mass (M.U., F.W.R.)
| | - Raymund Horch
- Department of Radiology (R. Heiss, E.B., A.M.N., M.U., F.W.R.) and Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine (A.A., R. Horch), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054 Erlangen, Germany; Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany (M.A.W.); Department of Radiology, Ludwig Maximilian University of Munich, Munich, Germany (R.S.); Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (C.R.); Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (A.L.); Medizinisches Versorgungszentrum am Rotes Kreuz Krankenhaus, Bremen, Germany (A.S.); University of Minnesota Medical School, Minneapolis, Minnesota (J.J.E.); Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.M.N., M.E.L.); Statscoach, Eckental, Germany (M.E.); VA Boston Healthcare System, West Roxbury, Mass (A.G.); and Boston University School of Medicine, Boston, Mass (M.U., F.W.R.)
| | - Ali Guermazi
- Department of Radiology (R. Heiss, E.B., A.M.N., M.U., F.W.R.) and Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine (A.A., R. Horch), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054 Erlangen, Germany; Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany (M.A.W.); Department of Radiology, Ludwig Maximilian University of Munich, Munich, Germany (R.S.); Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (C.R.); Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (A.L.); Medizinisches Versorgungszentrum am Rotes Kreuz Krankenhaus, Bremen, Germany (A.S.); University of Minnesota Medical School, Minneapolis, Minnesota (J.J.E.); Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.M.N., M.E.L.); Statscoach, Eckental, Germany (M.E.); VA Boston Healthcare System, West Roxbury, Mass (A.G.); and Boston University School of Medicine, Boston, Mass (M.U., F.W.R.)
| | - Michael Uder
- Department of Radiology (R. Heiss, E.B., A.M.N., M.U., F.W.R.) and Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine (A.A., R. Horch), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054 Erlangen, Germany; Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany (M.A.W.); Department of Radiology, Ludwig Maximilian University of Munich, Munich, Germany (R.S.); Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (C.R.); Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (A.L.); Medizinisches Versorgungszentrum am Rotes Kreuz Krankenhaus, Bremen, Germany (A.S.); University of Minnesota Medical School, Minneapolis, Minnesota (J.J.E.); Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.M.N., M.E.L.); Statscoach, Eckental, Germany (M.E.); VA Boston Healthcare System, West Roxbury, Mass (A.G.); and Boston University School of Medicine, Boston, Mass (M.U., F.W.R.)
| | - Frank W Roemer
- Department of Radiology (R. Heiss, E.B., A.M.N., M.U., F.W.R.) and Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine (A.A., R. Horch), University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054 Erlangen, Germany; Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany (M.A.W.); Department of Radiology, Ludwig Maximilian University of Munich, Munich, Germany (R.S.); Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany (C.R.); Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (A.L.); Medizinisches Versorgungszentrum am Rotes Kreuz Krankenhaus, Bremen, Germany (A.S.); University of Minnesota Medical School, Minneapolis, Minnesota (J.J.E.); Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.M.N., M.E.L.); Statscoach, Eckental, Germany (M.E.); VA Boston Healthcare System, West Roxbury, Mass (A.G.); and Boston University School of Medicine, Boston, Mass (M.U., F.W.R.)
| |
Collapse
|
9
|
Abstract
ABSTRACT This review summarizes the current state-of-the-art of musculoskeletal 7 T magnetic resonance imaging (MRI), the associated technological challenges, and gives an overview of current and future clinical applications of 1 H-based 7 T MRI. The higher signal-to-noise ratio at 7 T is predominantly used for increased spatial resolution and thus the visualization of anatomical details or subtle lesions rather than to accelerate the sequences. For musculoskeletal MRI, turbo spin echo pulse sequences are particularly useful, but with altered relaxation times, B1 inhomogeneity, and increased artifacts at 7 T; specific absorption rate limitation issues quickly arise for turbo spin echo pulse sequences. The development of dedicated pulse sequence techniques in the last 2 decades and the increasing availability of specialized coils now facilitate several clinical musculoskeletal applications. 7 T MRI is performed in vivo in a wide range of applications for the knee joint and other anatomical areas, such as ultra-high-resolution nerve imaging or bone trabecular microarchitecture imaging. So far, however, it has not been shown systematically whether the higher field strength compared with the established 3 T MRI systems translates into clinical advantages, such as an early-stage identification of tissue damage allowing for preventive therapy or an influence on treatment decisions and patient outcome. At the moment, results tend to suggest that 7 T MRI will be reserved for answering specific, targeted musculoskeletal questions rather than for a broad application, as is the case for 3 T MRI. Future data regarding the implementation of clinical use cases are expected to clarify if 7 T musculoskeletal MRI applications with higher diagnostic accuracy result in patient benefits compared with MRI at lower field strengths.
Collapse
|
10
|
Bosco F, Giustra F, Lusso A, Faccenda C, Artiaco S, Massè A. Closed flexor pulley injuries: A literature review and current practice. J Orthop 2022; 34:246-249. [PMID: 36131797 PMCID: PMC9483560 DOI: 10.1016/j.jor.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 09/01/2022] [Accepted: 09/03/2022] [Indexed: 11/22/2022] Open
Abstract
Background Closed flexor pulley injuries are a clinical entity of great interest in hand surgery, and these lesions could be observed mainly in rock-climbing athletes. Objective An extensive literature search of PubMed, SCOPUS, Cochrane Library, and Web of Sciences databases on closed finger pulley rupture, related treatments, and outcomes were performed. All relevant information was used in this literature review. Conclusions Many athletes are potentially exposed to these uncommon injuries. Therefore, these lesions require careful examination and a high index of suspicion to confirm the diagnosis and identify the degree of soft tissue injury, particularly in patients not involved in sporting activities. The data summarized in this literature review demonstrated that according to Schöffl's classification, conservative treatment should be indicated for low-grade injuries (grade 1 or 2), whereas surgical treatment should be performed in patients with more severe acute injuries (grade 4). Grade 3 flexor pulley injuries lie in a grey area where conservative and surgical treatment may give good clinical and return-to-sport patient results.
Collapse
Affiliation(s)
- Francesco Bosco
- Department of Orthopaedics and Traumatology, University of Turin, CTO, Turin, Italy
| | - Fortunato Giustra
- Department of Orthopaedics and Traumatology, University of Turin, CTO, Turin, Italy
| | - Alessandro Lusso
- Department of Orthopaedics and Traumatology, University of Turin, CTO, Turin, Italy
| | - Carlotta Faccenda
- Department of Orthopaedics and Traumatology, University of Turin, CTO, Turin, Italy
| | - Stefano Artiaco
- Department of Orthopaedics and Traumatology, University of Turin, CTO, Turin, Italy
| | - Alessandro Massè
- Department of Orthopaedics and Traumatology, University of Turin, CTO, Turin, Italy
| |
Collapse
|
11
|
Mills ES, Becerra JA, Yensen K, Bolia IK, Shontz EC, Kebaish KJ, Dobitsch A, Hasan LK, Haratian A, Ong CD, Gross J, Petrigliano FA, Weber AE. Current and Future Advanced Imaging Modalities for the Diagnosis of Early Osteoarthritis of the Hip. Orthop Res Rev 2022; 14:327-338. [PMID: 36131944 PMCID: PMC9482955 DOI: 10.2147/orr.s357498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 08/16/2022] [Indexed: 12/04/2022] Open
Abstract
Hip osteoarthritis (OA) can be idiopathic or develop secondary to structural joint abnormalities of the hip joint (alteration of normal anatomy) and/or due to a systemic condition with joint involvement. Early osteoarthritic changes to the hip can be completely asymptomatic or may cause the development hip symptomatology without evidence of OA on radiographs. Delaying the progression of hip OA is critical due to the significant impact of this condition on the patient’s quality of life. Pre-OA of the hip is a newly established term that is often described as the development of signs and symptoms of degenerative hip disease but no radiographic evidence of OA. Advanced imaging methods can help to diagnose pre-OA of the hip in patients with hip pain and normal radiographs or aid in the surveillance of asymptomatic patients with an underlying hip diagnosis that is known to increase the risk of early OA of the hip. These methods include the delayed gadolinium-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC), quantitative magnetic resonance imaging (qMRI- T1rho, T2, and T2* relaxation time mapping), 7-Tesla MRI, computed tomography (CT), and optical coherence tomography (OCT). dGEMRIC proved to be a reliable and accurate modality though it is limited by the significant time necessary for contrast washout between scans. This disadvantage is potentially overcome by T2 weighted MRIs, which do not require contrast. 7-Tesla MRI is a promising development for enhanced imaging resolution compared to 1.5 and 3T MRIs. This technique does require additional optimization and development prior to widespread clinical use. The purpose of this review was to summarize the results of translational and clinical studies investigating the utilization of the above-mentioned imaging modalities to diagnose hip pre-OA, with special focus on recent research evaluating their implementation into clinical practice.
Collapse
Affiliation(s)
- Emily S Mills
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jacob A Becerra
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Katie Yensen
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Ioanna K Bolia
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Correspondence: Ioanna K Bolia, USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, 1520 San Pablo st #2000, Los Angeles, CA, 90033, USA, Tel +1 9703432813, Fax +8181 658 5920, Email
| | - Edward C Shontz
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Kareem J Kebaish
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Andrew Dobitsch
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Laith K Hasan
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Aryan Haratian
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Charlton D Ong
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jordan Gross
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Frank A Petrigliano
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Alexander E Weber
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
12
|
Bazzocchi A, Isaac A, Dalili D, Fotiadou A, Kariki EP, Kirschke JS, Krestan CR, Messina C, Oei EHG, Phan CM, Prakash M, Sabir N, Tagliafico A, Aparisi F, Baum T, Link TM, Guglielmi G, Aparisi Gómez MP. Imaging of Metabolic Bone Diseases: The Spine View, Part I. Semin Musculoskelet Radiol 2022; 26:478-490. [PMID: 36103889 DOI: 10.1055/s-0042-1754340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Metabolic bone diseases comprise a wide spectrum. Of them, osteoporosis is the most frequent and the most commonly found in the spine, with a high impact on health care systems and on morbidity due to vertebral fractures (VFs).This article discusses state-of-the-art techniques on the imaging of metabolic bone diseases in the spine, from the well-established methods to the latest improvements, recent developments, and future perspectives.We review the classical features of involvement of metabolic conditions involving the spine. Then we analyze the different imaging techniques for the diagnosis, characterization, and monitoring of metabolic bone disease: dual-energy X-ray absorptiometry (DXA) and DXA-based fracture risk assessment applications or indexes, such as the geometric parameters, Bone Strain Index, and Trabecular Bone Score; quantitative computed tomography; and magnetic resonance and ultrasonography-based techniques, such as radiofrequency echographic multi spectrometry. We also describe the current possibilities of imaging to guide the treatment of VFs secondary to metabolic bone disease.
Collapse
Affiliation(s)
- Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Amanda Isaac
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Danoob Dalili
- Academic Surgical Unit, South West London Elective Orthopaedic Centre (SWLEOC), Epsom, London, United Kingdom.,Department of Diagnostic and Interventional Radiology, Epsom and St. Helier University Hospitals NHS Trust, London, United Kingdom
| | | | - Eleni P Kariki
- Manchester University NHS Foundation Trust, Manchester, United Kingdom.,Division of Informatics, Imaging & Data Sciences, School of Health Sciences, The University of Manchester, Manchester, United Kingdom
| | - Jan S Kirschke
- Interventional und Diagnostic Neuroradiology, School of Medicine, Technical University Munich, Munich, Germany
| | | | | | - Edwin H G Oei
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Catherine M Phan
- Service de Radiologie Ostéo-Articulaire, APHP, Nord-Université de Paris, Hôpital Lariboisière, Paris, France
| | - Mahesh Prakash
- Department of Radiodiagnosis & Imaging, PGIMER, Chandigarh, India
| | - Nuran Sabir
- Department of Radiology, Pamukkale University School of Medicine, Denizli, Turkey
| | - Alberto Tagliafico
- DISSAL, University of Genova, Genoa, Italy.,Ospedale Policlinico San Martino, Genova, Italy
| | - Francisco Aparisi
- Department of Radiology, Hospital Vithas Nueve de Octubre, Valencia, Spain
| | - Thomas Baum
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Thomas M Link
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, California
| | | | - Maria Pilar Aparisi Gómez
- Department of Radiology, Auckland City Hospital, Auckland, New Zealand.,Department of Radiology, IMSKE, Valencia, Spain
| |
Collapse
|
13
|
Heiss DMR, Guermazi A, Janka PDMR, Uder PDMM, Li X, Hayashi D, Roemer FW. Update: Posttreatment Imaging of the Knee after Cartilage Repair. Semin Musculoskelet Radiol 2022; 26:216-229. [PMID: 35654091 DOI: 10.1055/s-0042-1743405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Focal cartilage lesions are common pathologies at the knee joint that are considered important risk factors for the premature development of osteoarthritis. A wide range of surgical options, including but not limited to marrow stimulation, osteochondral auto- and allografting, and autologous chondrocyte implantation, allows for targeted treatment of focal cartilage defects. Arthroscopy is the standard of reference for the assessment of cartilage integrity and quality before and after repair. However, deep cartilage layers, intrachondral composition, and the subchondral bone are only partially or not at all visualized with arthroscopy. In contrast, magnetic resonance imaging offers noninvasive evaluation of the cartilage repair site, the subchondral bone, and the soft tissues of the joint pre- and postsurgery. Radiologists need to be familiar with the different surgical procedures available and their characteristic postsurgical imaging appearances to assess treatment success and possible complications adequately. We provide an overview of the most commonly performed surgical procedures for cartilage repair at the knee and typical postsurgical imaging characteristics.
Collapse
Affiliation(s)
- Dr Med Rafael Heiss
- Department of Radiology, Universityhospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Ali Guermazi
- Department of Radiology, VA Healthcare System, West Roxbury, Massachusetts.,Department of Radiology, Boston University School of Medicine, Boston, Massachusetts
| | - Prof Dr Med Rolf Janka
- Department of Radiology, Universityhospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Prof Dr Med Michael Uder
- Department of Radiology, Universityhospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Xinning Li
- Department of Orthopedic Surgery, Boston University School of Medicine, Boston, Massachusetts
| | - Daichi Hayashi
- Department of Radiology, Stony Brook University Renaissance School of Medicine, Stony Brook, New York
| | - Frank W Roemer
- Department of Radiology, Universityhospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.,Department of Radiology, Boston University School of Medicine, Boston, Massachusetts
| |
Collapse
|
14
|
Cai Z, Tao Q, Scotti A, Yi P, Feng Y, Cai K. Early detection of increased marrow adiposity with age in rats using Z-spectral MRI at ultra-high field (7 T). NMR IN BIOMEDICINE 2022; 35:e4633. [PMID: 34658086 DOI: 10.1002/nbm.4633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 09/16/2021] [Accepted: 09/18/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Nowadays, the drive towards high-field MRI is fueled by the pursuit of higher signal-to-noise ratio, spatial resolution, and imaging speed. However, high field strength is associated with field inhomogeneity, acceleration of T2 * decay, and increased chemical shift, which may pose challenges to conventional MRI for fat quantification in complex tissues such as bone marrow. With proton MRI spectroscopy (1 H-MRS), on the other hand, it is difficult to produce high resolution. As a novel alternative fat quantification method, high-resolution Z-spectral MRI (ZS-MRI) can achieve fat quantification by acquiring direct saturated images of both fat and water under the same TE , which may be less affected by T2 * decay and field inhomogeneity. PURPOSE To demonstrate ZS-MRI for marrow adipose tissue (MAT) quantification in rat's lumbar spine and the early detection of MAT changes with age. METHODS The accuracy of ZS-MRI for fat quantification at ultra-high-field MRI (7 T) was verified with MRS and conventional Dixon MRI in water-oil mixed phantoms with varying fat fraction (FF). Dixon MRI data were processed with iterative decomposition of water and fat with echo asymmetry and least-squares estimation. ZS-MRI was then used to longitudinally monitor the adiposity in the lumbar spine of young healthy rats at 13, 17, and 21 weeks to detect the early changes of FF with age in MAT. Hematoxylin-eosin staining of lumbar spines from separated rat groups was performed for verification. RESULTS In ex vivo phantom experiments, both Dixon MRI and ZS-MRI were well correlated with 1 H-MRS for the quantification of FF at 7 T (R > 0.99). Compared with Dixon MRI, ZS-MRI showed reduced image artifacts due to field inhomogeneity and presented better agreement with 1 H-MRS for the early detection of increased MAT due to age at 7 T (ZS-MRI R = 0.78 versus Dixon MRI R = 0.34). The increased MAT FF due to age was confirmed by histology. CONCLUSION ZS-MRI proves itself as an alternative fat quantification method for bone marrow in rats at 7 T.
Collapse
Affiliation(s)
- Zimeng Cai
- School of Biomedical Engineering, Southern Medical University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, China
| | - Quan Tao
- School of Biomedical Engineering, Southern Medical University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, China
| | - Alessandro Scotti
- Department of Radiology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
- Department of Bioengineering, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Peiwei Yi
- School of Biomedical Engineering, Southern Medical University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, China
| | - Yanqiu Feng
- School of Biomedical Engineering, Southern Medical University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, China
| | - Kejia Cai
- Department of Radiology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
- Department of Bioengineering, University of Illinois at Chicago, Chicago, Illinois, USA
| |
Collapse
|
15
|
Platt T, Ladd ME, Paech D. 7 Tesla and Beyond: Advanced Methods and Clinical Applications in Magnetic Resonance Imaging. Invest Radiol 2021; 56:705-725. [PMID: 34510098 PMCID: PMC8505159 DOI: 10.1097/rli.0000000000000820] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/07/2021] [Accepted: 08/07/2021] [Indexed: 12/15/2022]
Abstract
ABSTRACT Ultrahigh magnetic fields offer significantly higher signal-to-noise ratio, and several magnetic resonance applications additionally benefit from a higher contrast-to-noise ratio, with static magnetic field strengths of B0 ≥ 7 T currently being referred to as ultrahigh fields (UHFs). The advantages of UHF can be used to resolve structures more precisely or to visualize physiological/pathophysiological effects that would be difficult or even impossible to detect at lower field strengths. However, with these advantages also come challenges, such as inhomogeneities applying standard radiofrequency excitation techniques, higher energy deposition in the human body, and enhanced B0 field inhomogeneities. The advantages but also the challenges of UHF as well as promising advanced methodological developments and clinical applications that particularly benefit from UHF are discussed in this review article.
Collapse
Affiliation(s)
- Tanja Platt
- From the Medical Physics in Radiology, German Cancer Research Center (DKFZ)
| | - Mark E. Ladd
- From the Medical Physics in Radiology, German Cancer Research Center (DKFZ)
- Faculty of Physics and Astronomy
- Faculty of Medicine, University of Heidelberg, Heidelberg
- Erwin L. Hahn Institute for MRI, University of Duisburg-Essen, Essen
| | - Daniel Paech
- Division of Radiology, German Cancer Research Center (DKFZ), Heidelberg
- Clinic for Neuroradiology, University of Bonn, Bonn, Germany
| |
Collapse
|
16
|
von Deuster C, Sommer S, Germann C, Hinterholzer N, Heidemann RM, Sutter R, Nanz D. Controlling Through-Slice Chemical-Shift Artifacts for Improved Non-Fat-Suppressed Musculoskeletal Turbo-Spin-Echo Magnetic Resonance Imaging at 7 T. Invest Radiol 2021; 56:545-552. [PMID: 33813573 DOI: 10.1097/rli.0000000000000778] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Through-slice chemical shift artifacts in state-of-the-art turbo-spin-echo (TSE) images can be significantly more severe at 7 T than at lower field strengths. In musculoskeletal applications, these artifacts appear similar to bone fractures or neoplastic bone marrow disease. The objective of this work was to explore and reduce through-slice chemical shift artifacts in 2-dimensional (2D) TSE imaging at 7 T. MATERIALS AND METHODS This prospective study was approved by the local ethics board. The bandwidths of the excitation and refocusing radiofrequency (RF) pulses of a prototype 2D TSE sequence were individually modified and their effect on the slice profiles and relative slice locations of water and fat spins was assessed in an oil-water phantom. Based on these results, it was hypothesized that the combination of matched and increased excitation and refocusing RF pulse bandwidths ("MIB") of 1500 Hz would enable 2D TSE imaging with significantly reduced chemical shift artifacts compared with a state-of-the-art sequence with unmatched and moderate RF pulse bandwidths ("UMB") of 1095 and 682 Hz.A series of T1-weighted sagittal knee examinations in 10 healthy human subjects were acquired using the MIB and UMB sequences and independently evaluated by 2 radiologists. They measured the width of chemical shift artifacts at 2 standardized locations and graded the perceived negative effect of chemical shift artifacts on image quality in the bones and in the whole gastrocnemius muscle on a 5-point scale. Similar knee, wrist, and foot images were acquired in a single subject. Signal-to-noise ratios in the femoral bone marrow were computed between the UMB and MIB sequences. RESULTS Phantom measurements confirmed the expected spatial separation of simultaneously affected water and fat slices between 40% and 200% of the prescribed slice thickness for RF pulse bandwidths between 2500 and 500 Hz. Through-slice chemical shift artifacts at the bone-cartilage interface were significantly smaller with MIB than with UMB (location 1: 0.35 ± 0.20 mm vs 1.27 ± 0.27 mm, P < 0.001; location 2: 0.25 ± 0.13 mm vs 1.48 ± 0.46 mm, P < 0.001; intraclass correlation coefficient = 0.98). The negative effect of chemical shift artifacts on image quality was significantly smaller with MIB than with UMB (bone: 2 ± 0 vs 4 ± 1, P < 0.004 [both readers]; muscle: 3 ± 0 vs 2 ± 0, P < 0.004 [both readers]; κ = 0.69). The signal-to-noise ratio of the UMB and MIB sequences was comparable, with a ratio of 99 ± 7%. Images acquired using the UMB sequence displayed numerous artifactual hyperintensities and diffuse, as well as locally severe, fat signal loss in all examined regions, whereas the MIB sequence consistently yielded high image quality with bright T1-weighted fat signal and excellent depiction of fine tissue structures. CONCLUSIONS On 7 T systems, the selection of high and matched RF bandwidths for excitation and refocusing pulses for 2D TSE imaging without fat suppression showed consistently better image quality than state-of-the-art sequences with unmatched lower RF pulse bandwidths.
Collapse
Affiliation(s)
| | | | | | - Natalie Hinterholzer
- SCMI, Swiss Center for Musculoskeletal Imaging, Balgrist Campus AG, Zurich, Switzerland
| | | | | | | |
Collapse
|
17
|
MRI of Finger Pulleys at 7T-Direct Characterization of Pulley Ruptures in an Ex Vivo Model. Diagnostics (Basel) 2021; 11:diagnostics11071206. [PMID: 34359289 PMCID: PMC8303165 DOI: 10.3390/diagnostics11071206] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 06/29/2021] [Accepted: 06/30/2021] [Indexed: 11/18/2022] Open
Abstract
The aim of this study was to evaluate 7 Tesla (7T) magnetic resonance imaging (MRI) for direct visualization and specific characterization of the finger flexor pulleys A2, A3, and A4 before and after ex vivo pulley rupture. Thirty fingers of human cadavers were examined before and after pulley disruption with a 26 min clinical 7T pulse sequence protocol. Images were assessed by two experienced radiologists for the presence of pulley rupture. Injury characterization included definition of rupture location, morphology, and complications. Image quality was evaluated according to a 4-point Likert-type scale from “not evaluable” to “excellent”. Macroscopic preparations were used as the reference standard. Direct characterization of intact A2, A3, and A4 pulleys and the corresponding pulley lesions was possible in all cases. The rupture location was distributed equally at the radial, ulnar, and central parts of the pulleys. A dislocation and intercalation of the pulley stump between the flexor tendon and finger phalanges was observed as a complication in 62.5% of cases. The average Likert score for direct visualization of pulleys was 2.67 before rupture and 2.79 after rupture creation, demonstrating adequate image quality for routine application. 7T MRI enables a direct characterization of A2, A3, and A4 pulleys before and after artificial disruption, including the definition of rupture morphology and location as well as the detection of rupture complications. This promises a precise presurgical evaluation of pulley injuries and complicated pulley stump dislocations.
Collapse
|
18
|
PSR: Unified Framework of Parameter-Learning-Based MR Image Superresolution. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:5591660. [PMID: 33968351 PMCID: PMC8084653 DOI: 10.1155/2021/5591660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/27/2021] [Accepted: 04/09/2021] [Indexed: 11/23/2022]
Abstract
Magnetic resonance imaging has significant applications for disease diagnosis. Due to the particularity of its imaging mechanism, hardware imaging suffers from resolution and reaches its limit, and higher radiation intensity and longer radiation time will cause damage to the human body. The problem is expected to be solved by a superresolution algorithm, especially the image superresolution based on sparse reconstruction has good performance. Dictionary generation is a key issue that affects the performance of superresolution algorithms, and dictionary performance is affected by dictionary construction parameters: balance parameters, dictionary size, overlapping block size, and a number of training sample blocks. In response to this problem, we propose an optimal dictionary construction parameter search method through the experiment to find the optimal dictionary construction parameters on the MR image and compare them with the dictionary obtained by multiple sets of random dictionary construction parameters. The dictionary we searched for the optimal parameters of the dictionary construction training has more powerful feature expressions, which can improve the superresolution effect of MR images.
Collapse
|
19
|
Abstract
Regulatory approval of ultrahigh field (UHF) MR imaging scanners for clinical use has opened new opportunities for musculoskeletal imaging applications. UHF MR imaging has unique advantages in terms of signal-to-noise ratio, contrast-to-noise ratio, spectral resolution, and multinuclear applications, thus providing unique information not available at lower field strengths. But UHF also comes with a set of technical challenges that are yet to be resolved and may not be suitable for all imaging applications. This review focuses on the latest research in musculoskeletal MR imaging applications at UHF including morphologic imaging, T2, T2∗, and T1ρ mapping, chemical exchange saturation transfer, sodium imaging, and phosphorus spectroscopy imaging applications.
Collapse
|
20
|
Lazik-Palm A, Kraff O, Rietsch SHG, Ladd ME, Kamminga M, Beck S, Quick HH, Theysohn JM. 7-T clinical MRI of the shoulder in patients with suspected lesions of the rotator cuff. Eur Radiol Exp 2020; 4:10. [PMID: 32030499 PMCID: PMC7005228 DOI: 10.1186/s41747-019-0142-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 12/06/2019] [Indexed: 01/30/2023] Open
Abstract
Background To evaluate feasibility and diagnostic performance of clinical 7-T magnetic resonance imaging (MRI) of the shoulder. Methods Eight patients with suspected lesions of the rotator cuff underwent 7-T MRI before arthroscopy. Image quality was scored for artifacts, B1+ inhomogeneities, and assessability of anatomical structures. A structured radiological report was compared to arthroscopy. In four patients, a visual comparison with pre-existing 1.5-T examinations was performed. Results Regarding image quality, the majority of the sequences reached values above the middle of each scoring scale. Fat-saturated proton density sequences showed least artifacts and best structure assessability. The most homogenous B1+ field was reached with gradient-echo sequences. Arthroscopy did not confirm tendinopathy/partial tear of supraspinatus in 5/8 patients, of subscapularis in 5/6, and of infraspinatus in one patient; only a partial lesion of the subscapularis tendon was missed. Pathologic findings of long bicipital tendon, acromioclavicular joint, glenohumeral cartilage, labrum, and subacromial subdeltoideal bursa were mainly confirmed; exceptions were one lesion of the long bicipital tendon, one subacromial bursitis, and one superior glenoid labrum anterior-to-posterior lesion, missed on 7-T MRI. Evaluating all structures together, sensitivity was 86%, and specificity 74%. A better contrast and higher image resolution was noted in comparison to previous 1.5-T examinations. Conclusions 7-T MRI of the shoulder with diagnostic image quality is feasible. Overrating of tendon signal alterations was the main limitation. Although the diagnostic performance did not reach the current results of 3-T MRI, our study marks the way to implement clinical 7-T MRI of the shoulder.
Collapse
Affiliation(s)
- Andrea Lazik-Palm
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany. .,Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany.
| | - Oliver Kraff
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany
| | - Stefan H G Rietsch
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany.,High Field and Hybrid MR Imaging, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Mark E Ladd
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany.,Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Faculty of Physics and Astronomy and Faculty of Physics, University of Heidelberg, Heidelberg, Germany
| | | | - Sascha Beck
- Department of Trauma and Orthopedic Surgery, University Hospital Essen, University Duisburg-Essen, Essen, Germany.,Department of Orthopaedics and Orthopaedic Surgery, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg, Germany
| | - Harald H Quick
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany.,High Field and Hybrid MR Imaging, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Jens M Theysohn
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| |
Collapse
|
21
|
Next-generation imaging of the skeletal system and its blood supply. Nat Rev Rheumatol 2019; 15:533-549. [PMID: 31395974 DOI: 10.1038/s41584-019-0274-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2019] [Indexed: 12/16/2022]
Abstract
Bone is organized in a hierarchical 3D architecture. Traditionally, analysis of the skeletal system was based on bone mass assessment by radiographic methods or on the examination of bone structure by 2D histological sections. Advanced imaging technologies and big data analysis now enable the unprecedented examination of bone and provide new insights into its 3D macrostructure and microstructure. These technologies comprise ex vivo and in vivo methods including high-resolution computed tomography (CT), synchrotron-based imaging, X-ray microscopy, ultra-high-field magnetic resonance imaging (MRI), light-sheet fluorescence microscopy, confocal and intravital two-photon imaging. In concert, these techniques have been used to detect and quantify a novel vascular system of trans-cortical vessels in bone. Furthermore, structures such as the lacunar network, which harbours and connects osteocytes, become accessible for 3D imaging and quantification using these methods. Next-generation imaging of the skeletal system and its blood supply are anticipated to contribute to an entirely new understanding of bone tissue composition and function, from macroscale to nanoscale, in health and disease. These insights could provide the basis for early detection and precision-type intervention of bone disorders in the future.
Collapse
|
22
|
Abstract
BACKGROUND Cartilage imaging of small joints is increasingly of interest, as early detection of cartilage damage may be relevant regarding individualized surgical therapies and long-term outcomes. PURPOSE The aim of this review is to explain modern cartilage imaging of small joints with emphasis on MRI and to discuss the role of methods such as CT arthrography as well as compositional and high-field MRI. MATERIALS AND METHODS A PubMed literature search was performed for the years 2008-2018. RESULTS Clinically relevant cartilage imaging to detect chondral damage in small joints remains challenging. Conventional MRI at 3 T can still be considered as a reference for cartilage imaging in clinical routine. In terms of sensitivity, MR arthrography (MR-A) and computed tomography arthrography (CT-A) are superior to non-arthrographic MRI at 1.5 T in the detection of chondral damage. Advanced degenerative changes of the fingers and toes are usually sufficiently characterized by conventional radiography. MRI at field strengths of 3 T and ultrahigh-field imaging at 7 T can provide additional quantifiable, functional and metabolic information. CONCLUSION Standardized cartilage imaging plays an important role in clinical diagnostics in the ankle joint due to the availability of different and individualized therapeutic concepts. In contrast, cartilage imaging of other small joints as commonly performed in clinical studies has not yet become standard of care in daily clinical routine. Although individual study results are promising, additional studies with large patient collectives are needed to validate these techniques. With rapid development of new treatment concepts radiological diagnostics will play a more significant role in the diagnosis of cartilage lesions of small joints.
Collapse
|
23
|
Alizai H, Chang G, Regatte RR. MR Imaging of the Musculoskeletal System Using Ultrahigh Field (7T) MR Imaging. PET Clin 2019; 13:551-565. [PMID: 30219187 DOI: 10.1016/j.cpet.2018.05.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
MR imaging is an indispensable instrument for the diagnosis of musculoskeletal diseases. In vivo MR imaging at 7T offers many advantages, including increased signal-to-noise ratio, higher spatial resolution, improved spectral resolution for spectroscopy, improved sensitivity for X-nucleus imaging, and decreased image acquisition times. There are also however technical challenges of imaging at a higher field strength compared with 1.5 and 3T MR imaging systems. We discuss the many potential opportunities as well as the challenges presented by 7T MR imaging systems and highlight recent developments in in vivo research imaging of musculoskeletal applications in general and cartilage, skeletal muscle, and bone in particular.
Collapse
Affiliation(s)
- Hamza Alizai
- Department of Radiology, New York University Langone Medical Center, 660 First Avenue, New York, NY 10016, USA.
| | - Gregory Chang
- Department of Radiology, New York University Langone Medical Center, 660 First Avenue, New York, NY 10016, USA
| | - Ravinder R Regatte
- Department of Radiology, New York University Langone Medical Center, 660 First Avenue, New York, NY 10016, USA
| |
Collapse
|
24
|
Menon RG, Chang G, Regatte RR. The Emerging Role of 7 Tesla MRI in Musculoskeletal Imaging. CURRENT RADIOLOGY REPORTS 2018. [DOI: 10.1007/s40134-018-0286-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
25
|
West SL, Rajapakse CS, Rayner T, Miller R, Slinger MA, Wells GD. The reproducibility of measuring trabecular bone parameters using a commercially available high-resolution magnetic resonance imaging approach: A pilot study. Bone Rep 2018; 8:180-186. [PMID: 29955637 PMCID: PMC6020268 DOI: 10.1016/j.bonr.2018.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 04/09/2018] [Accepted: 04/23/2018] [Indexed: 02/02/2023] Open
Abstract
Bone imaging is currently the best non-invasive way to assess changes to bone associated with aging or chronic disease. However, common imaging techniques such as dual energy x-ray absorptiometry are associated with limitations. Magnetic resonance imaging (MRI) is a radiation-free technique that can measure bone microarchitecture. However, published MRI bone assessment protocols use specialized MRI coils and sequences and therefore have limited transferability across institutions. We developed a protocol on a Siemens 3 Tesla MRI machine, using a commercially available coil (Siemens 15 CH knee coil), and manufacturer supplied sequences to acquire images at the tibia. We tested the reproducibility of the FSE and the GE Axial sequences and hypothesized that both would generate reproducible trabecular bone parameters. Eight healthy adults (age 25.5 ± 5.4 years) completed three measurements of each MRI sequence at the tibia. Each of the images was processed for 8 different bone parameters (such as volumetric bone volume fraction). We computed the coefficient of variation (CV) and intraclass correlation coefficients (ICC) to assess reproducibility and reliability. Both sequences resulted in trabecular parameters that were reproducible (CV <5% for most) and reliable (ICC >80% for all). Our study is one of the first to report that a commercially available MRI protocol can result in reproducible data, and is significant as MRI may be an accessible method to measure bone microarchitecture in clinical or research environments. This technique requires further testing, including validation and evaluation in other populations. Trabecular bone is difficult to measure using commercial MRI techniques Reproducibility of a MRI protocol measuring trabecular bone was assessed Tibia trabecular bone was reproducible using a knee coil and a FSE Axial sequence Tibia trabecular bone was reproducible using a knee coil and a GE Axial sequence
Collapse
Affiliation(s)
- Sarah L West
- Department of Biology, Trent/Fleming School of Nursing, Trent University, Peterborough, Ontario, Canada.,Translational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Chamith S Rajapakse
- Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.,Department of Orthopaedic Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Tammy Rayner
- Radiology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Rhiannon Miller
- Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.,Department of Orthopaedic Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Michelle A Slinger
- Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.,Department of Orthopaedic Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Greg D Wells
- Translational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.,Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
26
|
Santini T, Kim J, Wood S, Krishnamurthy N, Farhat N, Maciel C, Raval SB, Zhao T, Ibrahim TS. A new RF transmit coil for foot and ankle imaging at 7T MRI. Magn Reson Imaging 2018; 45:1-6. [PMID: 28893660 PMCID: PMC5935253 DOI: 10.1016/j.mri.2017.09.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 09/05/2017] [Accepted: 09/05/2017] [Indexed: 12/31/2022]
Abstract
A four-channel Tic-Tac-Toe (TTT) transmit RF coil was designed and constructed for foot and ankle imaging at 7T MRI. Numerical simulations using an in-house developed FDTD package and experimental analyses using a homogenous phantom show an excellent agreement in terms of B1+ field distribution and s-parameters. Simulations performed on an anatomically detailed human lower leg model demonstrated an B1+ field distribution with a coefficient of variation (CV) of 23.9%/15.6%/28.8% and average B1+ of 0.33μT/0.56μT/0.43μT for 1W input power (i.e., 0.25W per channel) in the ankle/calcaneus/mid foot respectively. In-vivo B1+ mapping shows an average B1+ of 0.29μT over the entire foot/ankle. This newly developed RF coil also presents acceptable levels of average SAR (0.07W/kg for 10g per 1W of input power) and peak SAR (0.34W/kg for 10g per 1W of input power) over the whole lower leg. Preliminary in-vivo images in the foot/ankle were acquired using the T2-DESS MRI sequence without the use of a dedicated receive-only array.
Collapse
Affiliation(s)
- Tales Santini
- University of Pittsburgh, Department of Bioengineering, United States
| | - Junghwan Kim
- University of Pittsburgh, Department of Bioengineering, United States
| | - Sossena Wood
- University of Pittsburgh, Department of Bioengineering, United States
| | | | - Nadim Farhat
- University of Pittsburgh, Department of Bioengineering, United States
| | - Carlos Maciel
- University of Sao Paulo, Department of Electrical and Computer Engineering, Brazil
| | | | | | - Tamer S Ibrahim
- University of Pittsburgh, Department of Bioengineering, United States; University of Pittsburgh, Department of Radiology, United States.
| |
Collapse
|
27
|
Gupta S, Klein K, Singh AH, Thrall JH. Analysis of Low Appropriateness Score Exam Trends in Decision Support–based Radiology Order Entry System. J Am Coll Radiol 2017; 14:615-621. [DOI: 10.1016/j.jacr.2016.12.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 12/14/2016] [Accepted: 12/15/2016] [Indexed: 11/25/2022]
|
28
|
|
29
|
Kuhn FP, Spinner G, Del Grande F, Wyss M, Piccirelli M, Erni S, Pfister P, Ho M, Sah BR, Filli L, Ettlin DA, Gallo LM, Andreisek G, Manoliu A. MR imaging of the temporomandibular joint: comparison between acquisitions at 7.0 T using dielectric pads and 3.0 T. Dentomaxillofac Radiol 2016; 46:20160280. [PMID: 27704872 DOI: 10.1259/dmfr.20160280] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES To qualitatively and quantitatively compare MRI of the temporomandibular joint (TMJ) at 7.0 T using high-permittivity dielectric pads and 3.0 T using a clinical high-resolution protocol. METHODS Institutional review board-approved study with written informed consent. 12 asymptomatic volunteers were imaged at 7.0 and 3.0 T using 32-channel head coils. High-permittivity dielectric pads consisting of barium titanate in deuterated suspension were used for imaging at 7.0 T. Imaging protocol consisted of oblique sagittal proton density weighted turbo spin echo sequences. For quantitative analysis, pixelwise signal-to-noise ratio maps of the TMJ were calculated. For qualitative analysis, images were evaluated by two independent readers using 5-point Likert scales. Quantitative and qualitative results were compared using t-tests and Wilcoxon signed-rank tests, respectively. RESULTS TMJ imaging at 7.0 T using high-permittivity dielectric pads was feasible in all volunteers. Quantitative analysis showed similar signal-to-noise ratio for both field strengths (mean ± SD; 7.0 T, 13.02 ± 3.92; 3.0 T, 14.02 ± 3.41; two-sample t-tests, p = 0.188). At 7.0 T, qualitative analysis yielded better visibility of all anatomical subregions of the temporomandibular disc (anterior band, intermediate zone and posterior band) than 3.0 T (Wilcoxon signed-rank tests, p < 0.05, corrected for multiple comparisons). CONCLUSIONS MRI of the TMJ at 7.0 T using high-permittivity dielectric pads yields superior visibility of the temporomandibular disc compared with 3.0 T.
Collapse
Affiliation(s)
- Felix P Kuhn
- 1 Institute for Diagnostic and Interventional Radiology, Department of Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Georg Spinner
- 2 Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Filippo Del Grande
- 3 Department of Diagnostic and Interventional Radiology, Ospedale Regionale di Lugano, Lugano, Switzerland
| | - Michael Wyss
- 2 Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Marco Piccirelli
- 4 Department of Neuroradiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Stefan Erni
- 5 Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Pascal Pfister
- 1 Institute for Diagnostic and Interventional Radiology, Department of Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Michael Ho
- 1 Institute for Diagnostic and Interventional Radiology, Department of Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Bert-Ram Sah
- 1 Institute for Diagnostic and Interventional Radiology, Department of Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Lukas Filli
- 1 Institute for Diagnostic and Interventional Radiology, Department of Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Dominik A Ettlin
- 5 Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Luigi M Gallo
- 5 Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Gustav Andreisek
- 1 Institute for Diagnostic and Interventional Radiology, Department of Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Andrei Manoliu
- 1 Institute for Diagnostic and Interventional Radiology, Department of Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,2 Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland.,6 Psychiatric University Hospital, Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
| |
Collapse
|
30
|
Willey JS, Kwok AT, Moore JE, Payne V, Lindburg CA, Balk SA, Olson J, Black PJ, Walb MC, Yammani RR, Munley MT. Spaceflight-Relevant Challenges of Radiation and/or Reduced Weight Bearing Cause Arthritic Responses in Knee Articular Cartilage. Radiat Res 2016; 186:333-344. [PMID: 27602483 DOI: 10.1667/rr14400.1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
There is little known about the effect of both reduced weight bearing and exposure to radiation during spaceflight on the mechanically-sensitive cartilage lining the knee joint. In this study, we characterized cartilage damage in rat knees after periods of reduced weight bearing with/without exposure to solar-flare-relevant radiation, then cartilage recovery after return to weight bearing. Male Sprague Dawley rats (n = 120) were either hindlimb unloaded (HLU) via tail suspension or remained weight bearing in cages (GROUND). On day 5, half of the HLU and GROUND rats were 1 Gy total-body X-ray irradiated during HLU, and half were sham irradiated (SHAM), yielding 4 groups: GROUND-SHAM; GROUND-IR; HLU-SHAM; and HLU-IR. Hindlimbs were collected from half of each group of rats on day 13. The remaining rats were then removed from HLU or remained weight bearing, and hindlimbs from these rats were collected on day 62. On day 13, glycosaminoglycan (GAG) content in cartilage lining the tibial plateau and femoral condyles of HLU rats was lower than that of the GROUND animals. Likewise, on day 13, immunoreactivity of the collagen type II-degrading matrix metalloproteinase-13 (MMP-13) and of a resultant metalloproteinase-generated neoepitope VDIPEN was increased in all groups versus GROUND-SHAM. Clustering of chondrocytes indicating cartilage damage was present in all HLU and IR groups versus GROUND-SHAM on day 13. On day 62, after 49 days of reloading, the loss of GAG content was attenuated in the HLU-SHAM and HLU-IR groups, and the increased VDIPEN staining in all treatment groups was attenuated. However, the increased chondrocyte clustering remained in all treatment groups on day 62. MMP-13 activity also remained elevated in the GROUND-IR and HLU-IR groups. Increased T2 relaxation times, measured on day 62 using 7T MRI, were greater in GROUND-IR and HLU-IR knees, indicating persistent cartilage damage in the irradiated groups. Both HLU and total-body irradiation resulted in acute degenerative and pre-arthritic changes in the knee articular cartilage of rats. A return to normal weight bearing resulted in some recovery from cartilage degradation. However, radiation delivered as both a single challenge and when combined with HLU resulted in chronic cartilage damage. These findings suggest that radiation exposure during spaceflight leads to and/or impairs recovery of cartilage upon return to reloading, generating long-term joint problems for astronauts.
Collapse
Affiliation(s)
- J S Willey
- a Department of Radiation Oncology, Wake Forest School of Medicine Comprehensive Cancer Center, Winston-Salem, North Carolina
| | - A T Kwok
- a Department of Radiation Oncology, Wake Forest School of Medicine Comprehensive Cancer Center, Winston-Salem, North Carolina
| | - J E Moore
- a Department of Radiation Oncology, Wake Forest School of Medicine Comprehensive Cancer Center, Winston-Salem, North Carolina
| | - V Payne
- a Department of Radiation Oncology, Wake Forest School of Medicine Comprehensive Cancer Center, Winston-Salem, North Carolina
| | - C A Lindburg
- a Department of Radiation Oncology, Wake Forest School of Medicine Comprehensive Cancer Center, Winston-Salem, North Carolina
| | - S A Balk
- b Transportation Solutions and Technology Applications Division, Leidos, Reston, Virginia; and
| | - J Olson
- a Department of Radiation Oncology, Wake Forest School of Medicine Comprehensive Cancer Center, Winston-Salem, North Carolina
| | - P J Black
- a Department of Radiation Oncology, Wake Forest School of Medicine Comprehensive Cancer Center, Winston-Salem, North Carolina
| | - M C Walb
- a Department of Radiation Oncology, Wake Forest School of Medicine Comprehensive Cancer Center, Winston-Salem, North Carolina
| | - R R Yammani
- c Department of Internal Medicine, Sections of Molecular Medicine and Rheumatology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - M T Munley
- a Department of Radiation Oncology, Wake Forest School of Medicine Comprehensive Cancer Center, Winston-Salem, North Carolina
| |
Collapse
|
31
|
Morphological and Quantitative 7 T MRI of Hip Cartilage Transplants in Comparison to 3 T—Initial Experiences. Invest Radiol 2016; 51:552-9. [DOI: 10.1097/rli.0000000000000264] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
32
|
Schmidt R, Webb A. Improvements in RF Shimming in High Field MRI Using High Permittivity Materials With Low Order Pre-Fractal Geometries. IEEE TRANSACTIONS ON MEDICAL IMAGING 2016; 35:1837-1844. [PMID: 26890643 DOI: 10.1109/tmi.2016.2531120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Ultra-high field MRI is an area of great interest for clinical research and basic science due to the increased signal-to-noise, spatial resolution and magnetic-susceptibility-based contrast. However, the fact that the electromagnetic wavelength in tissue is comparable to the relevant body dimensions means that the uniformity of the excitation field is much poorer than at lower field strengths. In addition to techniques such as transmit arrays, one simple but effective method to counteract this effect is to use high permittivity "pads". Very high permittivities enable thinner, flexible pads to be used, but the limiting factor is wavelength effects within the pads themselves, which can lead to image artifacts. So far, all studies have used simple continuous rectangular/circular pad geometries. In this work we investigate how the wavelength effects can be partially mitigated utilizing shaped pad with holes. Several arrangements have been simulated, including low order pre-fractal geometries, which maintain the overall coverage of the pad, but can provide better image homogeneity in the region of interest or higher sensitivity depending on the setup. Experimental data in the form of in vivo human images at 7T were acquired to validate the simulation results.
Collapse
|
33
|
7 Tesla quantitative hip MRI: a comparison between TESS and CPMG for T2 mapping. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2016; 29:503-12. [DOI: 10.1007/s10334-016-0557-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 03/21/2016] [Accepted: 03/31/2016] [Indexed: 12/20/2022]
|
34
|
Morphological imaging and T2 and T2* mapping of hip cartilage at 7 Tesla MRI under the influence of intravenous gadolinium. Eur Radiol 2016; 26:3923-3931. [DOI: 10.1007/s00330-016-4247-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 01/21/2016] [Accepted: 01/25/2016] [Indexed: 12/16/2022]
|
35
|
|
36
|
Lazik A, Theysohn JM, Geis C, Johst S, Ladd ME, Quick HH, Kraff O. 7 Tesla quantitative hip MRI: T1, T2 and T2* mapping of hip cartilage in healthy volunteers. Eur Radiol 2015; 26:1245-53. [DOI: 10.1007/s00330-015-3964-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 07/28/2015] [Accepted: 08/03/2015] [Indexed: 12/26/2022]
|
37
|
Chang G, Xia D, Chen C, Madelin G, Abramson SB, Babb JS, Saha PK, Regatte RR. 7T MRI detects deterioration in subchondral bone microarchitecture in subjects with mild knee osteoarthritis as compared with healthy controls. J Magn Reson Imaging 2015; 41:1311-7. [PMID: 24979471 PMCID: PMC9982830 DOI: 10.1002/jmri.24683] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 05/30/2014] [Indexed: 01/26/2023] Open
Abstract
PURPOSE To determine how subchondral bone microarchitecture is altered in patients with mild knee osteoarthritis. MATERIALS AND METHODS This study had Institutional Review Board approval. We recruited 24 subjects with mild radiographic knee osteoarthritis and 16 healthy controls. The distal femur was scanned at 7T using a high-resolution 3D FLASH sequence. We applied digital topological analysis to assess bone volume fraction, markers of trabecular number (skeleton density), trabecular network osteoclastic resorption (erosion index), plate-like structure (surface), rod-like structure (curve), and plate-to-rod ratio (surface-curve ratio). We used two-tailed t-tests to compare differences between osteoarthritis subjects and controls. RESULTS 7T magnetic resonance imaging (MRI) detected deterioration in subchondral bone microarchitecture in both medial and lateral femoral condyles in osteoarthritis subjects as compared with controls. This was manifested by lower bone volume fraction (-1.03% to -5.43%, P < 0.04), higher erosion index (+8.49 to +22.76%, P < 0.04), lower surface number (-2.31% to -9.63%, P < 0.007), higher curve number (+6.85% to +16.93%, P < 0.03), and lower plate-to-rod ratio (-7.92% to -21.71%, P < 0.05). CONCLUSION The results provide further support for the concept that poor subchondral bone quality is associated with osteoarthritis and may serve as a potential therapeutic target for osteoarthritis interventions. J. Magn. Reson. Imaging 2015;41:1311-1317. © 2014 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Gregory Chang
- Department of Radiology, NYU Langone Medical Center, Center for Musculoskeletal Care, New York, New York, USA.,Department of Radiology, NYU Langone Medical Center, Center for Biomedical Imaging, New York, New York, USA.,Address reprint requests to: G.C., Department of Radiology, NYU Langone Medical Center, Center for Musculoskeletal Care, 333 E. 38 St., 6 Fl., Rm. 6–210, New York, NY, 10016.
| | - Ding Xia
- Department of Radiology, NYU Langone Medical Center, Center for Biomedical Imaging, New York, New York, USA
| | - Cheng Chen
- Departments of Radiology and Electrical and Computer Engineering, University of Iowa, Iowa City, Iowa, USA
| | - Guillaume Madelin
- Departments of Radiology and Electrical and Computer Engineering, University of Iowa, Iowa City, Iowa, USA
| | - Steven B. Abramson
- Department of Medicine, NYU Langone Medical Center, New York, New York, USA
| | - James S. Babb
- Department of Radiology, NYU Langone Medical Center, Center for Biomedical Imaging, New York, New York, USA
| | - Punam K. Saha
- Departments of Radiology and Electrical and Computer Engineering, University of Iowa, Iowa City, Iowa, USA
| | | |
Collapse
|
38
|
Chang G, Honig S, Liu Y, Chen C, Chu KK, Rajapakse CS, Egol K, Xia D, Saha PK, Regatte RR. 7 Tesla MRI of bone microarchitecture discriminates between women without and with fragility fractures who do not differ by bone mineral density. J Bone Miner Metab 2015; 33:285-93. [PMID: 24752823 PMCID: PMC4363287 DOI: 10.1007/s00774-014-0588-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 03/17/2014] [Indexed: 01/23/2023]
Abstract
Osteoporosis is a disease of poor bone quality. Bone mineral density (BMD) has limited ability to discriminate between subjects without and with poor bone quality, and assessment of bone microarchitecture may have added value in this regard. Our goals were to use 7 T MRI to: (1) quantify and compare distal femur bone microarchitecture in women without and with poor bone quality (defined clinically by presence of fragility fractures); and (2) determine whether microarchitectural parameters could be used to discriminate between these two groups. This study had institutional review board approval, and we obtained written informed consent from all subjects. We used a 28-channel knee coil to image the distal femur of 31 subjects with fragility fractures and 25 controls without fracture on a 7 T MRI scanner using a 3-D fast low angle shot sequence (0.234 mm × 0.234 mm × 1 mm, parallel imaging factor = 2, acquisition time = 7 min 9 s). We applied digital topological analysis to quantify parameters of bone microarchitecture. All subjects also underwent standard clinical BMD assessment in the hip and spine. Compared to controls, fracture cases demonstrated lower bone volume fraction and markers of trabecular number, plate-like structure, and plate-to-rod ratio, and higher markers of trabecular isolation, rod disruption, and network resorption (p < 0.05 for all). There were no differences in hip or spine BMD T-scores between groups (p > 0.05). In receiver-operating-characteristics analyses, microarchitectural parameters could discriminate cases and controls (AUC = 0.66-0.73, p < 0.05). Hip and spine BMD T-scores could not discriminate cases and controls (AUC = 0.58-0.64, p ≥ 0.08). We conclude that 7 T MRI can detect bone microarchitectural deterioration in women with fragility fractures who do not differ by BMD. Microarchitectural parameters might some day be used as an additional tool to detect patients with poor bone quality who cannot be detected by dual-energy X-ray absorptiometry (DXA).
Collapse
Affiliation(s)
- Gregory Chang
- Department of Radiology, NYU Langone Medical Center, Center for Musculoskeletal Care, 333 E. 38th Street, 6th Floor, Room 6-210, New York, NY, 10016, USA,
| | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Goebel L, Müller A, Bücker A, Madry H. High resolution MRI imaging at 9.4 Tesla of the osteochondral unit in a translational model of articular cartilage repair. BMC Musculoskelet Disord 2015; 16:91. [PMID: 25888208 PMCID: PMC4404065 DOI: 10.1186/s12891-015-0543-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 03/27/2015] [Indexed: 12/13/2022] Open
Abstract
Background Non-destructive structural evaluation of the osteochondral unit is challenging. Here, the capability of high-field magnetic resonance imaging (μMRI) at 9.4 Tesla (T) was explored to examine osteochondral repair ex vivo in a preclinical large animal model. A specific aim of this study was to detect recently described alterations of the subchondral bone associated with cartilage repair. Methods Osteochondral samples of medial femoral condyles from adult ewes containing full-thickness articular cartilage defects treated with marrow stimulation were obtained after 6 month in vivo and scanned in a 9.4 T μMRI. Ex vivo imaging of small osteochondral samples (typical volume: 1–2 cm3) at μMRI was optimised by variation of repetition time (TR), time echo (TE), flip angle (FA), spatial resolution and number of excitations (NEX) from standard MultiSliceMultiEcho (MSME) and three-dimensional (3D) spoiled GradientEcho (SGE) sequences. Results A 3D SGE sequence with the parameters: TR = 10 ms, TE = 3 ms, FA = 10 °, voxel size = 120 × 120 × 120 μm3 and NEX = 10 resulted in the best fitting for sample size, image quality, scanning time and artifacts. An isovolumetric voxel shape allowed for multiplanar reconstructions. Within the osteochondral unit articular cartilage, cartilaginous repair tissue and bone marrow could clearly be distinguished from the subchondral bone plate and subarticular spongiosa. Specific alterations of the osteochondral unit associated with cartilage repair such as persistent drill holes, subchondral bone cysts, sclerosis of the subchondral bone plate and of the subarticular spongiosa and intralesional osteophytes were precisely detected. Conclusions High resolution, non-destructive ex vivo analysis of the entire osteochondral unit in a preclinical large animal model that is sufficient for further analyses is possible using μMRI at 9.4 T. In particular, 9.4 T is capable of accurately depicting alterations of the subchondral bone that are associated with osteochondral repair.
Collapse
Affiliation(s)
- Lars Goebel
- Center of Experimental Orthopaedics, Saarland University Medical Center, Kirrberger Straße, Building 37, Homburg/Saar, D-66421, Germany. .,Department of Orthopaedic Surgery, Saarland University Medical Center, Kirrberger Straße, Building 37, Homburg/Saar, D-66421, Germany. .,Cartilage Net of the Greater Region, University of the Greater Region, Homburg/Saar, D-66421, Germany.
| | - Andreas Müller
- Department of Diagnostic and Interventional Radiology, Saarland University Medical Center, Kirrberger Straße, Building 57, Homburg/Saar, D-66421, Germany.
| | - Arno Bücker
- Department of Diagnostic and Interventional Radiology, Saarland University Medical Center, Kirrberger Straße, Building 57, Homburg/Saar, D-66421, Germany.
| | - Henning Madry
- Center of Experimental Orthopaedics, Saarland University Medical Center, Kirrberger Straße, Building 37, Homburg/Saar, D-66421, Germany. .,Department of Orthopaedic Surgery, Saarland University Medical Center, Kirrberger Straße, Building 37, Homburg/Saar, D-66421, Germany. .,Cartilage Net of the Greater Region, University of the Greater Region, Homburg/Saar, D-66421, Germany.
| |
Collapse
|
40
|
Abstract
Excellent morphological imaging of cartilage is now possible and allows the detection of subtle cartilage pathologies. Besides the standard 2D sequences, a multitude of 3D sequences are available for high-resolution cartilage imaging. The first part therefore deals with modern possibilities of morphological imaging. The second part deals with functional cartilage imaging with which it is possible to detect changes in cartilage composition and thus early osteoarthritis as well as to monitor biochemical changes after therapeutic interventions. Validated techniques such as delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) and T2 mapping as well the latest techniques, such as the glycosaminoglycan chemical exchange-dependent saturation transfer (gagCEST) technique will be discussed.
Collapse
|
41
|
Goebel L, Zurakowski D, Müller A, Pape D, Cucchiarini M, Madry H. 2D and 3D MOCART scoring systems assessed by 9.4 T high-field MRI correlate with elementary and complex histological scoring systems in a translational model of osteochondral repair. Osteoarthritis Cartilage 2014; 22:1386-95. [PMID: 25278050 DOI: 10.1016/j.joca.2014.05.027] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Revised: 04/30/2014] [Accepted: 05/30/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To compare the 2D and 3D MOCART system obtained with 9.4 T high-field magnetic resonance imaging (MRI) for the ex vivo analysis of osteochondral repair in a translational model and to correlate the data with semiquantitative histological analysis. METHODS Osteochondral samples representing all levels of repair (sheep medial femoral condyles; n = 38) were scanned in a 9.4 T high-field MRI. The 2D and adapted 3D MOCART systems were used for grading after point allocation to each category. Each score was correlated with corresponding reconstructions between both MOCART systems. Data were next correlated with corresponding categories of an elementary (Wakitani) and a complex (Sellers) histological scoring system as gold standards. RESULTS Correlations between most 2D and 3D MOCART score categories were high, while mean total point values of 3D MOCART scores tended to be 15.8-16.1 points higher compared to the 2D MOCART scores based on a Bland-Altman analysis. "Defect fill" and "total points" of both MOCART scores correlated with corresponding categories of Wakitani and Sellers scores (all P ≤ 0.05). "Subchondral bone plate" also correlated between 3D MOCART and Sellers scores (P < 0.001). CONCLUSIONS Most categories of the 2D and 3D MOCART systems correlate, while total scores were generally higher using the 3D MOCART system. Structural categories "total points" and "defect fill" can reliably be assessed by 9.4 T MRI evaluation using either system, "subchondral bone plate" using the 3D MOCART score. High-field MRI is valuable to objectively evaluate osteochondral repair in translational settings.
Collapse
Affiliation(s)
- L Goebel
- Center of Experimental Orthopaedics, Saarland University Medical Center, Kirrberger Straße, Building 37, 66421 Homburg/Saar, Germany; Department of Orthopaedic Surgery, Saarland University Medical Center, Kirrberger Straße, Building 37, 66421 Homburg/Saar, Germany.
| | - D Zurakowski
- Departments of Anesthesia and Surgery, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA.
| | - A Müller
- Department of Diagnostic and Interventional Radiology, Saarland University Medical Center, Kirrberger Straße, Building 57, 66421 Homburg/Saar, Germany.
| | - D Pape
- Department of Orthopaedic Surgery, Centre Hospitalier, Clinique d'Eich, 76, Rue d'Eich, L-1460 Luxembourg, Luxembourg.
| | - M Cucchiarini
- Center of Experimental Orthopaedics, Saarland University Medical Center, Kirrberger Straße, Building 37, 66421 Homburg/Saar, Germany.
| | - H Madry
- Center of Experimental Orthopaedics, Saarland University Medical Center, Kirrberger Straße, Building 37, 66421 Homburg/Saar, Germany; Department of Orthopaedic Surgery, Saarland University Medical Center, Kirrberger Straße, Building 37, 66421 Homburg/Saar, Germany.
| |
Collapse
|
42
|
Friebe B, Wollrab A, Thormann M, Fischbach K, Ricke J, Grueschow M, Kropf S, Fischbach F, Speck O. Sensory perceptions of individuals exposed to the static field of a 7T MRI: A controlled blinded study. J Magn Reson Imaging 2014; 41:1675-81. [PMID: 25236353 DOI: 10.1002/jmri.24748] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 07/21/2014] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To determine the subjective experience of subjects undergoing 7T magnetic resonance imaging (MRI) compared to a mock scanner with no magnetic field. METHODS AND MATERIALS In all, 44 healthy subjects were exposed to both the B0 field of a 7T whole-body MRI and a realistic mock scanner with no magnetic field. Subjects were blinded to the actual field strength and no scanning was performed. After exposure, subjects rated their experience of potential sensory perceptions. RESULTS The most frequently observed side effect was vertigo while entering the gantry, which was reported by 38.6% (n = 17). Other frequent side effects were the appearance of phosphenes (18.2%, n = 8), thermal heat sensation (15.9%), unsteady gait after exposure (13.6%, n = 6), and dizziness (13.6%). All side effects were reported significantly more often after 7T exposure. Nine subjects (20.5%) did not report any sensory perceptions at all, ie, neither in the 7T scanner nor in the mock scanner. CONCLUSION Light, acute, and transient sensory perceptions can occur in subjects undergoing ultrahighfield MRI, of which vertigo seems to be the most frequently reported. Possible psychological effects might contribute to the emergence of such sensory perceptions, as some subjects also reported them to appear in a realistic mock scanner with no magnetic field.
Collapse
Affiliation(s)
- Björn Friebe
- Department of Radiology and Nuclear Medicine, Otto-von-Guericke University Magdeburg, Germany
| | - Astrid Wollrab
- Department of Biomedical Magnetic Resonance (BMMR), Division Experimental Physics, Faculty of Physics, Otto-von-Guericke University Magdeburg, Germany
| | - Markus Thormann
- Department of Radiology and Nuclear Medicine, Otto-von-Guericke University Magdeburg, Germany
| | - Katharina Fischbach
- Department of Radiology and Nuclear Medicine, Otto-von-Guericke University Magdeburg, Germany
| | - Jens Ricke
- Department of Radiology and Nuclear Medicine, Otto-von-Guericke University Magdeburg, Germany
| | | | - Siegfried Kropf
- Institute for Biometrics and Biomedical Informatics, Otto-von-Guericke University Magdeburg, Germany
| | - Frank Fischbach
- Department of Radiology and Nuclear Medicine, Otto-von-Guericke University Magdeburg, Germany
| | - Oliver Speck
- Department of Biomedical Magnetic Resonance (BMMR), Division Experimental Physics, Faculty of Physics, Otto-von-Guericke University Magdeburg, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
| |
Collapse
|
43
|
|
44
|
Han M, Larson PEZ, Liu J, Krug R. Depiction of achilles tendon microstructure in vivo using high-resolution 3-dimensional ultrashort echo-time magnetic resonance imaging at 7 T. Invest Radiol 2014; 49:339-45. [PMID: 24500089 PMCID: PMC4143127 DOI: 10.1097/rli.0000000000000025] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES The objective of this study was to demonstrate the feasibility of depicting the internal structure of the Achilles tendon in vivo using high-resolution 3-dimensional ultrashort echo-time (UTE) magnetic resonance imaging at 7 T. MATERIALS AND METHODS For our UTE imaging, a minimum-phase radiofrequency pulse and an anisotropic field-of-view 3-dimensional radial acquisition were used to minimize the echo time and scan time. A fat saturation pulse was applied every 8 spoke acquisitions to reduce blurring and chemical shift artifacts from fat and to improve the dynamic range of the tendon signal. Five healthy volunteers and 1 patient were scanned with an isotropic spatial resolution of up to 0.6 mm. Fat-suppressed UTE images were qualitatively evaluated and compared with non-fat-suppressed UTE images and longer echo-time images. RESULTS High-resolution UTE imaging was able to visualize the microstructure of the Achilles tendon. Fat suppression substantially improved the depiction of the internal structure. The UTE images revealed a fascicular pattern in the Achilles tendon and fibrocartilage at the tendon insertion. In a patient who had tendon elongation surgery after birth, there was a clear depiction of disrupted tendon structure. CONCLUSIONS High-resolution fat-suppressed 3-dimensional UTE imaging at 7 T allows for the evaluation of the Achilles tendon microstructure in vivo.
Collapse
Affiliation(s)
- Misung Han
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Peder E. Z. Larson
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Jing Liu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Roland Krug
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| |
Collapse
|
45
|
Kraff O, Fischer A, Nagel AM, Mönninghoff C, Ladd ME. MRI at 7 Tesla and above: demonstrated and potential capabilities. J Magn Reson Imaging 2014; 41:13-33. [PMID: 24478137 DOI: 10.1002/jmri.24573] [Citation(s) in RCA: 129] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 01/03/2014] [Indexed: 12/29/2022] Open
Abstract
With more than 40 installed MR systems worldwide operating at 7 Tesla or higher, ultra-high-field (UHF) imaging has been established as a platform for clinically oriented research in recent years. Along with technical developments that, in part, have also been successfully transferred to lower field strengths, MR imaging and spectroscopy at UHF have demonstrated capabilities and potentials for clinical diagnostics in a variety of studies. In terms of applications, this overview article focuses on already achieved advantages for in vivo imaging, i.e., in imaging the brain and joints of the musculoskeletal system, but also considers developments in body imaging, which is particularly challenging. Furthermore, new applications for clinical diagnostics such as X-nuclei imaging and spectroscopy, which only really become feasible at ultra-high magnetic fields, will be presented.
Collapse
Affiliation(s)
- Oliver Kraff
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany
| | | | | | | | | |
Collapse
|
46
|
McDougall MP, Cheshkov S, Rispoli J, Malloy C, Dimitrov I, Wright SM. Quadrature transmit coil for breast imaging at 7 tesla using forced current excitation for improved homogeneity. J Magn Reson Imaging 2014; 40:1165-73. [PMID: 24459091 DOI: 10.1002/jmri.24473] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 09/16/2013] [Indexed: 11/11/2022] Open
Abstract
PURPOSE To demonstrate the use of forced current excitation (FCE) to create homogeneous excitation of the breast at 7 tesla, insensitive to the effects of asymmetries in the electrical environment. MATERIALS AND METHODS FCE was implemented on two breast coils: one for quadrature (1) H imaging and one for proton-decoupled (13) C spectroscopy. Both were a Helmholtz-saddle combination, with the saddle tuned to 298 MHz for imaging and 75 MHz for spectroscopy. Bench measurements were acquired to demonstrate the ability to force equal currents on elements in the presence of asymmetric loading to improve homogeneity. Modeling and temperature measurements were conducted per safety protocol. B1 mapping, imaging, and proton-decoupled (13) C spectroscopy were demonstrated in vivo. RESULTS Using FCE to ensure balanced currents on elements enabled straightforward tuning and maintaining of isolation between quadrature elements of the coil. Modeling and bench measurements confirmed homogeneity of the field, which resulted in images with excellent fat suppression and in broadband proton-decoupled carbon-13 spectra. CONCLUSION FCE is a straightforward approach to ensure equal currents on multiple coil elements and a homogeneous excitation field, insensitive to the effects of asymmetries in the electrical environment. This enabled effective breast imaging and proton-decoupled carbon-13 spectroscopy at 7T.
Collapse
Affiliation(s)
- Mary Preston McDougall
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas, USA; Department of Electrical Engineering, Texas A&M University, College Station, Texas, USA
| | | | | | | | | | | |
Collapse
|
47
|
Sprinkhuizen SM, Ackerman JL, Song YQ. Influence of bone marrow composition on measurements of trabecular microstructure using decay due to diffusion in the internal field MRI: simulations and clinical studies. Magn Reson Med 2013; 72:1499-508. [PMID: 24382681 DOI: 10.1002/mrm.25061] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 11/06/2013] [Accepted: 11/07/2013] [Indexed: 11/06/2022]
Abstract
PURPOSE Decay due to diffusion in the internal field (DDIF) MRI allows for measurements of microstructures of porous materials at low spatial resolution and thus has potential for trabecular bone quality measurements. In trabecular bone, solid bone changes (osteoporosis) as well as changes in bone marrow composition occur. The influence of such changes on DDIF MRI was studied by simulations and in vivo measurements. METHODS Monte Carlo simulations of DDIF in various trabecular bone models were conducted. Changes in solid bone and marrow composition were simulated with numerical bone erosion and marrow susceptibility variations. Additionally, in vivo measurements were performed in the lumbar spine of healthy volunteers aged 23-62 years. RESULTS Simulations and in vivo results showed that 1) DDIF decay times decrease with increasing marrow fat and 2) the marrow fat percentage needs to be incorporated in the DDIF analysis to discriminate between healthy and osteoporotic solid bone structures. CONCLUSIONS Bone marrow composition plays an important role in DDIF MRI: incorporation of marrow fat percentage into DDIF MRI allowed for differentiation of young and old age groups (in vivo experiments). DDIF MRI may develop into a means of assessing osteoporosis and disorders that affect marrow composition.
Collapse
Affiliation(s)
- Sara M Sprinkhuizen
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, Massachusetts, USA
| | | | | |
Collapse
|
48
|
Chang G, Deniz CM, Honig S, Egol K, Regatte RR, Zhu Y, Sodickson DK, Brown R. MRI of the hip at 7T: feasibility of bone microarchitecture, high-resolution cartilage, and clinical imaging. J Magn Reson Imaging 2013; 39:1384-93. [PMID: 24115554 DOI: 10.1002/jmri.24305] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 06/18/2013] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To demonstrate the feasibility of performing bone microarchitecture, high-resolution cartilage, and clinical imaging of the hip at 7T. MATERIALS AND METHODS This study had Institutional Review Board approval. Using an 8-channel coil constructed in-house, we imaged the hips of 15 subjects on a 7T magnetic resonance imaging (MRI) scanner. We applied: 1) a T1-weighted 3D fast low angle shot (3D FLASH) sequence (0.23 × 0.23 × 1-1.5 mm(3) ) for bone microarchitecture imaging; 2) T1-weighted 3D FLASH (water excitation) and volumetric interpolated breath-hold examination (VIBE) sequences (0.23 × 0.23 × 1.5 mm(3) ) with saturation or inversion recovery-based fat suppression for cartilage imaging; 3) 2D intermediate-weighted fast spin-echo (FSE) sequences without and with fat saturation (0.27 × 0.27 × 2 mm) for clinical imaging. RESULTS Bone microarchitecture images allowed visualization of individual trabeculae within the proximal femur. Cartilage was well visualized and fat was well suppressed on FLASH and VIBE sequences. FSE sequences allowed visualization of cartilage, the labrum (including cartilage and labral pathology), joint capsule, and tendons. CONCLUSION This is the first study to demonstrate the feasibility of performing a clinically comprehensive hip MRI protocol at 7T, including high-resolution imaging of bone microarchitecture and cartilage, as well as clinical imaging.
Collapse
Affiliation(s)
- Gregory Chang
- Department of Radiology, NYU Langone Medical Center, Center for Musculoskeletal Care, New York, New York, USA
| | | | | | | | | | | | | | | |
Collapse
|
49
|
Chang G, Xia D, Sherman O, Strauss E, Jazrawi L, Recht MP, Regatte RR. High resolution morphologic imaging and T2 mapping of cartilage at 7 Tesla: comparison of cartilage repair patients and healthy controls. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2013; 26:539-48. [PMID: 23657612 DOI: 10.1007/s10334-013-0379-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Revised: 03/20/2013] [Accepted: 04/22/2013] [Indexed: 11/26/2022]
Abstract
OBJECT Our objective was to use 7 T MRI to compare cartilage morphology (thickness) and collagen composition (T2 values) in cartilage repair patients and healthy controls. MATERIALS AND METHODS We scanned the knees of 11 cartilage repair patients and 11 controls on a 7 T MRI scanner using a high-resolution, gradient-echo sequence to measure cartilage thickness and a multi-echo spin-echo sequence to measure cartilage T2 values. We used two-tailed t tests to compare cartilage thickness and T2 values in: repair tissue (RT) versus adjacent cartilage (AC); RT versus healthy control cartilage (HC); AC versus HC. RESULTS Mean thickness in RT, AC, HC were: 2.2±1.4, 3.6±1.1, 3.3±0.7 mm. Differences in thickness between RT-AC (p=0.01) and RT-HC (p=0.02) were significant, but not AC-HC (p=0.45). Mean T2 values in RT, AC, HC were: 51.6±7.6, 40.0±4.7, 45.9±3.7 ms. Differences in T2 values between RT-AC (p=0.0005), RT-HC (p=0.04), and AC-HC (p=0.004) were significant. CONCLUSION 7 T MRI allows detection of differences in morphology and collagen architecture in: (1) cartilage repair tissue compared to adjacent cartilage and (2) cartilage repair tissue compared to cartilage from healthy controls. Although cartilage adjacent to repair tissue may be normal in thickness, it can demonstrate altered collagen composition.
Collapse
Affiliation(s)
- Gregory Chang
- Department of Radiology, NYU Langone Medical Center, Center for Musculoskeletal Care, 333 East 38th Street, 6th Floor, Room 610, New York, NY, 10016, USA,
| | | | | | | | | | | | | |
Collapse
|
50
|
Chang G, Diamond M, Nevsky G, Regatte RR, Weiss DS. Early knee changes in dancers identified by ultra-high-field 7 T MRI. Scand J Med Sci Sports 2013; 24:678-82. [PMID: 23346987 DOI: 10.1111/sms.12039] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2012] [Indexed: 11/30/2022]
Abstract
We aimed to determine whether a unique, ultra-high-field 7 T magnetic resonance imaging (MRI) scanner could detect occult cartilage and meniscal injuries in asymptomatic female dancers. This study had Institutional Review Board approval. We recruited eight pre-professional female dancers and nine non-athletic, female controls. We scanned the dominant knee on a 7 T MRI scanner using a three-dimensional fast low-angle shot sequence and a proton density, fast spin-echo sequence to evaluate cartilage and menisci, respectively. Two radiologists scored cartilage (International Cartilage Repair Society classification) and meniscal (Stoller classification) lesions. We applied two-tailed z- and t-tests to determine statistical significance. There were no cartilage lesions in dancers or controls. For the medial meniscus, the dancers demonstrated higher mean MRI score (2.38 ± 0.61 vs 1.0 ± 0.97, P < 0.0001) and higher frequency of mean grade 2 lesions (88% vs 11%, P < 0.01) compared with the controls. For the lateral meniscus, there was no difference in score (0.5 ± 0.81 vs 0.5 ± 0.78, P = 0.78) in dancers compared with the control groups. Asymptomatic dancers demonstrate occult medial meniscal lesions. Because this has been described in early osteoarthritis, close surveillance of dancers' knee symptoms and function with appropriate activity modification may help maintain their long-term knee health.
Collapse
Affiliation(s)
- G Chang
- Department of Radiology, NYU Langone Medical Center, New York, New York, USA
| | - M Diamond
- Harkness Center for Dance Injuries, Hospital for Joint Diseases, NYU Langone Medical Center, New York, New York, USA.,Department of Rehabilitation Medicine, Rusk Institute of Rehabilitation Medicine, NYU Langone Medical Center, New York, New York, USA
| | - G Nevsky
- Department of Radiology, NYU Langone Medical Center, New York, New York, USA
| | - R R Regatte
- Department of Radiology, NYU Langone Medical Center, New York, New York, USA
| | - D S Weiss
- Harkness Center for Dance Injuries, Hospital for Joint Diseases, NYU Langone Medical Center, New York, New York, USA.,Department of Orthopaedic Surgery, New York University School of Medicine, New York, New York, USA
| |
Collapse
|