1
|
Bajaj S, Chhabra A, Taneja AK. 3D isotropic MRI of ankle: review of literature with comparison to 2D MRI. Skeletal Radiol 2024; 53:825-846. [PMID: 37978990 DOI: 10.1007/s00256-023-04513-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/01/2023] [Accepted: 11/06/2023] [Indexed: 11/19/2023]
Abstract
The ankle joint has complex anatomy with different tissue structures and is commonly involved in traumatic injuries. Magnetic resonance imaging (MRI) is the primary imaging modality used to assess the soft tissue structures around the ankle joint including the ligaments, tendons, and articular cartilage. Two-dimensional (2D) fast spin echo/turbo spin echo (FSE/TSE) sequences are routinely used for ankle joint imaging. While the 2D sequences provide a good signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) with high spatial resolution, there are some limitations to their use owing to the thick slices, interslice gaps leading to partial volume effects, limited fluid contrast, and the need to acquire separate images in different orthogonal planes. The 3D MR imaging can overcome these limitations and recent advances have led to technical improvements that enable its widespread clinical use in acceptable time periods. The volume imaging renders the advantage of reconstructing into thin continuous slices with isotropic voxels enabling multiplanar reconstructions that helps in visualizing complex anatomy of the structure of interest throughout their course with improved sharpness, definition of anatomic variants, and fluid conspicuity of lesions and injuries. Recent advances have also reduced the acquisition time of the 3D datasets making it more efficient than 2D sequences. This article reviews the recent technical developments in the domain 3D MRI, compares imaging with 3D versus 2D sequences, and demonstrates the use-case scenarios with interesting cases, and benefits of 3D MRI in evaluating various ankle joint components and their lesions.
Collapse
Affiliation(s)
- Suryansh Bajaj
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Avneesh Chhabra
- Musculoskeletal Radiology Division, Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
- Department of Orthopaedic Surgery, UT Southwestern Medical Center, Dallas, TX, USA
- Johns Hopkins University, Baltimore, MD, USA
- Walton Center of Neurosciences, Liverpool, UK
- University of Dallas, Richardson, TX, USA
| | - Atul Kumar Taneja
- Musculoskeletal Radiology Division, Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA.
| |
Collapse
|
2
|
Feuerriegel GC, Weiss K, Tu Van A, Leonhardt Y, Neumann J, Gassert FT, Haas Y, Schwarz M, Makowski MR, Woertler K, Karampinos DC, Gersing AS. Deep-learning-based image quality enhancement of CT-like MR imaging in patients with suspected traumatic shoulder injury. Eur J Radiol 2024; 170:111246. [PMID: 38056345 DOI: 10.1016/j.ejrad.2023.111246] [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: 10/16/2023] [Revised: 11/21/2023] [Accepted: 11/29/2023] [Indexed: 12/08/2023]
Abstract
PURPOSE To evaluate the diagnostic performance of CT-like MR images reconstructed with an algorithm combining compressed sense (CS) with deep learning (DL) in patients with suspected osseous shoulder injury compared to conventional CS-reconstructed images. METHODS Thirty-two patients (12 women, mean age 46 ± 14.9 years) with suspected traumatic shoulder injury were prospectively enrolled into the study. All patients received MR imaging of the shoulder, including a CT-like 3D T1-weighted gradient-echo (T1 GRE) sequence and in case of suspected fracture a conventional CT. An automated DL-based algorithm, combining CS and DL (CS DL) was used to reconstruct images of the same k-space data as used for CS reconstructions. Two musculoskeletal radiologists assessed the images for osseous pathologies, image quality and visibility of anatomical landmarks using a 5-point Likert scale. Moreover, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. RESULTS Compared to CT, all acute fractures (n = 23) and osseous pathologies were detected accurately on the CS only and CS DL images with almost perfect agreement between the CS DL and CS only images (κ 0.95 (95 %confidence interval 0.82-1.00). Image quality as well as the visibility of the fracture lines, bone fragments and glenoid borders were overall rated significantly higher for the CS DL reconstructions than the CS only images (CS DL range 3.7-4.9 and CS only range 3.2-3.8, P = 0.01-0.04). Significantly higher SNR and CNR values were observed for the CS DL reconstructions (P = 0.02-0.03). CONCLUSION Evaluation of traumatic shoulder pathologies is feasible using a DL-based algorithm for reconstruction of high-resolution CT-like MR imaging.
Collapse
Affiliation(s)
- Georg C Feuerriegel
- Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
| | | | - Anh Tu Van
- Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
| | - Yannik Leonhardt
- Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
| | - Jan Neumann
- Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany; Musculoskeletal Radiology Section, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
| | - Florian T Gassert
- Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
| | - Yannick Haas
- Department of Trauma Surgery, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
| | - Markus Schwarz
- Department of Trauma Surgery, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
| | - Marcus R Makowski
- Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
| | - Klaus Woertler
- Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany; Musculoskeletal Radiology Section, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
| | - Dimitrios C Karampinos
- Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
| | - Alexandra S Gersing
- Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany; Department of Neuroradiology, University Hospital of Munich, LMU Munich, Munich, Germany.
| |
Collapse
|
3
|
Butler JJ, Wingo T, Kennedy JG. Presurgical and Postsurgical MRI Evaluation of Osteochondral Lesions of the Foot and Ankle: A Primer. Foot Ankle Clin 2023; 28:603-617. [PMID: 37536821 DOI: 10.1016/j.fcl.2023.04.010] [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] [Indexed: 08/05/2023]
Abstract
The gold standard diagnostic imaging tool for ankle OCLs is magnetic resonance imaging, which allows precise evaluation of the articular cartilage and assessment of the surrounding soft tissue structures. Post-operative morphologic MRI assessment via MOCART scores provide semi-quantitative analysis of the repair tissue, but mixed evidence exists regarding its association with post-operative outcomes. Post-operative biochemical MRIs allow assessment of the collagen network of the articular cartilage via T2-mapping and T2∗ mapping, and assessment of the articular glycosaminoglycan content via delayed gadolinium-enhanced MRI of cartilage (dGEMRIC), T1rho mapping and sodium imaging.
Collapse
Affiliation(s)
- James J Butler
- Foot and Ankle Division, Department of Orthopaedic Surgery, NYU Langone Health, 171 Delancey Street, 2nd Floor, New York City, NY 10002, USA
| | - Taylor Wingo
- Foot and Ankle Division, Department of Orthopaedic Surgery, NYU Langone Health, 171 Delancey Street, 2nd Floor, New York City, NY 10002, USA
| | - John G Kennedy
- Foot and Ankle Division, Department of Orthopaedic Surgery, NYU Langone Health, 171 Delancey Street, 2nd Floor, New York City, NY 10002, USA.
| |
Collapse
|
4
|
Fritz B, de Cesar Netto C, Fritz J. Multiaxial 3D MRI of the Ankle: Advanced High-Resolution Visualization of Ligaments, Tendons, and Articular Cartilage. Foot Ankle Clin 2023; 28:529-550. [PMID: 37536817 DOI: 10.1016/j.fcl.2023.05.008] [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] [Indexed: 08/05/2023]
Abstract
MRI is a valuable tool for diagnosing a broad spectrum of acute and chronic ankle disorders, including ligament tears, tendinopathy, and osteochondral lesions. Traditional two-dimensional (2D) MRI provides a high image signal and contrast of anatomic structures for accurately characterizing articular cartilage, bone marrow, synovium, ligaments, tendons, and nerves. However, 2D MRI limitations are thick slices and fixed slice orientations. In clinical practice, 2D MRI is limited to 2 to 3 mm slice thickness, which can cause blurred contours of oblique structures due to volume averaging effects within the image slice. In addition, image plane orientations are fixated and cannot be changed after the scan, resulting in 2D MRI lacking multiplanar and multiaxial reformation abilities for individualized image plane orientations along oblique and curved anatomic structures, such as ankle ligaments and tendons. In contrast, three-dimensional (3D) MRI is a newer, clinically available MRI technique capable of acquiring high-resolution ankle MRI data sets with isotropic voxel size. The inherently high spatial resolution of 3D MRI permits up to five times thinner (0.5 mm) image slices. In addition, 3D MRI can be acquired image voxel with the same edge length in all three space dimensions (isotropism), permitting unrestricted multiplanar and multiaxial image reformation and postprocessing after the MRI scan. Clinical 3D MRI of the ankle with 0.5 to 0.7 mm isotropic voxel size resolves the smallest anatomic ankle structures and abnormalities of ligament and tendon fibers, osteochondral lesions, and nerves. After acquiring the images, operators can align image planes individually along any anatomic structure of interest, such as ligaments and tendons segments. In addition, curved multiplanar image reformations can unfold the entire course of multiaxially curved structures, such as perimalleolar tendons, into one image plane. We recommend adding 3D MRI pulse sequences to traditional 2D MRI protocols to visualize small and curved ankle structures to better advantage. This article provides an overview of the clinical application of 3D MRI of the ankle, compares diagnostic performances of 2D and 3D MRI for diagnosing ankle abnormalities, and illustrates clinical 3D ankle MRI applications.
Collapse
Affiliation(s)
- Benjamin Fritz
- Department of Radiology, Balgrist University Hospital, Forchstrasse 340, Zurich 8008, Switzerland; Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Cesar de Cesar Netto
- Department of Orthopaedics and Rehabilitation, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA
| | - Jan Fritz
- Department of Radiology, Division of Musculoskeletal Radiology, NYU Grossman School of Medicine, 660 1st Avenue, New York, NY 10016, USA.
| |
Collapse
|
5
|
Feuerriegel GC, Burian E, Sollmann N, Leonhardt Y, Burian G, Griesbauer M, Bumm C, Makowski MR, Probst M, Probst FA, Karampinos DC, Folwaczny M. Evaluation of 3D MRI for early detection of bone edema associated with apical periodontitis. Clin Oral Investig 2023; 27:5403-5412. [PMID: 37464086 PMCID: PMC10492681 DOI: 10.1007/s00784-023-05159-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: 02/09/2023] [Accepted: 07/11/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVES To detect and evaluate early signs of apical periodontitis using MRI based on a 3D short-tau-inversion-recovery (STIR) sequence compared to conventional panoramic radiography (OPT) and periapical radiographs in patients with apical periodontitis. MATERIALS AND METHODS Patients with clinical evidence of periodontal disease were enrolled prospectively and received OPT as well as MRI of the viscerocranium including a 3D-STIR sequence. The MRI sequences were assessed for the occurrence and extent of bone changes associated with apical periodontitis including bone edema, periradicular cysts, and dental granulomas. OPTs and intraoral periapical radiographs, if available, were assessed for corresponding periapical radiolucencies using the periapical index (PAI). RESULTS In total, 232 teeth of 37 patients (mean age 62±13.9 years, 18 women) were assessed. In 69 cases reactive bone edema was detected on MRI with corresponding radiolucency according to OPT. In 105 cases edema was detected without corresponding radiolucency on OPT. The overall extent of edema measured on MRI was significantly larger compared to the radiolucency on OPT (mean: STIR 2.4±1.4 mm, dental radiograph 1.3±1.2 mm, OPT 0.8±1.1 mm, P=0.01). The overall PAI score was significantly higher on MRI compared to OPT (mean PAI: STIR 1.9±0.7, dental radiograph 1.3±0.5, OPT 1.2±0.7, P=0.02). CONCLUSION Early detection and assessment of bone changes of apical periodontitis using MRI was feasible while the extent of bone edema measured on MRI exceeded the radiolucencies measured on OPT. CLINICAL RELEVANCE In clinical routine, dental MRI might be useful for early detection and assessment of apical periodontitis before irreversible bone loss is detected on conventional panoramic and intraoral periapical radiographs.
Collapse
Affiliation(s)
- Georg C. Feuerriegel
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675 Munich, Germany
| | - Egon Burian
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675 Munich, Germany
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
| | - Nico Sollmann
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Yannik Leonhardt
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675 Munich, Germany
| | - Gintare Burian
- Department of Prosthodontics, LMU University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Magdalena Griesbauer
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Caspar Bumm
- Department of Restorative Dentistry and Periodontology, LMU University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Marcus R. Makowski
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675 Munich, Germany
| | - Monika Probst
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Florian A. Probst
- Department of Restorative Dentistry and Periodontology, LMU University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Dimitrios C. Karampinos
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675 Munich, Germany
| | - Matthias Folwaczny
- Department of Restorative Dentistry and Periodontology, LMU University Hospital, Ludwig-Maximilians-University, Munich, Germany
| |
Collapse
|
6
|
Feuerriegel GC, Weiss K, Kronthaler S, Leonhardt Y, Neumann J, Wurm M, Lenhart NS, Makowski MR, Schwaiger BJ, Woertler K, Karampinos DC, Gersing AS. Evaluation of a deep learning-based reconstruction method for denoising and image enhancement of shoulder MRI in patients with shoulder pain. Eur Radiol 2023; 33:4875-4884. [PMID: 36806569 PMCID: PMC10289918 DOI: 10.1007/s00330-023-09472-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/07/2023] [Accepted: 01/22/2023] [Indexed: 02/21/2023]
Abstract
OBJECTIVES To evaluate the diagnostic performance of an automated reconstruction algorithm combining MR imaging acquired using compressed SENSE (CS) with deep learning (DL) in order to reconstruct denoised high-quality images from undersampled MR images in patients with shoulder pain. METHODS Prospectively, thirty-eight patients (14 women, mean age 40.0 ± 15.2 years) with shoulder pain underwent morphological MRI using a pseudo-random, density-weighted k-space scheme with an acceleration factor of 2.5 using CS only. An automated DL-based algorithm (CS DL) was used to create reconstructions of the same k-space data as used for CS reconstructions. Images were analyzed by two radiologists and assessed for pathologies, image quality, and visibility of anatomical landmarks using a 4-point Likert scale. RESULTS Overall agreement for the detection of pathologies between the CS DL reconstructions and CS images was substantial to almost perfect (κ 0.95 (95% confidence interval 0.82-1.00)). Image quality and the visibility of the rotator cuff, articular cartilage, and axillary recess were overall rated significantly higher for CS DL images compared to CS (p < 0.03). Contrast-to-noise ratios were significantly higher for cartilage/fluid (CS DL 198 ± 24.3, CS 130 ± 32.2, p = 0.02) and ligament/fluid (CS DL 184 ± 17.3, CS 141 ± 23.5, p = 0.03) and SNR values were significantly higher for ligaments and muscle of the CS DL reconstructions (p < 0.04). CONCLUSION Evaluation of shoulder pathologies was feasible using a DL-based algorithm for MRI reconstruction and denoising. In clinical routine, CS DL may be beneficial in particular for reducing image noise and may be useful for the detection and better discrimination of discrete pathologies. Assessment of shoulder pathologies was feasible with improved image quality as well as higher SNR using a compressed sensing deep learning-based framework for image reconstructions and denoising. KEY POINTS • Automated deep learning-based reconstructions showed a significant increase in signal-to-noise ratio and contrast-to-noise ratio (p < 0.04) with only a slight increase of reconstruction time of 40 s compared to CS. • All pathologies were accurately detected with no loss of diagnostic information or prolongation of the scan time. • Significant improvements of the image quality as well as the visibility of the rotator cuff, articular cartilage, and axillary recess were detected.
Collapse
Affiliation(s)
- Georg C Feuerriegel
- Department of Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany.
| | | | - Sophia Kronthaler
- Department of Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany
| | - Yannik Leonhardt
- Department of Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany
| | - Jan Neumann
- Department of Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany
- Musculoskeletal Radiology Section, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Markus Wurm
- Department of Trauma Surgery, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Nicolas S Lenhart
- Department of Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany
| | - Marcus R Makowski
- Department of Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany
| | - Benedikt J Schwaiger
- Department of Neuroradiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Klaus Woertler
- Department of Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany
- Musculoskeletal Radiology Section, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Dimitrios C Karampinos
- Department of Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany
| | - Alexandra S Gersing
- Department of Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany
- Department of Neuroradiology, University Hospital of Munich, LMU Munich, Munich, Germany
| |
Collapse
|
7
|
Keller G, Estler A, Herrmann J, Afat S, Othman AE, Nickel D, Koerzdoerfer G, Springer F. Prospective intraindividual comparison of a standard 2D TSE MRI protocol for ankle imaging and a deep learning-based 2D TSE MRI protocol with a scan time reduction of 48. LA RADIOLOGIA MEDICA 2023; 128:347-356. [PMID: 36807027 PMCID: PMC10020308 DOI: 10.1007/s11547-023-01604-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 01/24/2023] [Indexed: 02/23/2023]
Abstract
PURPOSE Magnetic resonance imaging (MRI) scan time remains a limited and valuable resource. This study evaluates the diagnostic performance of a deep learning (DL)-based accelerated TSE study protocol compared to a standard TSE study protocol in ankle MRI. MATERIAL AND METHODS Between October 2020 and July 2021 forty-seven patients were enrolled in this study for an intraindividual comparison of a standard TSE study protocol and a DL TSE study protocol either on a 1.5 T or a 3 T scanner. Two radiologists evaluated the examinations regarding structural pathologies and image quality categories (5-point-Likert-scale; 1 = "non diagnostic", 5 = "excellent"). RESULTS Both readers showed almost perfect/perfect agreement of DL TSE with standard TSE in all analyzed structural pathologies (0.81-1.00) with a median "good" or "excellent" rating (4-5/5) in all image quality categories in both 1.5 T and 3 T MRI. The reduction of total acquisition time of DL TSE compared to standard TSE was 49% in 1.5 T and 48% in 3 T MRI to a total acquisition time of 5 min 41 s and 5 min 46 s. CONCLUSION In ankle MRI the new DL-based accelerated TSE study protocol delivers high agreement with standard TSE and high image quality, while reducing the acquisition time by 48%.
Collapse
Affiliation(s)
- Gabriel Keller
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Eberhard Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.
| | - Arne Estler
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Eberhard Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Judith Herrmann
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Eberhard Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Saif Afat
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Eberhard Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Ahmed E Othman
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Eberhard Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- Universitätsklink für Neuroradiologie, Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - Dominik Nickel
- MR Applications Predevelopment, Siemens Healthcare GmbH, Allee Am Roethelheimpark 2, 91052, Erlangen, Germany
| | - Gregor Koerzdoerfer
- MR Applications Predevelopment, Siemens Healthcare GmbH, Allee Am Roethelheimpark 2, 91052, Erlangen, Germany
| | - Fabian Springer
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Eberhard Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- Department of Diagnostic Radiology, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Schnarrenbergstr. 95, 72076, Tübingen, Germany
| |
Collapse
|
8
|
Dai M, Liu X, Yang L, Wang J, Ye F, Zhao H, Duan D, Liu X. Morphologic evaluation of injured and contralateral uninjured ankles in patients with unilateral chronic ankle instability. Br J Radiol 2022; 95:20220155. [PMID: 35766941 PMCID: PMC10996958 DOI: 10.1259/bjr.20220155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/12/2022] [Accepted: 06/20/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To compare the morphological anatomy and abnormalities of the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) in unilateral chronic ankle instability (CAI). METHODS 22 patients (men: women, 13:9; mean age, 28.95 ± 8.127 years) with unilateral CAI and 18 healthy volunteers (men: women, 9:9, mean age, 28.33 ± 3.678 years) were recruited. MRI scans were divided into Group 1 (22 injured ankles), Group 2 (22 contralateral uninjured ankles), and Group 3 (36 healthy volunteer ankles). The morphologic variables, MRI signal intensity (SI) values were evaluated. RESULTS The ATFL proximal, intermediate, and distal sites and the CFL proximal and distal sites in Group 3 were narrower than those in Group 1 (P <0.05). Both ATFL and CFL in Group 1 were thicker than those in Group 3 (P <0.01). The proximal and intermediate sites of the ATFL and the proximal site of the CFL in Group 3 were narrower than those in Group 2 (P <0.01). The intermediate site of the ATFL and the proximal and distal sites of the CFL in Group 2 were thicker than those in Group 3 (P <0.01). The mean SI values of the ATFL in Group 1 were higher than those in Groups 2 and 3 (P <0.01). The ATFL and CFL SI values were higher in Group 2 than those in Group 3 (P <0.05). CONCLUSION Both the injured and contralateral uninjured ankles had wider ATFL and CFL, more thickness, and higher SI values compared with those of healthy volunteer ankles. ADVANCES IN KNOWLEDGE High-resolution three-dimensional MRI provides a potential tool assisting clinical decision on the treatment and rehabilitation therapy of patients with unilateral CAI.
Collapse
Affiliation(s)
- Meng Dai
- Department of Radiology, Union Hospital, Tongji Medical
College, Huazhong University of Science and Technology,
Wuhan, China
- Hubei Province Key Laboratory of Molecular
Imaging, Wuhan,
China
| | - Xiaoming Liu
- Department of Radiology, Union Hospital, Tongji Medical
College, Huazhong University of Science and Technology,
Wuhan, China
- Hubei Province Key Laboratory of Molecular
Imaging, Wuhan,
China
| | - Lian Yang
- Department of Radiology, Union Hospital, Tongji Medical
College, Huazhong University of Science and Technology,
Wuhan, China
- Hubei Province Key Laboratory of Molecular
Imaging, Wuhan,
China
| | - Jiazheng Wang
- MSC Clinical & Technical Solutions, Philips
Healthcare, Beijing,
China
| | - Fang Ye
- Department of Occupational and Environmental Health and
Ministry of Education Key Lab for Environment and Health, School of
Public Health, Tongji Medical College, Huazhong University of Science
and Technology, Wuhan,
China
| | - Hu Zhao
- Department of Human Anatomy, School of Basic Medicine, Tongji
Medical College, Huazhong University of Science and
Technology, Wuhan,
China
| | - Deyu Duan
- Department of Orthopaedics, Union Hospital, Tongji Medical
College, Huazhong University of Science and Technology,
Wuhan, China
| | - Xi Liu
- Department of Radiology, Union Hospital, Tongji Medical
College, Huazhong University of Science and Technology,
Wuhan, China
- Hubei Province Key Laboratory of Molecular
Imaging, Wuhan,
China
| |
Collapse
|
9
|
Anatomical variants of the acromioclavicular joint influence its visibility in the standard MRI protocol in patients aged 18-31 years. SURGICAL AND RADIOLOGIC ANATOMY : SRA 2022; 44:951-961. [PMID: 35792912 PMCID: PMC9308581 DOI: 10.1007/s00276-022-02973-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 06/11/2022] [Indexed: 11/11/2022]
Abstract
Purpose Visualization of a structure in orthogonal planes is essential for correct radiological assessment. The aim was to assess the utility of the standard MRI protocol for the shoulder in the assessment of the acromioclavicular joint (ACJ). Methods A total of 204 MRI scans of the shoulder were re-reviewed. Visibility of the ACJ in orthogonal planes was assessed, and the type of acromion and the angle between the ACJ and the glenoid cavity were assessed by two observers. Results Agreement in the assessment of ACJ visibility was moderate to substantial. The ACJ was visible in the three anatomical views in 48% (confidence interval [CI] 95% = [41–54%]) of the examinations, and no significant difference regarding gender or age was noticed. The mean angle between the ACJ and the glenoid cavity was 41.12 deg. CI95% = (39.72, 42.53) in the axial plane, 33.39 deg. CI95% = (31.33, 35.45) in the coronal plane and 52.49 deg. CI95% = (50.10, 54.86) in the sagittal plane. When the ACJ was visible in the sagittal and axial planes, significant differences were noticed in the remaining planes (p < .05). Conclusion Anatomical variations of the ACJ influence its visibility in the standard MRI protocol for examining the shoulder, making this protocol insufficient for ACJ assessment in the examined population.
Collapse
|
10
|
Foreman SC, Neumann J, Han J, Harrasser N, Weiss K, Peeters JM, Karampinos DC, Makowski MR, Gersing AS, Woertler K. Deep learning-based acceleration of Compressed Sense MR imaging of the ankle. Eur Radiol 2022; 32:8376-8385. [PMID: 35751695 DOI: 10.1007/s00330-022-08919-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 05/13/2022] [Accepted: 05/30/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To evaluate a compressed sensing artificial intelligence framework (CSAI) to accelerate MRI acquisition of the ankle. METHODS Thirty patients were scanned at 3T. Axial T2-w, coronal T1-w, and coronal/sagittal intermediate-w scans with fat saturation were acquired using compressed sensing only (12:44 min, CS), CSAI with an acceleration factor of 4.6-5.3 (6:45 min, CSAI2x), and CSAI with an acceleration factor of 6.9-7.7 (4:46 min, CSAI3x). Moreover, a high-resolution axial T2-w scan was obtained using CSAI with a similar scan duration compared to CS. Depiction and presence of abnormalities were graded. Signal-to-noise and contrast-to-noise were calculated. Wilcoxon signed-rank test and Cohen's kappa were used to compare CSAI with CS sequences. RESULTS The correlation was perfect between CS and CSAI2x (κ = 1.0) and excellent for CS and CSAI3x (κ = 0.86-1.0). No significant differences were found for the depiction of structures between CS and CSAI2x and the same abnormalities were detected in both protocols. For CSAI3x the depiction was graded lower (p ≤ 0.001), though most abnormalities were also detected. For CSAI2x contrast-to-noise fluid/muscle was higher compared to CS (p ≤ 0.05), while no differences were found for other tissues. Signal-to-noise and contrast-to-noise were higher for CSAI3x compared to CS (p ≤ 0.05). The high - resolution axial T2-w sequence specifically improved the depiction of tendons and the tibial nerve (p ≤ 0.005). CONCLUSIONS Acquisition times can be reduced by 47% using CSAI compared to CS without decreasing diagnostic image quality. Reducing acquisition times by 63% is feasible but should be reserved for specific patients. The depiction of specific structures is improved using a high-resolution axial T2-w CSAI scan. KEY POINTS • Prospective study showed that CSAI enables reduction in acquisition times by 47% without decreasing diagnostic image quality. • Reducing acquisition times by 63% still produces images with an acceptable diagnostic accuracy but should be reserved for specific patients. • CSAI may be implemented to scan at a higher resolution compared to standard CS images without increasing acquisition times.
Collapse
Affiliation(s)
- Sarah C Foreman
- Department of Radiology, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany.
| | - Jan Neumann
- Department of Radiology, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany
| | - Jessie Han
- Department of Radiology, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany
| | - Norbert Harrasser
- Department of Orthopaedic Surgery, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany
| | - Kilian Weiss
- Philips GmbH, Röntgenstrasse 22, 22335, Hamburg, Germany
| | - Johannes M Peeters
- Philips Healthcare, Veenpluis 4-6, Building QR-0.113, 5684, Best, PC, Netherlands
| | - Dimitrios C Karampinos
- Department of Radiology, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany
| | - Marcus R Makowski
- Department of Radiology, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany
| | - Alexandra S Gersing
- Department of Radiology, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany.,Department of Neuroradiology, University Hospital Munich (LMU), Marchioninistrasse 15, 81377, Munich, Germany
| | - Klaus Woertler
- Department of Radiology, Klinikum Rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany
| |
Collapse
|
11
|
Khodarahmi I, Fritz J. The Value of 3 Tesla Field Strength for Musculoskeletal Magnetic Resonance Imaging. Invest Radiol 2021; 56:749-763. [PMID: 34190717 DOI: 10.1097/rli.0000000000000801] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Musculoskeletal magnetic resonance imaging (MRI) is a careful negotiation between spatial, temporal, and contrast resolution, which builds the foundation for diagnostic performance and value. Many aspects of musculoskeletal MRI can improve the image quality and increase the acquisition speed; however, 3.0-T field strength has the highest impact within the current diagnostic range. In addition to the favorable attributes of 3.0-T field strength translating into high temporal, spatial, and contrast resolution, many 3.0-T MRI systems yield additional gains through high-performance gradients systems and radiofrequency pulse transmission technology, advanced multichannel receiver technology, and high-end surface coils. Compared with 1.5 T, 3.0-T MRI systems yield approximately 2-fold higher signal-to-noise ratios, enabling 4 times faster data acquisition or double the matrix size. Clinically, 3.0-T field strength translates into markedly higher scan efficiency, better image quality, more accurate visualization of small anatomic structures and abnormalities, and the ability to offer high-end applications, such as quantitative MRI and magnetic resonance neurography. Challenges of 3.0-T MRI include higher magnetic susceptibility, chemical shift, dielectric effects, and higher radiofrequency energy deposition, which can be managed successfully. The higher total cost of ownership of 3.0-T MRI systems can be offset by shorter musculoskeletal MRI examinations, higher-quality examinations, and utilization of advanced MRI techniques, which then can achieve higher gains and value than lower field systems. We provide a practice-focused review of the value of 3.0-T field strength for musculoskeletal MRI, practical solutions to challenges, and illustrations of a wide spectrum of gainful clinical applications.
Collapse
Affiliation(s)
- Iman Khodarahmi
- From the Division of Musculoskeletal Radiology, Department of Radiology, NYU Grossman School of Medicine, New York, NY
| | | |
Collapse
|
12
|
Fritz B, Fritz J, Sutter R. 3D MRI of the Ankle: A Concise State-of-the-Art Review. Semin Musculoskelet Radiol 2021; 25:514-526. [PMID: 34547816 DOI: 10.1055/s-0041-1731332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Magnetic resonance imaging (MRI) is a powerful imaging modality for visualizing a wide range of ankle disorders that affect ligaments, tendons, and articular cartilage. Standard two-dimensional (2D) fast spin-echo (FSE) and turbo spin-echo (TSE) pulse sequences offer high signal-to-noise and contrast-to-noise ratios, but slice thickness limitations create partial volume effects. Modern three-dimensional (3D) FSE/TSE pulse sequences with isotropic voxel dimensions can achieve higher spatial resolution and similar contrast resolutions in ≤ 5 minutes of acquisition time. Advanced acceleration schemes have reduced the blurring effects of 3D FSE/TSE pulse sequences by affording shorter echo train lengths. The ability for thin-slice partitions and multiplanar reformation capabilities eliminate relevant partial volume effects and render modern 3D FSE/TSE pulse sequences excellently suited for MRI visualization of several oblique and curved structures around the ankle. Clinical efficiency gains can be achieved by replacing two or three 2D FSE/TSE sequences within an ankle protocol with a single isotropic 3D FSE/TSE pulse sequence. In this article, we review technical pulse sequence properties for 3D MRI of the ankle, discuss practical considerations for clinical implementation and achieving the highest image quality, compare diagnostic performance metrics of 2D and 3D MRI for major ankle structures, and illustrate a broad spectrum of ankle abnormalities.
Collapse
Affiliation(s)
- Benjamin Fritz
- Department of Radiology, University Hospital Balgrist, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Jan Fritz
- New York University Grossman School of Medicine, New York University, New York, New York
| | - Reto Sutter
- Department of Radiology, University Hospital Balgrist, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| |
Collapse
|
13
|
Comparison of CAIPIRINHA-accelerated 3D fat-saturated-SPACE MRI with 2D MRI sequences for the assessment of shoulder pathology. Eur Radiol 2021; 32:593-601. [PMID: 34258637 DOI: 10.1007/s00330-021-08183-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 06/20/2021] [Accepted: 06/29/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To compare the performance of 6-min MRI with a fat-saturated 3D-controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA) Sampling perfection with application-optimized contrast using different flip angle evolution (SPACE) TSE protocol with 10-min 2D TSE MRI protocol for assessment of abnormalities of the shoulder. METHODS Forty-nine subjects underwent both 3D fat-saturated-CAIPIRINHA SPACE and 2D TSE sequences of the shoulder on a 3.0-T system. Following randomization and anonymization, two musculoskeletal radiologists evaluated the 2D and 3D images independently for image quality and diagnostic capability. Descriptive statistics, inter-observer, and inter-method concordance were investigated. p values < 0.05 were considered significant. RESULTS For image quality assessment, 2D images were similar to 3D CAIPIRINHA SPACE images (p = 0.05). 3D had lower noise standard deviation (SD) and higher fluid CNR than 2D images (p = 0.00). For diagnostic capability assessment, using 2D TSE as a standard of reference, sensitivity, specificity, and accuracy of 3D SPACE were, respectively, 94.81%, 94.12%, and 94.39% for tendon abnormalities; 97.06%, 80.00%, and 91.84% for acromioclavicular joint abnormalities; 88.89%, 100.00%, and 93.89% for adjacent bone alterations; and 97.30%, 100%, and 97.96% for joint fluid/effusion assessment. The inter-method concordance was moderate to almost perfect. The inter-observer-concordance of the shoulder assessment was also moderate to almost perfect, with SSP lesions demonstrating the greatest concordance. CONCLUSIONS The performance of 6-min 3D fat-saturated-CAIPIRINHA SPACE MRI for shoulder MRI is similar to that of 10-min 2D TSE MRI. 3D fat-saturated-CAIPIRINHA SPACE MRI can be utilized to reduce scan time without degradation in image quality. KEY POINTS • CAIPIRINHA acceleration 3D fat-saturated-MRI of the shoulder is achievable in 6 min with high spatial resolution. • 3D fat-saturated CAIPIRINHA MRI is similar to 2D MRI in the shoulder assessment. • 3D CAIPIRINHA MRI images enable rapid diagnosis of shoulder abnormalities without image quality degradation.
Collapse
|
14
|
Fayad LM, Parekh VS, Luna RDC, Ko CC, Tank D, Fritz J, Ahlawat S, Jacobs MA. A Deep Learning System for Synthetic Knee Magnetic Resonance Imaging: Is Artificial Intelligence-Based Fat-Suppressed Imaging Feasible? Invest Radiol 2021; 56:357-368. [PMID: 33350717 PMCID: PMC8087629 DOI: 10.1097/rli.0000000000000751] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
MATERIALS AND METHODS This single-center study was approved by the institutional review board. Artificial intelligence-based FS MRI scans were created from non-FS images using a deep learning system with a modified convolutional neural network-based U-Net that used a training set of 25,920 images and validation set of 16,416 images. Three musculoskeletal radiologists reviewed 88 knee MR studies in 2 sessions, the original (proton density [PD] + FSPD) and the synthetic (PD + AFSMRI). Readers recorded AFSMRI quality (diagnostic/nondiagnostic) and the presence or absence of meniscal, ligament, and tendon tears; cartilage defects; and bone marrow abnormalities. Contrast-to-noise rate measurements were made among subcutaneous fat, fluid, bone marrow, cartilage, and muscle. The original MRI sequences were used as the reference standard to determine the diagnostic performance of AFSMRI (combined with the original PD sequence). This is a fully balanced study design, where all readers read all images the same number of times, which allowed the determination of the interchangeability of the original and synthetic protocols. Descriptive statistics, intermethod agreement, interobserver concordance, and interchangeability tests were applied. A P value less than 0.01 was considered statistically significant for the likelihood ratio testing, and P value less than 0.05 for all other statistical analyses. RESULTS Artificial intelligence-based FS MRI quality was rated as diagnostic (98.9% [87/88] to 100% [88/88], all readers). Diagnostic performance (sensitivity/specificity) of the synthetic protocol was high, for tears of the menisci (91% [71/78], 86% [84/98]), cruciate ligaments (92% [12/13], 98% [160/163]), collateral ligaments (80% [16/20], 100% [156/156]), and tendons (90% [9/10], 100% [166/166]). For cartilage defects and bone marrow abnormalities, the synthetic protocol offered an overall sensitivity/specificity of 77% (170/221)/93% (287/307) and 76% (95/125)/90% (443/491), respectively. Intermethod agreement ranged from moderate to substantial for almost all evaluated structures (menisci, cruciate ligaments, collateral ligaments, and bone marrow abnormalities). No significant difference was observed between methods for all structural abnormalities by all readers (P > 0.05), except for cartilage assessment. Interobserver agreement ranged from moderate to substantial for almost all evaluated structures. Original and synthetic protocols were interchangeable for the diagnosis of all evaluated structures. There was no significant difference for the common exact match proportions for all combinations (P > 0.01). The conspicuity of all tissues assessed through contrast-to-noise rate was higher on AFSMRI than on original FSPD images (P < 0.05). CONCLUSIONS Artificial intelligence-based FS MRI (3D AFSMRI) is feasible and offers a method for fast imaging, with similar detection rates for structural abnormalities of the knee, compared with original 3D MR sequences.
Collapse
Affiliation(s)
- Laura M. Fayad
- The Russell H. Morgan Department of Radiology & Radiological Science, The Johns Hopkins Medical Institutions MD, USA
| | - Vishwa S. Parekh
- The Russell H. Morgan Department of Radiology & Radiological Science, The Johns Hopkins Medical Institutions MD, USA
- Department of Computer Science, The Johns Hopkins University, Baltimore, MD, USA
| | - Rodrigo de Castro Luna
- The Russell H. Morgan Department of Radiology & Radiological Science, The Johns Hopkins Medical Institutions MD, USA
| | - Charles C. Ko
- The Russell H. Morgan Department of Radiology & Radiological Science, The Johns Hopkins Medical Institutions MD, USA
| | - Dharmesh Tank
- The Russell H. Morgan Department of Radiology & Radiological Science, The Johns Hopkins Medical Institutions MD, USA
| | - Jan Fritz
- The Russell H. Morgan Department of Radiology & Radiological Science, The Johns Hopkins Medical Institutions MD, USA
- Department of Radiology, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA
| | - Shivani Ahlawat
- The Russell H. Morgan Department of Radiology & Radiological Science, The Johns Hopkins Medical Institutions MD, USA
| | - Michael A. Jacobs
- The Russell H. Morgan Department of Radiology & Radiological Science, The Johns Hopkins Medical Institutions MD, USA
- Sidney Kimmel Comprehensive Cancer Center., The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| |
Collapse
|
15
|
Luna R, Fritz J, Del Grande F, Ahlawat S, Fayad LM. Determination of skeletal tumor extent: is an isotropic T1-weighted 3D sequence adequate? Eur Radiol 2020; 31:3138-3146. [PMID: 33179165 DOI: 10.1007/s00330-020-07394-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 10/08/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To test the hypothesis that an accelerated, T1-weighted 3D CAIPIRINHA SPACE sequence with isotropic voxel size offers a similar performance to conventional T1-weighted 2D TSE (turbo spin echo) for the evaluation of bone tumor extent and characteristics. METHODS Thirty-four patients who underwent 3-T MRI with 3DT1 (CAIPIRINHA SPACE TSE) and 2DT1 (TSE) were included. Sequence acquisition time was reported. Two radiologists independently evaluated each technique for tumor location, size/length, tumor-to-joint distance, signal intensity, margin/extraosseous extension, and signal-to-noise (SNR) and contrast-to-noise (CNR) ratios. RESULTS Tumors were located in long (20/36, 55.5%) and pelvic (16/36, 44.4%) bones. 3DT1 sequence required an average acquisition time of 235 s (± 42 s, range 156-372), while two plane 2DT1 sequences combined (coronal and axial) had an average acquisition time of 381 s (± 73 s, range 312-523). There was no difference in the measurements of tumor length and tumor-to-joint distance (p = 0.95) between 3DT1 and 2DT1 images. Tumors were hypointense (17/36, 47.2% vs 17/36, 47.2%), isointense (12/36, 33.3% vs 12/36, 33.3%), or hyperintense (7/36, 19.4% vs 7/36, 19.4%) on 3DT1 vs 2DT1, respectively. Assessment of tumor margins and extraosseous extension was similar, and there was no difference in tumor SNR or CNR (p > 0.05). CONCLUSIONS An accelerated 3D CAIPIRINHA SPACE T1 sequence provides comparable assessments of intramedullary bone tumor extent and similar tumor characteristics to conventional 2DT1 MRI. For the assessment of bone tumors, the isotropic volume acquisition and multiplanar reformation capability of the 3DT1 datasets can obviate the need for 2DT1 acquisitions in multiple planes. KEY POINTS • 3DT1 offers an equivalent performance to 2DT1 for the assessment of bone tumor characteristics, with faster and higher resolution capability, obviating the need for acquiring 2DT1 in multiple planes. • There was no difference in the measurements of tumor length and tumor-to-joint distance obtained on 3DT1 and 2DT1 images. • There was no difference in signal-to-noise ratio (SNR) or contrast-to-noise ratio (CNR) measures between 3DT1 and 2DT1.
Collapse
Affiliation(s)
- Rodrigo Luna
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA
| | - Jan Fritz
- Grossman School of Medicine, NYU Langone Health, 550 First Avenue, New York, NY, 10016, USA
| | - Filippo Del Grande
- Servizio si Radiologia del Sottoceneri, Ospedale Regionale di Lugano, Lugano, Ticino, Switzerland
| | - Shivani Ahlawat
- Division of Musculoskeletal Imaging, The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA
| | - Laura M Fayad
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA.
| |
Collapse
|
16
|
Pagliano S, Chemouni D, Guggenberger R, Pauly V, Guenoun D, Champsaur P, Le Corroller T. Flat-panel CT arthrography for cartilage defect detection in the ankle joint: first results in vivo. Skeletal Radiol 2020; 49:1259-1265. [PMID: 32146486 DOI: 10.1007/s00256-020-03398-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 02/06/2020] [Accepted: 02/11/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVES The purpose of this study was to compare the diagnostic performance of flat-panel computed tomography (FPCT) arthrography for cartilage defect detection in the ankle joint to direct magnetic resonance (MR) arthrography using multidetector computed tomography (MDCT) arthrography as the reference standard. METHODS Twenty-seven patients with specific suspicion of articular cartilage lesion underwent ankle arthrography with injection of a mixture of diluted gadolinium and iobitridol and were examined consecutively with the use of FPCT, MDCT, and 1.5 T MR imaging. FPCT, MDCT, and MR arthrography examinations were blinded and randomly evaluated by two musculoskeletal radiologists in consensus. In each ankle, eight articular cartilage areas were assessed separately: medial talar surface, medial talar trochlea, lateral talar trochlea, lateral talar surface, tibial malleolus, medial tibial plafond, lateral tibial plafond, and fibular malleolus. Findings at FPCT and MR were compared with MDCT assessments in 216 cartilage areas. RESULTS For the detection of cartilage defects, FPCT demonstrated a sensitivity of 97%, specificity of 95%, and accuracy of 96%; and MR arthrography showed a sensitivity of 69%, specificity of 94%, and accuracy of 87%. FPCT and MR arthrography presented almost perfect agreement (κ = 0.87) and moderate agreement (κ = 0.60), respectively, with MDCT arthrography. Mean diagnostic confidence was higher for FPCT (2.9/3) than for MR (2.3/3) and MDCT (2.7/3) arthrography. CONCLUSIONS FPCT demonstrated better accuracy than did 1.5 T MR arthrography for cartilage defect detection in the ankle joint. Therefore, FPCT should be considered in patients scheduled for dedicated imaging of ankle articular cartilage.
Collapse
Affiliation(s)
- Sarah Pagliano
- Radiology Department, APHM, Marseille, France.,CNRS, ISM UMR 7287, Aix-Marseille Université, Marseille, France
| | | | - Roman Guggenberger
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland
| | - Vanessa Pauly
- Unité de Recherche EA3279, Santé Publique et Maladies Chroniques: Qualité de vie Concepts, Usages et Limites, Déterminants, Aix-Marseille Université, Marseille, France
| | - Daphné Guenoun
- Radiology Department, APHM, Marseille, France.,CNRS, ISM UMR 7287, Aix-Marseille Université, Marseille, France
| | - Pierre Champsaur
- Radiology Department, APHM, Marseille, France.,CNRS, ISM UMR 7287, Aix-Marseille Université, Marseille, France
| | - Thomas Le Corroller
- Radiology Department, APHM, Marseille, France. .,CNRS, ISM UMR 7287, Aix-Marseille Université, Marseille, France.
| |
Collapse
|
17
|
3D MRI evaluation of morphological characteristics of lateral ankle ligaments in injured patients and uninjured controls. J Orthop Sci 2020; 25:183-187. [PMID: 30885728 DOI: 10.1016/j.jos.2019.02.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 02/19/2019] [Accepted: 02/22/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND With ultrasonography or 2D magnetic resonance imaging (MRI) of the lateral ankle ligament, it is particularly difficult to show the entire calcaneofibular ligament (CFL). The purpose of this study was to evaluate the morphological characteristics of the lateral ankle ligaments in injured patients and uninjured controls using 3D MRI. METHODS A total of 64 ankles of 59 healthy volunteers and lateral ligament injury patients (mean age of 32.4 years) were examined. The 64 ankles included a healthy group of 11 ankles, an acute injury group of 12 ankles that underwent MRI a month after injury, and a chronic injury group of 41 ankles that underwent MRI more than 3 months after injury. Using a 3.0-T MRI system, imaging was done with fast imaging employing steady-state acquisition cycled phases. Oblique sagittal images that most clearly depicted the entire anterior talofibular ligament (ATFL) and CFL were prepared manually and evaluated using a workstation. RESULTS In the healthy group, both the ATFL and CFL were clearly and entirely visualized. The mean width in the central portion was 4.0 ± 1.0 mm in the ATFL and 4.8 ± 0.6 mm in the CFL. 3D MRI in the acute injury group showed findings of diffuse swelling with hyperintensity in the ATFL of all patients. The CFL in 7 of 12 ankles showed findings of diffuse swelling with hyperintensity. In the chronic injury group, morphological abnormalities of the ATFL were seen in 19 of 41 ankles. The ligament signal disappeared in 2 ankles, thinned in 4 ankles, and showed swelling in 13 ankles. Morphological abnormalities of the CFL were seen in 17 of 41 ankles. The ligament signal disappeared in 1 ankle, thinned in 2 ankles, and showed swelling in 14 ankles. CONCLUSION 3D MRI may be a useful modality to visualize both the ATFL and the CFL.
Collapse
|
18
|
Gersing AS, Bodden J, Neumann J, Diefenbach MN, Kronthaler S, Pfeiffer D, Knebel C, Baum T, Schwaiger BJ, Hock A, Rummeny EJ, Woertler K, Karampinos DC. Accelerating anatomical 2D turbo spin echo imaging of the ankle using compressed sensing. Eur J Radiol 2019; 118:277-284. [DOI: 10.1016/j.ejrad.2019.06.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 05/11/2019] [Accepted: 06/10/2019] [Indexed: 11/27/2022]
|
19
|
Gersing AS, Schwaiger BJ, Wörtler K, Jungmann PM. [Advanced cartilage imaging for detection of cartilage injuries and osteochondral lesions]. Radiologe 2019; 58:422-432. [PMID: 29374314 DOI: 10.1007/s00117-017-0348-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Osteochondral defects represent a main risk factor for osteoarthritis of the ankle. OBJECTIVES The aim of this article is to provide an overview of current optimal clinical cartilage imaging techniques of the foot and ankle and to show typical osteochondral injuries on imaging. MATERIALS AND METHODS A thorough literature search was performed and was supported by personal experience. RESULTS Cartilage imaging of the foot and ankle remains challenging. However, advanced morphological and quantitative magnetic resonance (MR) imaging techniques may provide useful clinical information, for example, concerning cartilage repair surgery. Compared to MRI, MR arthrography (MR-A) and CT arthrography (CT-A) have higher sensitivity with respect to detection of osteochondral defects. Regarding smaller joints of the foot, mainly advanced osteoarthritic changes are detected on conventional radiography; only in rare cases, MR and CT imaging of these smaller joints is of relevance. CONCLUSIONS While at the smaller joints of the foot cartilage imaging only plays a minor role, at the ankle joint cross-sectional cartilage imaging using CT and MRI becomes more and more important for clinicians due to emerging therapeutic options, such as different osteochondral repair techniques.
Collapse
Affiliation(s)
- A S Gersing
- Institut für diagnostische und interventionelle Radiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland
| | - B J Schwaiger
- Institut für diagnostische und interventionelle Radiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland
| | - K Wörtler
- Institut für diagnostische und interventionelle Radiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland
| | - P M Jungmann
- Institut für diagnostische und interventionelle Radiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland. .,Klinik für Neuroradiologie, UniversitätsSpital Zürich, Universität Zürich, Frauenklinikstrasse 10, 8091, Zürich, Schweiz.
| |
Collapse
|
20
|
|
21
|
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
|
22
|
Yi J, Lee YH, Hahn S, Albakheet SS, Song HT, Suh JS. Fast isotropic volumetric magnetic resonance imaging of the ankle: Acceleration of the three-dimensional fast spin echo sequence using compressed sensing combined with parallel imaging. Eur J Radiol 2019; 112:52-58. [DOI: 10.1016/j.ejrad.2019.01.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 01/05/2019] [Accepted: 01/08/2019] [Indexed: 11/26/2022]
|
23
|
CAIPIRINHA-accelerated 10-min 3D TSE MRI of the ankle for the diagnosis of painful ankle conditions: Performance evaluation in 70 patients. Eur Radiol 2018; 29:609-619. [DOI: 10.1007/s00330-018-5591-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 05/19/2018] [Accepted: 06/04/2018] [Indexed: 10/28/2022]
|
24
|
Altahawi F, Subhas N. 3D MRI in Musculoskeletal Imaging: Current and Future Applications. CURRENT RADIOLOGY REPORTS 2018. [DOI: 10.1007/s40134-018-0287-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
|
25
|
Advanced Imaging Techniques in the Knee: Benefits and Limitations of New Rapid Acquisition Strategies for Routine Knee MRI. AJR Am J Roentgenol 2017. [DOI: 10.2214/ajr.17.18228] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
|
26
|
Bae WC, Ruangchaijatuporn T, Chung CB. New Techniques in MR Imaging of the Ankle and Foot. Magn Reson Imaging Clin N Am 2017; 25:211-225. [PMID: 27888849 DOI: 10.1016/j.mric.2016.08.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Foot and ankle disorders are common in everyday clinical practice. MR imaging is frequently required for diagnosis given the variety and complexity of foot and ankle anatomy. Although conventional MR imaging plays a significant role in diagnosis, contemporary management increasingly relies on advanced imaging for monitoring therapeutic response. There is an expanding need for identification of biomarkers for musculoskeletal tissues. Advanced imaging techniques capable of imaging these tissue substrates will be increasingly used in routine clinical practice. Radiologists should therefore become familiar with these innovative MR techniques. Many such techniques are already widely used in other organ systems.
Collapse
Affiliation(s)
- Won C Bae
- Radiology Service, Veterans Affairs San Diego Healthcare System, 3350 La Jolla Village Drive, MC 114, San Diego, CA 92161, USA; Department of Radiology, UCSD MSK Imaging Research Lab, University of California, San Diego, 9427 Health Sciences Drive, La Jolla, CA 92093-0997, USA
| | - Thumanoon Ruangchaijatuporn
- Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchatewi, Bangkok 10400, Thailand
| | - Christine B Chung
- Radiology Service, Veterans Affairs San Diego Healthcare System, 3350 La Jolla Village Drive, MC 114, San Diego, CA 92161, USA; Department of Radiology, UCSD MSK Imaging Research Lab, University of California, San Diego, 9427 Health Sciences Drive, La Jolla, CA 92093-0997, USA.
| |
Collapse
|
27
|
Comprehensive Assessment of Ankle Syndesmosis Injury Using 3D Isotropic Turbo Spin-Echo Sequences: Diagnostic Performance Compared With That of Conventional and Oblique 3-T MRI. AJR Am J Roentgenol 2017; 208:827-833. [DOI: 10.2214/ajr.16.16985] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
28
|
Kalia V, Fritz B, Johnson R, Gilson WD, Raithel E, Fritz J. CAIPIRINHA accelerated SPACE enables 10-min isotropic 3D TSE MRI of the ankle for optimized visualization of curved and oblique ligaments and tendons. Eur Radiol 2017; 27:3652-3661. [DOI: 10.1007/s00330-017-4734-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 12/14/2016] [Accepted: 01/02/2017] [Indexed: 11/28/2022]
|
29
|
Park HJ, Lee SY, Choi YJ, Hong HP, Park SJ, Park JH, Kim E. 3D isotropic T2-weighted fast spin echo (VISTA) versus 2D T2-weighted fast spin echo in evaluation of the calcaneofibular ligament in the oblique coronal plane. Clin Radiol 2016; 72:176.e1-176.e7. [PMID: 27836104 DOI: 10.1016/j.crad.2016.09.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 09/02/2016] [Accepted: 09/15/2016] [Indexed: 11/30/2022]
Abstract
AIM To investigate whether the image quality of three-dimensional (3D) volume isotropic fast spin echo acquisition (VISTA) magnetic resonance imaging (MRI) of the calcaneofibular ligament (CFL) view is comparable to that of 2D fast spin echo T2-weighted images (2D T2 FSE) for the evaluation of the CFL, and whether 3D VISTA can replace 2D T2 FSE for the evaluation of CFL injuries. MATERIALS AND METHODS This retrospective study included 76 patients who underwent ankle MRI with CFL views of both 2D T2 FSE MRI and 3D VISTA. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of both techniques were measured. The anatomical identification score and diagnostic performances were evaluated by two readers independently. The diagnostic performances of 3D VISTA and 2D T2 FSE were analysed by sensitivity, specificity, and accuracy for diagnosing CFL injury with reference standards of surgically or clinically confirmed diagnoses. Surgical correlation was performed in 29% of the patients, and clinical examination was used in those who did not have surgery (71%). RESULTS The SNRs and CNRs of 3D VISTA were significantly higher than those of 2D T2 FSE. The anatomical identification scores on 3D VISTA were inferior to those on 2D T2 FSE, and the differences were statistically significant (p<0.05). There were no significant differences in diagnostic performance between the two sequences when diagnoses were classified as normal or abnormal. CONCLUSION Although the image quality of 3D VISTA MRI of the CFL view is not equal to that of 2D T2 FSE for the anatomical evaluation of CFL, 3D VISTA has a diagnostic performance comparable to that of 2D T2 FSE for the diagnosis of CFL injuries.
Collapse
Affiliation(s)
- H J Park
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - S Y Lee
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Y J Choi
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - H P Hong
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - S J Park
- Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - J H Park
- Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - E Kim
- Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| |
Collapse
|
30
|
Three-Dimensional CAIPIRINHA SPACE TSE for 5-Minute High-Resolution MRI of the Knee. Invest Radiol 2016; 51:609-17. [DOI: 10.1097/rli.0000000000000287] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
31
|
Park HJ, Lee SY, Choi SH, Ahn JH, Park SJ, Park JH, Kim E. Comparison of oblique coronal images in knee of three-dimensional isotropic T 2-weighted turbo spin echo MRI versus two-dimensional fast spin echo T 2-weighted sequences for evaluation of posterior cruciate ligament injury. Br J Radiol 2016; 89:20160554. [PMID: 27653673 DOI: 10.1259/bjr.20160554] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To compare image quality between three-dimensional volume isotropic turbo spin echo acquisition (3D VISTA) with the posterior cruciate ligament (PCL) view and two-dimensional (2D) fast spin echo (FSE) for evaluation of PCL injury. METHODS This retrospective study included 60 patients with clinical suspicion of PCL injury who underwent both 2D FSE and 3D VISTA of the knee between January 2015 and December 2015. The diagnostic performance of each oblique coronal view and the combined images was evaluated for sensitivity, specificity and accuracy for diagnosing a PCL tear. The arthroscopically confirmed diagnoses were used as the reference standard. Data were analyzed using the McNemar test. RESULTS The mean contrast-to-noise ratio was significantly higher for 3D VISTA than for 2D FSE. The two imaging modalities did not differ significantly in anatomical identification ability, with the exception of margin sharpness, which was inferior for 3D VISTA with Reader 2 (p = 0.038). When we classified the diagnoses of PCL injury as normal or abnormal, there were no significant differences in sensitivity, specificity or accuracy between the PCL view of 3D VISTA and 2D FSE images (p > 0.05). CONCLUSION 3D VISTA had a superior contrast-to-noise ratio than 2D FSE and similar image quality in the evaluation of the PCL. The PCL view of 3D VISTA has the same diagnostic ability as 2D FSE in the diagnosis of PCL injury and can thus replace 2D FSE. Advances in knowledge: The oblique coronal view 3D VISTA MRI has similar diagnostic ability to 2D FSE in the diagnosis of PCL injury, and therefore 3D VISTA image can replace 2D FSE.
Collapse
Affiliation(s)
- Hee J Park
- 1 Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - So Y Lee
- 1 Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seon H Choi
- 1 Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jin H Ahn
- 2 Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Se J Park
- 2 Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jai H Park
- 2 Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Eugene Kim
- 2 Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| |
Collapse
|
32
|
Weiss J, Taron J, Othman AE, Grimm R, Kuendel M, Martirosian P, Ruff C, Schraml C, Nikolaou K, Notohamiprodjo M. Feasibility of self-gated isotropic radial late-phase MR imaging of the liver. Eur Radiol 2016; 27:985-994. [DOI: 10.1007/s00330-016-4433-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 05/15/2016] [Accepted: 05/20/2016] [Indexed: 12/13/2022]
|
33
|
Fritz J, Raithel E, Thawait GK, Gilson W, Papp DF. Six-Fold Acceleration of High-Spatial Resolution 3D SPACE MRI of the Knee Through Incoherent k-Space Undersampling and Iterative Reconstruction—First Experience. Invest Radiol 2016; 51:400-9. [DOI: 10.1097/rli.0000000000000240] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
34
|
Park HJ, Lee SY, Park NH, Rho MH, Chung EC, Park JH, Park SJ. Three-dimensional isotropic T2-weighted fast spin-echo (VISTA) ankle MRI versus two-dimensional fast spin-echo T2-weighted sequences for the evaluation of anterior talofibular ligament injury. Clin Radiol 2016; 71:349-55. [PMID: 26774370 DOI: 10.1016/j.crad.2015.12.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 11/30/2015] [Accepted: 12/14/2015] [Indexed: 11/19/2022]
Abstract
AIM To compare the performance of axial images of the ankle joint on three-dimensional (3D) volume isotropic turbo spin echo acquisition (VISTA) with that of two-dimensional (2D) fast spin echo (FSE) T2-weighted images for the diagnosis of anterior talofibular ligament (ATFL) injury. MATERIALS AND METHODS This retrospective study included 101 patients who underwent both 2D FSE T2-weighted and 3D VISTA magnetic resonance imaging (MRI) of the ankle. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of both sequences were measured. The anatomical identification score and diagnostic performances of both sequences were evaluated by two radiologists. The diagnostic performances of 3D VISTA and 2D FSE images were analysed in terms of sensitivity, specificity, and accuracy for diagnosing ATFL injury. Surgically or clinically confirmed diagnoses were used as reference standards. RESULTS The margin sharpness scores on 3D VISTA were significantly inferior to those of 2D FSE (p<0.001). Other scores (entire length, entire width) were not significantly different between the two imaging methods. The SNRs and CNRs of 3D VISTA were significantly higher than those of 2D FSE (p<0.001). When diagnoses were classified as normal and abnormal, the specificity of the 3D VISTA images for the diagnosis of ATFL injury was 95.7%, significantly superior to 2D FSE (84.3-85.7%). There were no significant differences between 3D VISTA and 2D FSE images in sensitivity or accuracy for diagnosis (p=0.227-1.000), with the exception of accuracy by reader 1 (p=0.039). CONCLUSION 3D VISTA imaging has a diagnostic performance comparable to that of 2D FSE for the diagnosis of ATFL injury, although 3D VISTA is inferior to 2D FSE for the evaluation of margin sharpness. Replacing axial and coronal images with 3D VISTA can save imaging time without negatively impacting the diagnostic ability for ATFL injury.
Collapse
Affiliation(s)
- H J Park
- Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Republic of Korea
| | - S Y Lee
- Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Republic of Korea
| | - N H Park
- Department of Radiology, Myongji Hospital, Seonam University College of Medicine, Republic of Korea.
| | - M H Rho
- Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Republic of Korea
| | - E C Chung
- Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Republic of Korea
| | - J H Park
- Department of Orthopaedic Surgery, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Republic of Korea
| | - S J Park
- Department of Orthopaedic Surgery, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Republic of Korea
| |
Collapse
|
35
|
Sodium magnetic resonance imaging of ankle joint in cadaver specimens, volunteers, and patients after different cartilage repair techniques at 7 T: initial results. Invest Radiol 2015; 50:246-54. [PMID: 25436618 DOI: 10.1097/rli.0000000000000117] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES The goal of cartilage repair techniques such as microfracture (MFX) or matrix-associated autologous chondrocyte transplantation (MACT) is to produce repair tissue (RT) with sufficient glycosaminoglycan (GAG) content. Sodium magnetic resonance imaging (MRI) offers a direct and noninvasive evaluation of the GAG content in native cartilage and RT. In the femoral cartilage, this method was able to distinguish between RTs produced by MFX and MACT having different GAG contents. However, it needs to be clarified whether sodium MRI can be useful for evaluating RT in thin ankle cartilage. Thus, the aims of this 7-T study were (1) to validate our sodium MRI protocol in cadaver ankle samples, (2) to evaluate the sodium corrected signal intensities (cSI) in cartilage of volunteers, (3) and to compare sodium values in RT between patients after MFX and MACT treatment. MATERIALS AND METHODS Five human cadaver ankle samples as well as ankles of 9 asymptomatic volunteers, 6 MFX patients and 6 MACT patients were measured in this 7-T study. Sodium values from the ankle samples were compared with histochemically evaluated GAG content. In the volunteers, sodium cSI values were calculated in the cartilages of ankle and subtalar joint. In the patients, sodium cSI in RT and reference cartilage were measured, morphological appearance of RT was evaluated using the magnetic resonance observation of cartilage repair tissue (MOCART) scoring system, and clinical outcome before and after surgery was assessed using the American Orthopaedic Foot and Ankle Society score and Modified Cincinnati Knee Scale. All regions of interest were defined on morphological images and subsequently transferred to the corresponding sodium images. Analysis of variance, t tests, and Pearson correlation coefficients were evaluated. RESULTS In the patients, significantly lower sodium cSI values were found in RT than in reference cartilage for the MFX (P = 0.007) and MACT patients (P = 0.008). Sodium cSI and MOCART scores in RT did not differ between the MFX and MACT patients (P = 0.185). No significant difference in sodium cSI was found between reference cartilage of the volunteers and the patients (P = 0.355). The patients showed significantly higher American Orthopaedic Foot and Ankle Society and Modified Cincinnati scores after treatment than they did before treatment. In the volunteers, sodium cSI was significantly higher in the tibial cartilage than in the talar cartilage of ankle joint (P = 0.002) and in the talar cartilage than in the calcaneal cartilage of subtalar joint (P < 0.001). Data from the cadaver ankle samples showed a strong linear relationship between the sodium values and the histochemically determined GAG content (r = 0.800; P < 0.001; R = 0.639). CONCLUSIONS This study demonstrates the feasibility of in vivo quantification of sodium cSI, which can be used for GAG content evaluation in thin cartilages of ankle and subtalar joints at 7 T. A strong correlation observed between the histochemically evaluated GAG content and the sodium values proved the sufficient sensitivity of sodium MRI to changes in the GAG content of cartilages in the ankle. Both MFX and MACT produced RT with lower sodium cSI and, thus, of lower quality compared with reference cartilage in the patients or in the volunteers. Our results suggest that MFX and MACT produce RT with similar GAG content and similar morphological appearance in patients with similar surgery outcome. Sodium MRI at 7 T allows a quantitative evaluation of RT quality in the ankle and may thus be useful in the noninvasive assessment of new cartilage repair procedures.
Collapse
|
36
|
Feasibility of CAIPIRINHA-Dixon-TWIST-VIBE for dynamic contrast-enhanced MRI of the prostate. Eur J Radiol 2015; 84:2110-6. [DOI: 10.1016/j.ejrad.2015.08.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Accepted: 08/19/2015] [Indexed: 11/22/2022]
|
37
|
Diagnostic performance of flat-panel CT arthrography for cartilage defect detection in the ankle joint: comparison with MDCT arthrography with gross anatomy as the reference standard. AJR Am J Roentgenol 2015; 203:1069-74. [PMID: 25341147 DOI: 10.2214/ajr.13.12163] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The purpose of this study is to compare the diagnostic performance and radiation exposure of flat-panel CT arthrography for cartilage defect detection in the ankle joint to standard MDCT arthrography, using gross anatomy and thermoluminescent dosimetry as reference standards. MATERIALS AND METHODS Ten cadaveric ankle specimens were obtained from individuals who had willed their bodies to science. Five milliliters of a mixture of diluted ioxaglate and saline were injected. Specimens were examined consecutively with the use of flat-panel CT and MDCT. Radiation doses of flat-panel CT and MDCT were recorded using thermoluminescent dosimeters. Flat-panel CT and MDCT arthrography examinations were blinded and randomly evaluated by two musculoskeletal radiologists in consensus. In each ankle specimen, eight cartilage areas were assessed separately: medial talar surface, medial talar trochlea, lateral talar trochlea, lateral talar surface, tibial malleolus, medial tibial pla-fond, lateral tibial plafond, and fibular malleolus. Findings at flat-panel CT and MDCT arthrography were compared with macroscopic assessments in 80 cartilage areas. RESULTS For the detection of cartilage lesions, flat-panel CT showed a sensitivity of 80%, specificity of 98%, and accuracy of 94%, and MDCT arthrography showed a sensitivity of 55%, specificity of 98%, and accuracy of 88%. Flat-panel CT and MDCT arthrography showed almost perfect (κ = 0.83) and substantial (κ = 0.65) agreement, respectively, with anatomic examination. Radiation dose was significantly lower for flat-panel CT (mean, 2.1 mGy; range, 1.1-3.0 mGy) than for MDCT (mean, 47.2 mGy; range, 39.3-53.8 mGy) (p < 0.01). CONCLUSION Flat-panel CT arthrography is accurate for detecting cartilage defects in the ankle joint and is an alternative to MDCT arthrography that may have better diagnostic performance and may permit the use of a lower radiation dose.
Collapse
|
38
|
Kloth JK, Winterstein M, Akbar M, Meyer E, Paul D, Kauczor HU, Weber MA. Comparison of 3D turbo spin-echo SPACE sequences with conventional 2D MRI sequences to assess the shoulder joint. Eur J Radiol 2014; 83:1843-9. [PMID: 25082477 DOI: 10.1016/j.ejrad.2014.06.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 05/20/2014] [Accepted: 06/16/2014] [Indexed: 11/29/2022]
Abstract
PURPOSE To determine the accuracy and reliability of three-dimensional (3D) T1- and proton density (PD)-weighted turbo spin-echo (TSE) sampling perfection with application-optimized contrasts using different flip-angle evolution (SPACE) compared with conventional 2D sequences in assessment of the shoulder-joint. MATERIALS AND METHODS Ninety-three subjects were examined on a 3-T MRI system with both conventional 2D-TSE sequences in T1-, T2- and PD-weighting and 3D SPACE sequences in T1- and PD-weighting. All examinations were assessed independently by two reviewers for common pathologies of the shoulder-joint. Agreement between 2D- and 3D-sequences and inter-observer-agreement was evaluated using kappa-statistics. RESULTS Using conventional 2D TSE sequences as standard of reference, sensitivity, specificity, and accuracy values of 3D SPACE were 81.8%, 95.1%, and 93.5% for injuries of the supraspinatus-tendon (SSP), 81.3%, 93.5%, and 91.4% for the cartilage layer and 82.4%, 98.5%, and 97.5% for the long biceps tendon. Concordance between 2D and 3D was almost perfect for tendinopathies of the SSP (κ=0.85), osteoarthritis (κ=1), luxation of the biceps tendon (κ=1) and adjacent bone marrow (κ=0.92). Inter-observer-agreement was generally higher for conventional 2D TSE sequences (κ, 0.23-1.0), when compared to 3D SPACE sequences (κ, -0.33 to 1.0) except for disorders of the long biceps tendon and supraspinatus tendon rupture. CONCLUSION Because of substantial and almost perfect concordance with conventional 2D TSE sequences for common shoulder pathologies, MRI examination-time can be reduced by nearly 40% (up to 11 min) using 3D-SPACE without loss of information.
Collapse
Affiliation(s)
- Jost Karsten Kloth
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany.
| | - Marianne Winterstein
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany.
| | - Michael Akbar
- Orthopedic and Trauma Surgery, University Hospital Heidelberg, Schlierbacher Landstraße 200a, D-69118 Heidelberg, Germany.
| | | | | | - Haus-Ulrich Kauczor
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany.
| | - Marc-André Weber
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany.
| |
Collapse
|
39
|
Mugler JP. Optimized three‐dimensional fast‐spin‐echo MRI. J Magn Reson Imaging 2014; 39:745-67. [PMID: 24399498 DOI: 10.1002/jmri.24542] [Citation(s) in RCA: 238] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 10/31/2013] [Indexed: 11/10/2022] Open
Affiliation(s)
- John P. Mugler
- Department of Radiology and Medical ImagingUniversity of Virginia School of MedicineCharlottesville Virginia USA
| |
Collapse
|
40
|
Multibanded Anterior Talofibular Ligaments in Normal Ankles and Sprained Ankles Using 3D Isotropic Proton Density–Weighted Fast Spin-Echo MRI Sequence. AJR Am J Roentgenol 2014; 202:W87-94. [DOI: 10.2214/ajr.13.10727] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
41
|
Dohan A, Gavini JP, Placé V, Sebbag D, Vignaud A, Herbin C, Hamzi L, Boudiaf M, Soyer P. T2-weighted MR imaging of the liver: Qualitative and quantitative comparison of SPACE MR imaging with turbo spin-echo MR imaging. Eur J Radiol 2013; 82:e655-61. [DOI: 10.1016/j.ejrad.2013.07.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Revised: 07/18/2013] [Accepted: 07/23/2013] [Indexed: 11/17/2022]
|
42
|
A historical overview of magnetic resonance imaging, focusing on technological innovations. Invest Radiol 2013; 47:725-41. [PMID: 23070095 DOI: 10.1097/rli.0b013e318272d29f] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Magnetic resonance imaging (MRI) has now been used clinically for more than 30 years. Today, MRI serves as the primary diagnostic modality for many clinical problems. In this article, historical developments in the field of MRI will be discussed with a focus on technological innovations. Topics include the initial discoveries in nuclear magnetic resonance that allowed for the advent of MRI as well as the development of whole-body, high field strength, and open MRI systems. Dedicated imaging coils, basic pulse sequences, contrast-enhanced, and functional imaging techniques will also be discussed in a historical context. This article describes important technological innovations in the field of MRI, together with their clinical applicability today, providing critical insights into future developments.
Collapse
|
43
|
Zhang S, Zhao C, Xia B, Zhu D, Qiu B, Gu H, Hong J, Bi Q. FS-3D-FISP for the diagnosis of ankle impingement syndrome and the evaluation of clinical outcomes of arthroscopic surgery. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2013; 23:839-42. [PMID: 23412210 DOI: 10.1007/s00590-012-1078-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Accepted: 08/25/2012] [Indexed: 11/30/2022]
Abstract
This study aimed to assess the diagnostic value of three types of MRI sequences and to observe the clinical outcomes of arthroscopy surgery for ankle joint impingement syndrome. Ankle joint impingement syndrome was confirmed by FSE-T2WI, FSE-PDWI, and FS-3D-FISP MRI in 23 patients with arthroscopically proven ankle impingement. All 23 patients underwent arthroscopic surgery and the ankle joint function was evaluated before, 1 week after and 6 months after the operation. The patients were followed-up for 12-64 months (average 28 months). There was no significant difference in ankle function score between preoperatively and 1 week postoperatively, but 86.96 % patients got overall excellent or good scores 6 months after the surgery, significantly higher than before the surgery. The FS-3D-FISP MRI exhibited a good consistency with arthroscopic examination and had higher sensitivity and specificity for the diagnosis of ankle impingement than FSE-T2WI and FSE-PDWI. In summary, arthroscopy surgery for ankle impingement syndrome has several advantages such as good efficacy, minimal trauma, quick recovery, and much less complications. The preoperative FS-3D-FISP MRI allows accurate diagnosis and positioning of ankle impingement syndrome.
Collapse
Affiliation(s)
- Shuijun Zhang
- Department of Orthopedics and Joint Surgery, Zhejiang Provincial People's Hospital, Hangzhou, 310014, China
| | | | | | | | | | | | | | | |
Collapse
|
44
|
Roemer FW, Guermazi A. Osteoarthritis year 2012 in review: imaging. Osteoarthritis Cartilage 2012; 20:1440-6. [PMID: 22824160 DOI: 10.1016/j.joca.2012.07.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2012] [Accepted: 07/03/2012] [Indexed: 02/02/2023]
Abstract
PURPOSE This article reviews original publications related to imaging in osteoarthritis (OA) published in English from September 2011 through March 2012. In vitro data and animal studies are not covered. METHODS To extract relevant studies, an extensive PubMed database search was performed using the query terms "osteoarthritis" in combination with "MRI", "imaging", "radiography", "ultrasound", "computed tomography" and "nuclear medicine". Publications were sorted according to relevance based on potential impact to the OA research community with the over all goal of a balanced overview of all aspects of imaging. Focus was on publications in high-impact special-interest journals. The literature will be presented by topics covering radiography, morphologic magnetic resonance imaging (MRI), compositional and high-field MRI, quantitative MRI, ultrasound, other joints and systematic reviews. Original research that was presented as a podium or poster presentation at osteoarthritis research society international (OARSI) 2012 will not be included. RESULTS AND CONCLUSIONS For the search topics "MRI" and "osteoarthritis" a decrease in overall publications was observed over the 6 months following September 2011 when compared to the previous 6 months (-38.1%). For the terms "radiography" and "osteoarthritis" a decrease of 56.9% was noted. The 6 months since the last OARSI conference were characterized by several MRI-based studies dealing with epidemiologic and methodologic aspects of disease. Other modalities such as radiography or ultrasound received much less attention. Most imaging research is still concentrated on the knee although interest in other sites, especially the hand, has increased since the last OARSI meeting.
Collapse
Affiliation(s)
- Frank W Roemer
- Quantitative Imaging Center (QIC), Department of Radiology, Boston University School of Medicine, Boston, MA, USA.
| | | |
Collapse
|