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Zhang X, Wang Y, Xu X, Hu M, Wang S, Chen Y, Zhao X. Prospective Comparison of 2D and 3D T2-Weighted Imaging in Multiparametric MRI for Assessing Muscle Invasion Accuracy Using VI-RADS in Bladder Cancer. Acad Radiol 2024:S1076-6332(24)00437-9. [PMID: 39043518 DOI: 10.1016/j.acra.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/24/2024] [Accepted: 07/02/2024] [Indexed: 07/25/2024]
Abstract
RATIONALE AND OBJECTIVES T2-weighted imaging (T2WI) is an essential sequence for assessing the staging of bladder cancer. This study aimed to compare the image quality and diagnostic performance of three-dimensional (3D) and two-dimensional (2D) T2WI in diagnosing muscle invasion of bladder cancer using Vesical Imaging Reporting and Data System (VI-RADS). MATERIALS AND METHODS Between August 2022 and May 2023, 101 participants with bladder cancer underwent multiparametric MRI including 3D and 2D T2WI. Two radiologists independently reviewed 2D and 3D T2WI, evaluating image quality and muscle invasion based on VI-RADS scoring. The paired Wilcoxon signed-rank test assessed the differences between 2D and 3D T2WI. The areas under the receiver operating characteristic curve (AUCs) were utilized to compare the diagnostic performance. RESULTS 3D T2WI demonstrated significantly superior overall image quality scores with less artifacts than 2D T2WI. Compared to 2D T2WI, 3D T2WI categories had significantly higher AUC for both readers (reader 1: 0.937 vs. 0.909, p = .02; reader 2: 0.923 vs.0.884, p = .04). The VI-RADS score of 3D MR protocol had higher accuracy than 2D MR protocol (reader 1: 0.931 vs. 0.921, p = .02; reader 2: 0.931 vs. 0.911, p = .02). However, there were no significant differences in AUC values of VI-RADS categories between 2D and 3D MR protocol (all p > 0.05). CONCLUSION In assessing muscle invasion of bladder cancer, 3D T2WI exhibited superior overall image quality and diagnostic performance than 2D T2WI. However, 3D T2WI did not significantly improve the diagnostic performance of VI-RADS.
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Affiliation(s)
- Xinxin Zhang
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China (X.Z., Y.W., X.X., M.H., Y.C., X.Z.)
| | - Yichen Wang
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China (X.Z., Y.W., X.X., M.H., Y.C., X.Z.)
| | - Xiaojuan Xu
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China (X.Z., Y.W., X.X., M.H., Y.C., X.Z.)
| | - Mancang Hu
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China (X.Z., Y.W., X.X., M.H., Y.C., X.Z.)
| | - Sicong Wang
- GE Healthcare, MR Research China, Tongji south road No1, Beijing 100176, China (S.W.)
| | - Yan Chen
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China (X.Z., Y.W., X.X., M.H., Y.C., X.Z.)
| | - Xinming Zhao
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China (X.Z., Y.W., X.X., M.H., Y.C., X.Z.).
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Yi J, Hahn S, Lee HJ, Lee Y, Bang JY, Kim Y, Lee J. Thin-slice elbow MRI with deep learning reconstruction: Superior diagnostic performance of elbow ligament pathologies. Eur J Radiol 2024; 175:111471. [PMID: 38636411 DOI: 10.1016/j.ejrad.2024.111471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/31/2024] [Accepted: 04/15/2024] [Indexed: 04/20/2024]
Abstract
PURPOSE With the slice thickness routinely used in elbow MRI, small or subtle lesions may be overlooked or misinterpreted as insignificant. To compare 1 mm slice thickness MRI (1 mm MRI) with deep learning reconstruction (DLR) to 3 mm slice thickness MRI (3 mm MRI) without/with DLR, and 1 mm MRI without DLR regarding image quality and diagnostic performance for elbow tendons and ligaments. METHODS This retrospective study included 53 patients between February 2021 and January 2022, who underwent 3 T elbow MRI, including T2-weighted fat-saturated coronal 3 mm and 1 mm MRI without/with DLR. Two radiologists independently assessed four MRI scans for image quality and artefacts, and identified the pathologies of the five elbow tendons and ligaments. In 19 patients underwent elbow surgery after elbow MRI, diagnostic performance was evaluated using surgical records as a reference standard. RESULTS For both readers, 3 mm MRI with DLR had significant higher image quality scores than 3 mm MRI without DLR and 1 mm MRI with DLR (all P < 0.01). For common extensor tendon and elbow ligament pathologies, 1 mm MRI with DLR showed the highest number of pathologies for both readers. The 1 mm MRI with DLR had the highest kappa values for all tendons and ligaments. For reader 1, 1 mm MRI with DLR showed superior diagnostic performance than 3 mm MRI without/with DLR. For reader 2, 1 mm MRI with DLR showed the highest diagnostic performance; however, there was no significant difference. CONCLUSIONS One mm MRI with DLR showed the highest diagnostic performance for evaluating elbow tendon and ligament pathologies, with similar subjective image qualities and artefacts.
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Affiliation(s)
- Jisook Yi
- Department of Radiology, Inje University College of Medicine, Haeundae Paik Hospital, 875 Haeundae-ro, Haeundae-gu, Busan 48108, Republic of Korea
| | - Seok Hahn
- Department of Radiology, Inje University College of Medicine, Haeundae Paik Hospital, 875 Haeundae-ro, Haeundae-gu, Busan 48108, Republic of Korea.
| | - Ho-Joon Lee
- Department of Radiology, Inje University College of Medicine, Haeundae Paik Hospital, 875 Haeundae-ro, Haeundae-gu, Busan 48108, Republic of Korea
| | - Yedaun Lee
- Department of Radiology, Inje University College of Medicine, Haeundae Paik Hospital, 875 Haeundae-ro, Haeundae-gu, Busan 48108, Republic of Korea
| | - Jin-Young Bang
- Department of Orthopaedic Surgery, Inje University College of Medicine, Haeundae Paik Hospital, 875 Haeundae-ro, Haeundae-gu, Busan 48108, Republic of Korea
| | - Youngbok Kim
- Department of Orthopaedic Surgery, Inje University College of Medicine, Haeundae Paik Hospital, 875 Haeundae-ro, Haeundae-gu, Busan 48108, Republic of Korea
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Chen X, You M, Liao K, Zhang M, Wang L, Zhou K, Chen G, Li J. Quantitative Magnetic Resonance Imaging Had Greater Sensitivity in Diagnosing Chondral Lesions of the Knee: A Systematic Review and Meta-Analysis. Arthroscopy 2024:S0749-8063(24)00091-4. [PMID: 38336108 DOI: 10.1016/j.arthro.2024.01.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 01/21/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024]
Abstract
PURPOSE To investigate the accuracy and reliability of magnetic resonance imaging (MRI) in identifying and grading chondral lesions and explore the optimal imaging technique to image cartilage. METHOD A comprehensive search was conducted on Medline, Embase, and Cochrane Library. Eligible cohort studies published before August 2022 were included. The study reports used MRI to diagnose and grade cartilage lesions, with intraoperative findings as the reference standard. Summary estimates of diagnostic performance were obtained. The reliability of MRI interpretation was summarized. Subgroup analyses were performed based on assessed imaging techniques, field strength, and joint surface. RESULTS Forty-three trials and 3,706 patients were included in the systematic review. The overall area under curve for hierarchical summarized receiver operating characteristics was 0.91 (95% confidence interval [CI] 0.88-0.93). The pooled sensitivity for quantitative MRI, 3-dimensional MRI, and 2-dimensional MRI was 0.82 (95% CI 0.64-0.92), 0.79 (95% CI 0.74-0.83), and 0.63 (95% CI 0.51-0.73), respectively. The pooled sensitivity of 3 Tesla (3T), 1.5 Tesla (1.5T), and <1.5 Tesla MRI was 0.79 (95% CI 0.72-0.85), 0.67 (95% CI 0.60-0.74), and 0.55 (95% CI 0.39-0.71), respectively. There were differences in interobserver consistency across different studies. CONCLUSIONS In general, MRI had high specificity in discriminating normal cartilage, but its sensitivity for identifying chondral lesions is less optimal. Further analysis showed that quantitative MRI, 3D MRI, and 3T MRI demonstrate greater sensitivity compared with 2D MRI, 1.5T MRI, and <1.5 Tesla MRI. LEVEL OF EVIDENCE Level III, systematic review of Level II-III studies.
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Affiliation(s)
- Xi Chen
- Sports Medicine Center, West China Hospital, West Chian School of Medicine, Sichuan University, Chengdu, Sichuan, China; Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Mingke You
- Sports Medicine Center, West China Hospital, West Chian School of Medicine, Sichuan University, Chengdu, Sichuan, China; Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Kai Liao
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | | | - Lingcheng Wang
- Sports Medicine Center, West China Hospital, West Chian School of Medicine, Sichuan University, Chengdu, Sichuan, China; Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Kai Zhou
- Sports Medicine Center, West China Hospital, West Chian School of Medicine, Sichuan University, Chengdu, Sichuan, China; Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Gang Chen
- Sports Medicine Center, West China Hospital, West Chian School of Medicine, Sichuan University, Chengdu, Sichuan, China; Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jian Li
- Sports Medicine Center, West China Hospital, West Chian School of Medicine, Sichuan University, Chengdu, Sichuan, China; Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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Omoumi P, Mourad C, Ledoux JB, Hilbert T. Morphological assessment of cartilage and osteoarthritis in clinical practice and research: Intermediate-weighted fat-suppressed sequences and beyond. Skeletal Radiol 2023; 52:2185-2198. [PMID: 37154871 PMCID: PMC10509097 DOI: 10.1007/s00256-023-04343-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/28/2023] [Accepted: 04/10/2023] [Indexed: 05/10/2023]
Abstract
Magnetic resonance imaging (MRI) is widely regarded as the primary modality for the morphological assessment of cartilage and all other joint tissues involved in osteoarthritis. 2D fast spin echo fat-suppressed intermediate-weighted (FSE FS IW) sequences with a TE between 30 and 40ms have stood the test of time and are considered the cornerstone of MRI protocols for clinical practice and trials. These sequences offer a good balance between sensitivity and specificity and provide appropriate contrast and signal within the cartilage as well as between cartilage, articular fluid, and subchondral bone. Additionally, FS IW sequences enable the evaluation of menisci, ligaments, synovitis/effusion, and bone marrow edema-like signal changes. This review article provides a rationale for the use of FSE FS IW sequences in the morphological assessment of cartilage and osteoarthritis, along with a brief overview of other clinically available sequences for this indication. Additionally, the article highlights ongoing research efforts aimed at improving FSE FS IW sequences through 3D acquisitions with enhanced resolution, shortened examination times, and exploring the potential benefits of different magnetic field strengths. While most of the literature on cartilage imaging focuses on the knee, the concepts presented here are applicable to all joints. KEY POINTS: 1. MRI is currently considered the modality of reference for a "whole-joint" morphological assessment of osteoarthritis. 2. Fat-suppressed intermediate-weighted sequences remain the keystone of MRI protocols for the assessment of cartilage morphology, as well as other structures involved in osteoarthritis. 3. Trends for further development in the field of cartilage and joint imaging include 3D FSE imaging, faster acquisition including AI-based acceleration, and synthetic imaging providing multi-contrast sequences.
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Affiliation(s)
- Patrick Omoumi
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
| | - Charbel Mourad
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Department of Diagnostic and Interventional Radiology, Hôpital Libanais Geitaoui CHU, Achrafieh, Beyrouth, Lebanon
| | - Jean-Baptiste Ledoux
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Tom Hilbert
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Advanced Clinical Imaging Technology, Siemens Healthineers International AG, Lausanne, Switzerland
- LTS5, École Polytechnique FÉdÉrale de Lausanne (EPFL), Lausanne, Switzerland
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Zhang S, Guo Q, Yang Y, Feng H, Zhao Y, Guo P, Li D, Du X, Song Q. Feasibility Study of 3D FACT and IVIM Sequences in the Evaluation of Female Osteoporosis. Bioengineering (Basel) 2023; 10:710. [PMID: 37370641 DOI: 10.3390/bioengineering10060710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/06/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND The aim of this study is to search for the predictive value of 3D fat analysis and calculation technique (FACT) and intravoxel incoherent motion (IVIM) parameters in identifying osteoporosis in women. METHODS We enrolled 48 female subjects who underwent 3.0 T MRI, including 3D FACT and IVIM sequences. Bone mineral density (BMD) values and Fracture Risk Assessment (FRAX) scores were obtained. Proton density fat fraction (PDFF) in the bone marrow and the real diffusion (D) value of intervertebral discs were measured on 3D FACT and IVIM images, respectively. Accuracy and bias were assessed by linear regression analysis and Bland-Altman plots. Intraclass correlation coefficients were used to assess the measurements' reproducibility. Spearman's rank correlation was applied to explore the correlation. MRI-based parameters were tested for significant differences among the three groups using ANOVA analyses. A receiver operating characteristic (ROC) analysis was performed. RESULTS The PDFF of the vertebral body showed a negative correlation with BMD (R = -0.393, p = 0.005) and a positive correlation with the FRAX score (R = 0.706, p < 0.001). The D value of intervertebral discs showed a positive correlation with BMD (R = 0.321, p = 0.024) and a negative correlation with the FRAX score (R = -0.334, p = 0.019). The area under the curve values from the ROC analysis showed that the 3D FACT and IVIM sequences could accurately differentiate between normal and osteoporosis (AUC = 0.88 using the PDFF; AUC = 0.77 using the D value). The PDFF value demonstrated a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 78.6%, 89.5%, 84.6%, and 85.0%, respectively, in its ability to predict osteoporosis. The D value had a sensitivity, specificity, PPV, and NPV of 63.16%, 92.9%, 65.0%, and 77.8%, respectively, for predicting osteoporosis. CONCLUSIONS The 3D FACT- and IVIM-measured PDFF and D values are promising biomarkers in the assessment of bone quality and fracture risk.
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Affiliation(s)
- Shuo Zhang
- Department of Nuclear Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Qianrui Guo
- Department of Nuclear Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Yang Yang
- Beijing United Imaging Research Institute of Intelligent Imaging, Beijing 100094, China
| | - Hongbo Feng
- Department of Nuclear Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Yan Zhao
- Department of Information Center, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Peng Guo
- Department of Nuclear Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Di Li
- Department of Nuclear Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Xuemei Du
- Department of Nuclear Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Qingwei Song
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
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Park HY, Suh CH, Kim SO. Use of "Diagnostic Yield" in Imaging Research Reports: Results from Articles Published in Two General Radiology Journals. Korean J Radiol 2022; 23:1290-1300. [PMID: 36447417 PMCID: PMC9747267 DOI: 10.3348/kjr.2022.0741] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 10/06/2022] [Accepted: 10/10/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE "Diagnostic yield," also referred to as the detection rate, is a parameter positioned between diagnostic accuracy and diagnosis-related patient outcomes in research studies that assess diagnostic tests. Unfamiliarity with the term may lead to incorrect usage and delivery of information. Herein, we evaluate the level of proper use of the term "diagnostic yield" and its related parameters in articles published in Radiology and Korean Journal of Radiology (KJR). MATERIALS AND METHODS Potentially relevant articles published since 2012 in these journals were identified using MEDLINE and PubMed Central databases. The initial search yielded 239 articles. We evaluated whether the correct definition and study setting of "diagnostic yield" or "detection rate" were used and whether the articles also reported companion parameters for false-positive results. We calculated the proportion of articles that correctly used these parameters and evaluated whether the proportion increased with time (2012-2016 vs. 2017-2022). RESULTS Among 39 eligible articles (19 from Radiology and 20 from KJR), 17 (43.6%; 11 from Radiology and 6 from KJR) correctly defined "diagnostic yield" or "detection rate." The remaining 22 articles used "diagnostic yield" or "detection rate" with incorrect meanings such as "diagnostic performance" or "sensitivity." The proportion of correctly used diagnostic terms was higher in the studies published in Radiology than in those published in KJR (57.9% vs. 30.0%). The proportion improved with time in Radiology (33.3% vs. 80.0%), whereas no improvement was observed in KJR over time (33.3% vs. 27.3%). The proportion of studies reporting companion parameters was similar between journals (72.7% vs. 66.7%), and no considerable improvement was observed over time. CONCLUSION Overall, a minority of articles accurately used "diagnostic yield" or "detection rate." Incorrect usage of the terms was more frequent without improvement over time in KJR than in Radiology. Therefore, improvements are required in the use and reporting of these parameters.
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Affiliation(s)
- Ho Young Park
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chong Hyun Suh
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seon-Ok Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Grasso D, Gnesutta A, Calvi M, Duvia M, Atria MG, Celentano A, Callegari L, Genovese EA. MRI evaluation of meniscal anatomy: which parameters reach the best inter-observer concordance? Radiol Med 2022; 127:991-997. [PMID: 35834110 PMCID: PMC9508209 DOI: 10.1007/s11547-022-01527-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 07/04/2022] [Indexed: 10/25/2022]
Abstract
Abstract
Purpose
The aim of the study is to evaluate which MRI parameters achieve the best degree of inter-individual concordance in the description of meniscal fibrocartilage, regarding its morphology, signal and position.
Materials and methods
Eighty-nine knee MRIs were included in the study, retrospectively re-evaluated by three radiologists who completed a binary report (normal/abnormal) describing the meniscus signal, position relative to the tibial plateau margin and morphology. The inter-individual concordance value was calculated using Cohen's test.
Results
We obtained different inter-individual concordance values according to the parameters considered. The concordance was poor in the description of the meniscal position relative to the tibial plateau margin (average k = 0.6); the result was comparable in the description of the meniscal morphology (average k = 0.56). The best results were obtained with the meniscal signal analysis (average k = 0.8).
Conclusion
To the best of our knowledge, there are no studies in the literature assessing the concordance between multiple readers in the description of the parameters we studied. The results we obtained suggest that the most reliable parameter for describing meniscal fibrocartilage is its signal intensity, whereas morphology and position may lead to different interpretations that are not always unequivocal.
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MRI evaluation of soft tissue tumors: comparison of a fast, isotropic, 3D T2-weighted fat-saturated sequence with a conventional 2D T2-weighted fat-saturated sequence for tumor characteristics, resolution, and acquisition time. Eur Radiol 2022; 32:8670-8680. [PMID: 35751699 DOI: 10.1007/s00330-022-08937-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/24/2022] [Accepted: 05/30/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To test whether a 4-fold accelerated 3D T2-weighted (T2) CAIPIRINHA SPACE TSE sequence with isotropic voxel size is equivalent to conventional 2DT2 TSE for the evaluation of intrinsic and perilesional soft tissue tumors (STT) characteristics. METHODS For 108 patients with histologically-proven STTs, MRI, including 3DT2 (CAIPIRINHA SPACE TSE) and 2DT2 (TSE) sequences, was performed. Two radiologists evaluated each sequence for quality (diagnostic, non-diagnostic), tumor characteristics (heterogeneity, signal intensity, margin), and the presence or absence of cortical involvement, marrow edema, and perilesional edema (PLE); tumor size and PLE extent were measured. Signal-to-noise (SNR) and contrast-to-noise (CNR) ratios and acquisition times for 2DT2 in two planes and 3DT2 sequences were reported. Descriptive statistics and inter-method agreement were reported. RESULTS Image quality was diagnostic for all sequences (100% [108/108]). No difference was observed between 3DT2 and 2DT2 tumor characteristics (p < 0.05). There was no difference in mean tumor size (3DT2: 2.9 ± 2.5 cm, 2DT2: 2.8 ± 2.6 cm, p = 0.4) or PLE extent (3DT2:0.5 ± 1.2 cm, 2DT2:0.5 ± 1.0 cm, p = 0.9) between the sequences. There was no difference in the SNR of tumors, marrow, and fat between the sequences, whereas the SNR of muscle was higher (p < 0.05) on 3DT2 than 2DT2. CNR measures on 3DT2 were similar to 2DT2 (p > 0.1). The average acquisition time was shorter for 3DT2 compared with 2DT2 (343 ± 127 s vs 475 ± 162 s, respectively). CONCLUSION Isotropic 3DT2 MRI offers higher spatial resolution, faster acquisition times, and equivalent assessments of STT characteristics compared to conventional 2DT2 MRI in two planes. 3DT2 is interchangeable with a 2DT2 sequence in tumor protocols. KEY POINTS • Isotropic 3DT2 CAIPIRINHA SPACE TSE offers higher spatial resolution than 2DT2 TSE and is equivalent to 2DT2 TSE for assessments of soft tissue tumor intrinsic and perilesional characteristics. • Multiplanar reformats of 3DT2 CAIPIRINHA SPACE TSE can substitute for 2DT2 TSE acquired in multiple planes, thereby reducing the acquisition time of MRI tumor protocols. • 3DT2 CAIPIRINHA SPACE TSE and 2DT2 TSE had similar CNR of tissues.
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Abstract
Osteoarthritis, characterized by the breakdown of articular cartilage and other joint structures, is one of the most prevalent and disabling chronic diseases in the United States. Magnetic resonance imaging is a commonly used imaging modality to evaluate patients with joint pain. Both two-dimensional fast spin-echo sequences (2D-FSE) and three-dimensional (3D) sequences are used in clinical practice to evaluate articular cartilage. The 3D sequences have many advantages compared with 2D-FSE sequences, such as their high in-plane spatial resolution, thin continuous slices that reduce the effects of partial volume averaging, and ability to create multiplanar reformat images following a single acquisition. This article reviews the different 3D imaging techniques available for evaluating cartilage morphology, illustrates the strengths and weaknesses of 3D approaches compared with 2D-FSE approaches for cartilage imaging, and summarizes the diagnostic performance of 2D-FSE and 3D sequences for detecting cartilage lesions within the knee and hip joints.
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Affiliation(s)
- Richard Kijowski
- Department of Radiology, New York University Grossman School of Medicine, New York, New York
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Image Quality and Diagnostic Performance of Accelerated Shoulder MRI With Deep Learning-Based Reconstruction. AJR Am J Roentgenol 2021; 218:506-516. [PMID: 34523950 DOI: 10.2214/ajr.21.26577] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background: Shoulder MRI using standard multiplanar sequences requires long scan times. Accelerated sequences have tradeoffs in noise and resolution. Deep learning-based reconstruction (DLR) may allow reduced scan time with preserved image quality. Objectives: To compare standard shoulder MRI sequences and accelerated sequences without and with DLR in terms of image quality and diagnostic performance. Methods: This retrospective study included 105 patients (45 men, 60 women; mean age 57.6±10.9 years) who underwent a total of 110 3-T shoulder MRI examinations. Examinations included standard sequences (scan time, 9 minutes 23 seconds) and accelerated sequences (3 minutes 5 seconds; 67% reduction), both including fast spin echo sequences in three planes. Standard sequences were reconstructed using the conventional pipeline; accelerated sequences were reconstructed using both conventional pipeline and a commercially available DLR pipeline. Two radiologists independently assessed three image sets (standard, accelerated without DLR, accelerated with DLR) for subjective image quality and artifacts using 4-point scales (4=highest quality), and identified pathologies of subscapularis tendon, supraspinatus-infraspinatus tendon, biceps brachii long head tendon, and glenoid labrum. Interobserver and inter-image set agreement for the evaluated pathologies was assessed using weighted kappa statistics. In 27 patients who underwent arthroscopy, diagnostic performance was calculated using arthroscopic findings as reference. Results: Mean subjective image quality for readers 1 and 2 was 10.6±1.2 and 10.5±1.4 for standard, 8.1±1.3 and 7.2±1.1 for accelerated without DLR, and 10.7±1.2 and 10.5±1.6 for accelerated with DLR. Mean artifact score for readers 1 and 2 was 9.3±1.2 and 10.0±1.0 for standard, 7.3±1.3 and 9.1±0.8 for accelerated without DLR, and 9.4±1.2 and 9.8±0.8 for accelerated with DLR. Interobserver agreement ranged from kappa=0.813-0.951 except for accelerated without DLR for SST-IST (κ=0.673). Inter-image set agreement ranged from kappa=0.809-0.957 except for reader 1 for SST-IST (κ=0.663-0.700). Accuracy, sensitivity, and specificity for tears of the four structures was not different (p>.05) among image sets. Conclusions: Accelerated sequences with DLR provide 67% scan time reduction with similar subjective image quality, artifacts, and diagnostic performance as standard sequences. Clinical impact: Accelerated sequences with DLR may provide an alternative to standard sequences for clinical shoulder MRI.
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Cheng KY, Lombardi AF, Chang EY, Chung CB. Knee Cartilage Imaging. Clin Sports Med 2021; 40:677-692. [PMID: 34509205 DOI: 10.1016/j.csm.2021.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Articular cartilage injury and degeneration represent common causes of knee pain, which can be evaluated accurately and noninvasively using MRI. This review describes the structure of cartilage focusing on its histologic appearance to emphasize that structure will dictate patterns of tissue failure as well as MR appearance. In addition to identifying cartilage loss, MRI can demonstrate signal changes that correspond to intrinsic structural abnormalities which place the cartilage at risk for subsequent more serious injury or premature degeneration, allowing for earlier intervention and treatment of important causes of pain and morbidity.
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Affiliation(s)
- Karen Y Cheng
- Department of Radiology, UC San Diego Health, 200 W. Arbor Drive MC 8226, San Diego, CA 92103, USA
| | - Alecio F Lombardi
- Department of Radiology, UC San Diego Health, 200 W. Arbor Drive MC 8226, San Diego, CA 92103, USA; VA San Diego Healthcare System, Radiology Service, 3350 La Jolla Village Drive, MC 114, San Diego, CA 92161, USA
| | - Eric Y Chang
- Department of Radiology, UC San Diego Health, 200 W. Arbor Drive MC 8226, San Diego, CA 92103, USA; VA San Diego Healthcare System, Radiology Service, 3350 La Jolla Village Drive, MC 114, San Diego, CA 92161, USA
| | - Christine B Chung
- Department of Radiology, UC San Diego Health, 200 W. Arbor Drive MC 8226, San Diego, CA 92103, USA; VA San Diego Healthcare System, Radiology Service, 3350 La Jolla Village Drive, MC 114, San Diego, CA 92161, USA.
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Zee MJM, Sulaihem RA, Diercks RL, van den Akker-Scheek I. Intra-and interobserver reliability of determining the femoral footprint of the torn anterior cruciate ligament on MRI scans. BMC Musculoskelet Disord 2021; 22:493. [PMID: 34049511 PMCID: PMC8164263 DOI: 10.1186/s12891-021-04376-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 05/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Re-injury rates following reconstruction of the anterior cruciate ligament (ACL) are significant; in more than 20% of patients a rupture of the graft occurs. One of the main reasons for graft failure is malposition of the femoral tunnel. The femoral origin of the torn ACL can be hard to visualize during arthroscopy, plus many individual variation in femoral origin anatomy exists, which may lead to this malpositioning. To develop a patient specific guide that may resolve this problem, a preoperative MRI is needed to identify the patient specific femoral origin of the ACL. The issue here is that there may be a difference in the reliability of identification of the femoral footprint of the ACL on MRI between different observers with different backgrounds and level of experience. The purpose of this study was to determine the intra- and interobserver reliability of identifying the femoral footprint of the torn ACL on MRI and to compare this between orthopedic surgeons, residents in orthopedic surgery and MSK radiologists. METHODS MR images of the knee joint were collected retrospectively from 20 subjects with a confirmed rupture of the ACL. The 2D (coronal, sagittal, transversal) proton-density (PD) images were selected for the segmentation procedure to create 3D models of the femurs. The center of the femoral footprint of the ACL on 20 MRI scans, with visual feedback on 3D models (as reference) was determined twice by eight observers. The intra- and interobserver reliability of determining the center of the femoral footprint on MRI was evaluated. Intraclass correlation coefficients (ICCs) were calculated for the X, Y and Z coordinates separately and for a 3D coordinate. RESULTS The mean 3D distance between the first and second assessment (intraobserver reliability) was 3.82 mm. The mean 3D distance between observers (interobserver reliability) was 8.67 mm. ICCs were excellent (> 0.95), except for those between the assessments of the two MSK radiologists of the Y and Z coordinates (0.890 and 0.800 respectively). Orthopedic surgeons outscored the residents and radiologists in terms of intra- and interobserver agreement. CONCLUSION Excellent intraobserver reliability was demonstrated (< 4 mm). However the results of the interobserver reliability manifested remarkably less agreement between observers (> 8 mm). An orthopedic background seems to increase both intra- and interobserver reliability. Preoperative planning of the femoral tunnel position in ACL reconstruction remains a surgical decision. Experienced orthopedic surgeons should be consulted when planning for patient specific instrumentation in ACL reconstruction.
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Affiliation(s)
- M J M Zee
- Department of Orthopedic Surgery, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700RB, Groningen, The Netherlands.
| | - R A Sulaihem
- Department of Orthopedic Surgery, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700RB, Groningen, The Netherlands
| | - R L Diercks
- Department of Orthopedic Surgery, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700RB, Groningen, The Netherlands
| | - I van den Akker-Scheek
- Department of Orthopedic Surgery, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700RB, Groningen, The Netherlands
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El-Liethy NE, Rashwan AS, Kamal H. Single isotropic 3D fast spin echo sequence compared with conventional 2D sequences for detecting meniscal and cruciate ligament tears in the knee. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2020. [DOI: 10.1186/s43055-020-00362-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
This work was conducted to assess the diagnostic efficiency of isotropic three-dimensional VISTA-fast spin echo versus standard two-dimensional fast spin echo at 1.5 T MRI, in the assessment of internal knee derangement in symptomatic patients, aiming to obtain similar diagnostic accuracy in a shorter time span, with reduction of partial volume artifacts by thin continuous sections.
Results
This was a non-randomized control study including 39 patients (32 male and 7 females, mean age 37 years old). A correlative study was done utilizing MRI standard 2D FSE (protocol A) versus 3D-VISTA-FSE (protocol B) for medial meniscus (MM) and lateral meniscus (LM), as well as anterior cruciate ligament ACL lesions, comparing the MRI results with the findings of arthroscopy as the gold standard. Both protocols depicted medial meniscus lesions with accuracy, specificity, and sensitivity (97.44%, 96.30%, and 100% respectively), lateral meniscus lesions with accuracy, specificity, and sensitivity (97.44%, 100%, and 50% respectively), and ACL lesions with accuracy, specificity, and sensitivity (100%, 100%, and 100% respectively), while there were no PCL lesions depicted through the study population. Comparing the time factor between both protocols revealed protocol A to consume 13.7 min, while protocol B consumed 6.6 min.
Conclusion
Three-dimensional isotropic VISTA-FSE sequence, although having similar accuracy in diagnosing cruciate and meniscal lesions as the standard sequences, facilitates thin-section data acquisition and multi-planar image reformation in standard and non-standard planes, without intersection gaps that are crucial for the detection and dissection of compound structures; also, it allows a shorter time span, which is more advantageous for patients, particularly the traumatized and emergency patients.
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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.
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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.
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Lin Y, Huang Z, Zhang K, Pan X, Huang X, Li J, Li Q. Lower Tibial Tunnel Placement in Isolated Posterior Cruciate Ligament Reconstruction: Clinical Outcomes and Quantitative Radiological Analysis of the Killer Turn. Orthop J Sports Med 2020; 8:2325967120923950. [PMID: 32874997 PMCID: PMC7436807 DOI: 10.1177/2325967120923950] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 12/17/2019] [Indexed: 02/05/2023] Open
Abstract
Background The "killer turn" effect after posterior cruciate ligament (PCL) reconstruction is a problem that can lead to graft laxity or failure. Solutions for this situation are currently lacking. Purpose To evaluate the clinical outcomes of a modified procedure for PCL reconstruction and quantify the killer turn using 3-dimensional (3D) computed tomography (CT). Study design Case series; Level of evidence, 4. Methods A total of 15 patients underwent modified PCL reconstruction with the tibial aperture below the center of the PCL footprint. Next, 2 virtual tibial tunnels with anatomic and proximal tibial apertures were created on 3D CT. All patients were assessed according to the Lysholm score, International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Tegner score, side-to-side difference (SSD) in tibial posterior translation using stress radiography, and 3D gait analysis. Results The modified tibial tunnel showed 2 significantly gentler turns (superior, 109.87° ± 10.12°; inferior, 151.25° ± 9.07°) compared with those reconstructed with anatomic (91.33° ± 7.28°; P < .001 for both comparisons) and proximal (99° ± 7.92°; P = .023 and P < .001, respectively) tibial apertures. The distance from the footprint to the tibial aperture was 16.49 ± 3.73 mm. All patient-reported outcome scores (mean ± SD) improved from pre- to postoperatively: Lysholm score, from 46.4 ± 18.87 to 83.47 ± 10.54 (P < .001); Tegner score, from 2.47 ± 1.85 to 6.07 ± 1.58 (P < .001); IKDC sports activities score, from 19 ± 9.90 to 33.07 ± 5.35 (P < .001); and IKDC knee symptoms score, from 17.87 ± 6.31 to 25.67 ± 3.66 (P < .001). The mean SSD improved from 9.15 ± 2.27 mm preoperatively to 4.20 ± 2.31 mm postoperatively (P < .001). The reconstructed knee showed significantly more adduction (by 1.642°), less flexion (by 1.285°), and more lateral translation (by 0.279 mm) than that of the intact knee (P < .001 for all). Conclusion Lowering the tibial aperture during PCL reconstruction reduced the killer turn, and the clinical outcomes remained satisfactory. However, SSD and clinical outcomes were similar to those of previously described techniques using an anatomic tibial tunnel.
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Affiliation(s)
- Yipeng Lin
- Department of Orthopedic Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Zeyuan Huang
- College of Software Engineering, Sichuan University, Chengdu, China
| | - Kaibo Zhang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Xuelin Pan
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Xihao Huang
- Department of Orthopedic Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jian Li
- Department of Orthopedic Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Qi Li
- Department of Orthopedic Surgery, West China Hospital, Sichuan University, Chengdu, China
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Lee S, Lee GY, Kim S, Park YB, Lee HJ. Clinical utility of fat-suppressed 3-dimensional controlled aliasing in parallel imaging results in higher acceleration sampling perfection with application optimized contrast using different flip angle evolutions MRI of the knee in adults. Br J Radiol 2020; 93:20190725. [PMID: 32516546 PMCID: PMC7446023 DOI: 10.1259/bjr.20190725] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 06/03/2020] [Accepted: 06/03/2020] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To compare htree-dimensional CAIPIRINHA SPACE and two-dimensional turbo spin echo (2D TSE) MRI in the diagnosis of knee pathology in symptomatic adult patients. METHODS From February to September in 2018, 120 patients who underwent a knee MRI using both 3D CAIPIRINHA SPACE and 2D TSE MRI were enrolled. The signal-to-noise ratios (SNRs) and contrast-to-noise ratio (CNR) of the 2D and 3D MRI were compared using a paired t-test. Two radiologists independently evaluated both 2D and 3D MRI images using scoring systems for the menisci, ligaments, and cartilage. Intermethod, inter- and intrareader agreements were determined using an intraclass correlation coefficient (ICC). The diagnostic performance of both methods was measured in 44 patients with arthroscopy. RESULTS The mean scan time of 3D CAIPIRINHA SPACE MRI (4' 43") was shorter than that of 2D TSE MRI (17' 27"). The mean SNR and CNR of 3D CAIPIRINHA SPACE was higher than those of 2D TSE MRI (mean difference, 3.97 of SNR and 1.58 of CNR; p < 0.001 and p = .038, respectively). Intermethod (ICC, 0.84-1.0) and inter-reader (ICC, 0.75-0.97), and intra-reader agreements (ICC, 0.87-1.0) were good or excellent. The diagnostic accuracy of 3D CAIPIRINHA SPACE sequence was equal for ligament (95.5%) and better for meniscal and cartilage evaluation (84.1% each), compared to 2D TSE MRI (79.5% each). CONCLUSION The fat-suppressed 3D CAIPIRINHA SPACE MRI maybe useful in clinical practice for the evaluation of the knee in place of the 2D conventional MRI protocol. ADVANCES IN KNOWLEDGE 1. The 3D CAIPIRINHA SPACE MRI of the knee joint may be acceptable to be used in clinical practice showing comparable imaging quality compared to conventional 2D TSE MRI.2. Compared with arthroscopic findings as the gold-standard, the diagnostic performance of 3D CAIPIRINHA SPACE MRI was equal or better for knee joint evaluation than that of 2D TSE MRI, as well as with shorter scan time.
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Affiliation(s)
- Seungho Lee
- Department of the Radiology, Chung-Ang University Hospital, Seoul, Korea
| | - Guen Young Lee
- Department of the Radiology, Chung-Ang University Hospital, Seoul, Korea
| | - Sujin Kim
- Department of the Radiology, Chung-Ang University Hospital, Seoul, Korea
| | - Yong-Beom Park
- Department of the orthopedic Surgery, Chung-Ang University Hospital, Seoul, Korea
| | - Han-Jun Lee
- Department of the orthopedic Surgery, Chung-Ang University Hospital, Seoul, Korea
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Update: Klinische Knorpelbildgebung – Teil 1. Radiologe 2019; 59:692-699. [DOI: 10.1007/s00117-019-0561-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Shakoor D, Guermazi A, Kijowski R, Fritz J, Roemer FW, Jalali‐Farahani S, Demehri S. Cruciate ligament injuries of the knee: A meta‐analysis of the diagnostic performance of 3D MRI. J Magn Reson Imaging 2019; 50:1545-1560. [DOI: 10.1002/jmri.26713] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 02/25/2019] [Accepted: 02/25/2019] [Indexed: 11/12/2022] Open
Affiliation(s)
- Delaram Shakoor
- Russell H. Morgan Department of Radiology and Radiological SciencesJohns Hopkins University Baltimore Maryland USA
| | - Ali Guermazi
- Quantitative Imaging Center, Department of RadiologyBoston University School of Medicine Boston Massachusetts USA
| | - Richard Kijowski
- Department of RadiologyUniversity of Wisconsin, Clinical Science Center Madison Wisconsin USA
| | - Jan Fritz
- Russell H. Morgan Department of Radiology and Radiological SciencesJohns Hopkins University Baltimore Maryland USA
| | - Frank W. Roemer
- Quantitative Imaging Center, Department of RadiologyBoston University School of Medicine Boston Massachusetts USA
- Department of RadiologyUniversity of Erlangen‐Nuremberg Erlangen Germany
| | - Sahar Jalali‐Farahani
- Russell H. Morgan Department of Radiology and Radiological SciencesJohns Hopkins University Baltimore Maryland USA
| | - Shadpour Demehri
- Russell H. Morgan Department of Radiology and Radiological SciencesJohns Hopkins University Baltimore Maryland USA
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Shakoor D, Kijowski R, Guermazi A, Fritz J, Roemer FW, Jalali-Farahani S, Eng J, Demehri S. Diagnosis of Knee Meniscal Injuries by Using Three-dimensional MRI: A Systematic Review and Meta-Analysis of Diagnostic Performance. Radiology 2019; 290:435-445. [DOI: 10.1148/radiol.2018181212] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Delaram Shakoor
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, 601 N Caroline St, JHOC 4240, Baltimore, Md, 21287 (D.S., J.F., S.J.F., J.E., S.D.); Department of Radiology, University of Wisconsin, Clinical Science Center, Madison, Wis (R.K.); Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, Mass (A.G., F.W.R.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - Richard Kijowski
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, 601 N Caroline St, JHOC 4240, Baltimore, Md, 21287 (D.S., J.F., S.J.F., J.E., S.D.); Department of Radiology, University of Wisconsin, Clinical Science Center, Madison, Wis (R.K.); Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, Mass (A.G., F.W.R.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - Ali Guermazi
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, 601 N Caroline St, JHOC 4240, Baltimore, Md, 21287 (D.S., J.F., S.J.F., J.E., S.D.); Department of Radiology, University of Wisconsin, Clinical Science Center, Madison, Wis (R.K.); Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, Mass (A.G., F.W.R.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - Jan Fritz
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, 601 N Caroline St, JHOC 4240, Baltimore, Md, 21287 (D.S., J.F., S.J.F., J.E., S.D.); Department of Radiology, University of Wisconsin, Clinical Science Center, Madison, Wis (R.K.); Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, Mass (A.G., F.W.R.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - Frank W. Roemer
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, 601 N Caroline St, JHOC 4240, Baltimore, Md, 21287 (D.S., J.F., S.J.F., J.E., S.D.); Department of Radiology, University of Wisconsin, Clinical Science Center, Madison, Wis (R.K.); Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, Mass (A.G., F.W.R.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - Sahar Jalali-Farahani
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, 601 N Caroline St, JHOC 4240, Baltimore, Md, 21287 (D.S., J.F., S.J.F., J.E., S.D.); Department of Radiology, University of Wisconsin, Clinical Science Center, Madison, Wis (R.K.); Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, Mass (A.G., F.W.R.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - John Eng
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, 601 N Caroline St, JHOC 4240, Baltimore, Md, 21287 (D.S., J.F., S.J.F., J.E., S.D.); Department of Radiology, University of Wisconsin, Clinical Science Center, Madison, Wis (R.K.); Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, Mass (A.G., F.W.R.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - Shadpour Demehri
- From the Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, 601 N Caroline St, JHOC 4240, Baltimore, Md, 21287 (D.S., J.F., S.J.F., J.E., S.D.); Department of Radiology, University of Wisconsin, Clinical Science Center, Madison, Wis (R.K.); Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, Mass (A.G., F.W.R.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
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Shakoor D, Guermazi A, Kijowski R, Fritz J, Jalali-Farahani S, Mohajer B, Eng J, Demehri S. Diagnostic Performance of Three-dimensional MRI for Depicting Cartilage Defects in the Knee: A Meta-Analysis. Radiology 2018; 289:71-82. [DOI: 10.1148/radiol.2018180426] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Fritz J, Ahlawat S, Fritz B, Thawait GK, Stern SE, Raithel E, Klyce W, Lee RJ. 10‐Min 3D Turbo Spin Echo MRI of the Knee in Children: Arthroscopy‐Validated Accuracy for the Diagnosis of Internal Derangement. J Magn Reson Imaging 2018; 49:e139-e151. [DOI: 10.1002/jmri.26241] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Accepted: 06/11/2018] [Indexed: 12/14/2022] Open
Affiliation(s)
- Jan Fritz
- Russell H. Morgan Department of Radiology and Radiological ScienceJohns Hopkins University School of Medicine Baltimore Maryland USA
| | - Shivani Ahlawat
- Russell H. Morgan Department of Radiology and Radiological ScienceJohns Hopkins University School of Medicine Baltimore Maryland USA
| | - Benjamin Fritz
- RadiologyBalgrist University Hospital Zurich Switzerland
- Faculty of MedicineUniversity of Zurich Zurich Switzerland
| | - Gaurav K. Thawait
- Russell H. Morgan Department of Radiology and Radiological ScienceJohns Hopkins University School of Medicine Baltimore Maryland USA
| | - Steven E. Stern
- Bond Business SchoolBond University Gold Coast QLD Australia
| | | | - Walter Klyce
- Department of Orthopaedic SurgeryJohns Hopkins University School of Medicine Baltimore Maryland USA
| | - Rushyuan J. Lee
- Department of Orthopaedic SurgeryJohns Hopkins University School of Medicine Baltimore Maryland USA
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Clinical value of pointwise encoding time reduction with radial acquisition (PETRA) MR sequence in assessing internal derangement of knee. Clin Imaging 2018; 51:260-265. [PMID: 29906783 DOI: 10.1016/j.clinimag.2018.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 05/28/2018] [Accepted: 05/29/2018] [Indexed: 11/21/2022]
Abstract
PURPOSE The purpose was to evaluate the clinical value of PETRA sequence for the diagnosis of internal derangement of the knee. MATERIALS AND METHODS The major structures of the knee in 34 patients were evaluated and compared among conventional MRI findings, PETRA images, and arthroscopic findings. RESULTS The specificities of PETRA with 2D FSE sequence were higher for meniscal lesions than those obtained when using 2D FSE alone. CONCLUSION Using PETRA images along with conventional 2D FSE images can increase the accuracy of assessing internal derangements of the knee and, specifically, meniscal lesions.
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Kraus MS, Notohamiprodjo M, Partovi S, Sobieh A, Baur-Melnyk A, Hausdorf J, Grosse U. MR arthrography of the hip: diagnostic performance and image quality of 3D-steady state free precession versus 2D turbo spin echo sequences. Skeletal Radiol 2018; 47:811-819. [PMID: 29330619 DOI: 10.1007/s00256-017-2865-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 11/24/2017] [Accepted: 12/27/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To retrospectively compare the diagnostic performance of isotropic 3D steady-state free precession (3D-SSFP) sequences with 2D turbo spin-echo proton density-weighted fat-saturated (2D-TSE-PD fs) images in hip magnetic resonance arthrography; arthroscopy was a standard of reference. METHODS Eighty-one patients with suspected labral tears who underwent hip MR arthrography (3-T scanner) were included. 2D-TSE-PD fs sequences were acquired in three planes and a singular sagittal 3D-SSFP. Labral tears, cartilage pathology and bone marrow were independently assessed by two blinded radiologists using a 5-point Likert scale. Accuracy was determined in 39 patients using invasive arthroscopy. RESULTS Diagnostic confidence of labral and cartilaginous pathologies based on image quality was rated higher for 3D-SSFP (4.5 ± 0.8; 4.35 ± 0.7; p < 0.0001), but inferior for bone marrow pathology (3.9 ± 0.7; 4.0 ± 0.7; p < 0.0001). In the arthroscopy patients, similar sensitivity (85.9%) but higher specificity (74.4vs.42.9%) and higher positive and negative predictive values were found in 3D-SSFP of labral and cartilage pathologies. CONCLUSIONS 3D-SSFP in hip magnetic resonance arthrography offers increased accuracy in detecting labral and cartilage pathologies compared with 2D-TSE-PD, while reducing the acquisition time. A drawback of 3D-SSFP was the inferior diagnostic confidence for bone marrow evaluation; thus, 3D-SSFP should be combined with conventional 2D-TSE sequences.
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Affiliation(s)
- Mareen Sarah Kraus
- Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076, Tuebingen, Germany.
| | - Mike Notohamiprodjo
- Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076, Tuebingen, Germany
| | - Sasan Partovi
- Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH, 44106, USA
| | - Ahmed Sobieh
- Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076, Tuebingen, Germany
| | - Andrea Baur-Melnyk
- Department of Clinical Radiology, University Hospital Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Joerg Hausdorf
- Department of Orthopedics, University Hospital Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Ulrich Grosse
- Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076, Tuebingen, Germany
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Boudabbous S, Neroladaki A, Bagetakos I, Hamard M, Delattre BM, Vargas MI. Feasibility of synthetic MRI in knee imaging in routine practice. Acta Radiol Open 2018; 7:2058460118769686. [PMID: 29780615 PMCID: PMC5952291 DOI: 10.1177/2058460118769686] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 03/14/2018] [Indexed: 12/18/2022] Open
Abstract
Background Synthetic magnetic resonance (MR) is a method allowing reduction of examination time and access to quantitative imaging. Purpose This study sought to assess the image quality and diagnostic accuracy of synthetic magnetic resonance imaging (MRI) compared to standard MRI in patients with knee pain. Material and Methods In total, 22 patients underwent standard 1.5 knee MRI with an added synthetic sequence. Quantitative T1, T2, and proton density (PD) images were generated synthetically; T1, PD, and short tau inversion recovery (STIR) weighted images were created with chosen echo time (TE), repetition time (TR), and inversion time (TI). Two blinded musculoskeletal radiologists evaluated the overall sequence quality, visualization of anatomic structures, and presence of artifacts using a 3-point score. Results The synthetic sequence was acquired in 39% less time than the conventional MRI. Synthetic PD, T1, and STIR images were rated fair (2%, 5%, and 2%, respectively) or good quality (98%, 95%, and 98%, respectively), despite the presence of popliteal artery artifacts. Cartilage and meniscus were well visualized in all cases. Anterior cruciate ligament visualization was rated poor in 7%, 14%, and 30% of PD, STIR, and T1 images, respectively. Conclusion Our pilot study confirmed the feasibility of synthetic MRI in knee examinations, proving faster and achieving appropriate quality and good diagnostic confidence.
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Affiliation(s)
- Sana Boudabbous
- Department of Radiology, Geneva University Hospital, Geneva, Switzerland
| | | | - Ilias Bagetakos
- Department of Radiology, Geneva University Hospital, Geneva, Switzerland
| | - Marion Hamard
- Department of Radiology, Geneva University Hospital, Geneva, Switzerland
| | | | - Maria Isabel Vargas
- Division of Neuroradiology, Department of Radiology, Geneva University Hospital, Geneva, Switzerland
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Yi J, Lee YH, Song HT, Suh JS. Clinical Feasibility of Synthetic Magnetic Resonance Imaging in the Diagnosis of Internal Derangements of the Knee. Korean J Radiol 2018. [PMID: 29520189 PMCID: PMC5840060 DOI: 10.3348/kjr.2018.19.2.311] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Objective To evaluate the feasibility of synthetic magnetic resonance imaging (MRI) compared to conventional MRI for the diagnosis of internal derangements of the knee at 3T. Materials and Methods Following Institutional Review Board approval, image sets of conventional and synthetic MRI in 39 patients were included. Two musculoskeletal radiologists compared the image sets and qualitatively analyzed the images. Subjective image quality was assessed using a four-grade scale. Interobserver agreement and intersequence agreement between conventional and synthetic images for cartilage lesions, tears of the cruciate ligament, and tears of the meniscus were independently assessed using Kappa statistics. In patients who underwent arthroscopy (n = 8), the sensitivity, specificity, and accuracy for evaluated internal structures were calculated using arthroscopic findings as the gold standard. Results There was no statistically significant difference in image quality (p = 0.90). Interobserver agreement (κ = 0.649– 0.981) and intersequence agreement (κ = 0.794–0.938) were nearly perfect for all evaluated structures. The sensitivity, specificity, and accuracy for detecting cartilage lesions (sensitivity, 63.6% vs. 54.6–63.6%; specificity, 91.9% vs. 91.9%; accuracy, 83.3–85.4% vs. 83.3–85.4%) and tears of the cruciate ligament (sensitivity, specificity, accuracy, 100% vs. 100%) and meniscus (sensitivity, 50.0–62.5% vs. 62.5%; specificity, 100% vs. 87.5–100%; accuracy, 83.3–85.4% vs. 83.3–85.4%) were similar between the two MRI methods. Conclusion Conventional and synthetic MRI showed substantial to almost perfect degree of agreement for the assessment of internal derangement of knee joints. Synthetic MRI may be feasible in the diagnosis of internal derangements of the knee.
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Affiliation(s)
- Jisook Yi
- Department of Radiology, Research Institute of Radiological Science, YUHS-KRIBB Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Young Han Lee
- Department of Radiology, Research Institute of Radiological Science, YUHS-KRIBB Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Ho-Taek Song
- Department of Radiology, Research Institute of Radiological Science, YUHS-KRIBB Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Jin-Suck Suh
- Department of Radiology, Research Institute of Radiological Science, YUHS-KRIBB Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul 03722, Korea
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Lee SH, Lee YH, Suh JS. Accelerating knee MR imaging: Compressed sensing in isotropic three-dimensional fast spin-echo sequence. Magn Reson Imaging 2018; 46:90-97. [DOI: 10.1016/j.mri.2017.10.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 10/12/2017] [Accepted: 10/31/2017] [Indexed: 11/16/2022]
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Park S, Kwack KS, Lee YJ, Gho SM, Lee HY. Initial experience with synthetic MRI of the knee at 3T: comparison with conventional T 1 weighted imaging and T 2 mapping. Br J Radiol 2017; 90:20170350. [PMID: 28934866 DOI: 10.1259/bjr.20170350] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To assess the feasibility and accuracy of synthetic MRI compared to conventional T1 weighted and multi-echo spin-echo (MESE) sequences for obtaining T2 values in the knee joint at 3 Tesla. METHODS This retrospective study included 19 patients with normal findings in the knee joint who underwent both synthetic MRI and MESE pulse sequences for T2 quantification. T2 values of the two sequences at the articular cartilage, bone marrow and muscle were measured. Relative signal intensity (SI) of each structure and relative contrast among structures of the knee were measured quantitatively by T1 weighted sequences. RESULTS The mean T2 values for cartilage and muscle were not significantly different between MESE pulse sequences and synthetic MRI. For the bone marrow, the mean T2 value obtained by MESE sequences (124.3 ± 3.6 ms) was significantly higher than that obtained by synthetic acquisition (73.1 ± 5.3 ms). There were no significant differences in the relative SI of each structure between the methods. The relative contrast of bone marrow to muscle was significantly higher with conventional T1 weighted images, while that for bone marrow to cartilage was similar for both sequences. CONCLUSION Synthetic MRI is able to simultaneously acquire conventional images and quantitative maps, and has the potential to reduce the overall examination time. It provides comparable image quality to conventional MRI for the knee joint, with the exception of the bone marrow. With further optimization, it will be possible to take advantage of the image quality of musculoskeletal tissue with synthetic imaging. Advances in knowledge: Synthetic MRI produces images of good contrast and is also a time-saving technique. Thus, it may be useful for assessing osteoarthritis in the knee joint in the early stages.
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Affiliation(s)
- Sunghoon Park
- 1 Department of Radiology,Ajou University School of Medicine , Ajou University School of Medicine , Suwon , South Korea.,2 Musculoskeletal Imaging Laboratory,Ajou University Medical Centre , Ajou University Medical Centre , Suwon , South Korea
| | - Kyu-Sung Kwack
- 1 Department of Radiology,Ajou University School of Medicine , Ajou University School of Medicine , Suwon , South Korea.,2 Musculoskeletal Imaging Laboratory,Ajou University Medical Centre , Ajou University Medical Centre , Suwon , South Korea
| | - Young Ju Lee
- 3 Department of Clinical Science,GE Healthcare , GE Healthcare , Seoul , South Korea
| | - Sung-Min Gho
- 3 Department of Clinical Science,GE Healthcare , GE Healthcare , Seoul , South Korea
| | - Hyun Young Lee
- 4 Regional Clinical Trial Centre,Ajou University Medical Centre , Ajou University Medical Centre , Suwon , South Korea.,5 Department of Biostatistics,Yonsei University College of Medicine , Yonsei University College of Medicine , Seoul , South Korea
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Cho HW, Suh JS, Park JO, Kim HS, Chung SY, Lee YH, Hahn S. Three-Dimensional Fast Spin-Echo Imaging without Fat Suppression of the Knee: Diagnostic Accuracy Comparison to Fat-Suppressed Imaging on 1.5T MRI. Yonsei Med J 2017; 58:1186-1194. [PMID: 29047243 PMCID: PMC5653484 DOI: 10.3349/ymj.2017.58.6.1186] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 08/22/2017] [Accepted: 08/22/2017] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To evaluate the diagnostic performance of three-dimensional fast spin-echo (3D FSE-Cube) without fat suppression (NFS) for detecting knee lesions, using comparison to 3D FSE-Cube with fat suppression (FS). MATERIALS AND METHODS One hundred twenty-four patients who underwent 1.5T knee magnetic resonance imaging (MRI) scans and 25 subsequent arthroscopic surgeries were retrospectively reviewed. Using arthroscopic results and two-dimensional images as reference standards, diagnostic performances of 3D FSE-Cube-NFS and FS imaging about lesions of ligament, meniscus, subchondral bone marrow edema (BME), and cartilage were compared. Scan parameters of 3D FSE-Cube imaging were previously optimized by a porcine knee phantom. RESULTS No significant differences were observed between detection rates of NFS and FS imaging for detecting lesions of meniscus and cartilage (p>0.05). However, NFS imaging had lower sensitivity for detection of medial collateral ligament (MCL) tears, and lower sensitivity and specificity for detection of BME lesions, compared to FS imaging (p<0.05). CONCLUSION 3D FSE-Cube-NFS imaging showed similar diagnostic performance for detecting lesions of meniscus or cartilage compared to FS imaging, unlike MCL or BME lesions.
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Affiliation(s)
- Hee Woo Cho
- Department of Radiology, Research Institute of Radiological Science, YUHS-KRIBB Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jin Suck Suh
- Department of Radiology, Research Institute of Radiological Science, YUHS-KRIBB Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea.
| | - Jin Oh Park
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Hyoung Sik Kim
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Soo Yoon Chung
- Department of Radiology, Research Institute of Radiological Science, YUHS-KRIBB Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Young Han Lee
- Department of Radiology, Research Institute of Radiological Science, YUHS-KRIBB Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Seok Hahn
- Department of Radiology, Research Institute of Radiological Science, YUHS-KRIBB Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea
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30
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[When is cartilage repair successful?]. Radiologe 2017; 57:907-914. [PMID: 28929186 DOI: 10.1007/s00117-017-0305-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Focal cartilage lesions are a cause of long-term disability and morbidity. After cartilage repair, it is crucial to evaluate long-term progression or failure in a reproducible, standardized manner. This article provides an overview of the different cartilage repair procedures and important characteristics to look for in cartilage repair imaging. Specifics and pitfalls are pointed out alongside general aspects. After successful cartilage repair, a complete, but not hypertrophic filling of the defect is the primary criterion of treatment success. The repair tissue should also be completely integrated to the surrounding native cartilage. After some months, the transplants signal should be isointense compared to native cartilage. Complications like osteophytes, subchondral defects, cysts, adhesion and chronic bone marrow edema or joint effusion are common and have to be observed via follow-up. Radiological evaluation and interpretation of postoperative changes should always take the repair method into account.
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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]
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Soliman M, Daruge P, Dertkigil SSJ, De Avila Fernandes E, Negrao JR, de Aguiar Vilela Mitraud S, Sakuma ETI, Fernandes ARC, Zhang N, Huo A, Li YJ, Zhou F, Rodrigues BM, Mohanta A, Blanchette VS, Doria AS. Imaging of haemophilic arthropathy in growing joints: pitfalls in ultrasound and MRI. Haemophilia 2017; 23:660-672. [PMID: 28574216 DOI: 10.1111/hae.13249] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2017] [Indexed: 11/28/2022]
Abstract
The purpose of this review was to summarize the current knowledge on the utilization of magnetic resonance imaging (MRI) and ultrasound (US) for assessing arthropathy in children and adolescents with haemophilia and to recognize the limitations of each imaging modality and pitfalls in the diagnosis of soft tissue and osteochondral abnormalities. Awareness of MRI and US limitations and pitfalls in the assessment of joints in persons with haemophilia is essential for accurate diagnosis and optimal management of haemophilic arthropathy.
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Affiliation(s)
- M Soliman
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.,Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - P Daruge
- Institute of Radiology, Universidade de Sao Paulo (USP), Sao Paulo, SP, Brazil
| | - S S J Dertkigil
- Department of Radiology, Universidade de Campinas (UNICAMP), Campinas, SP, Brazil
| | - E De Avila Fernandes
- Department of Radiology, Universidade de Federal de Sao Paulo (UNIFESP), Sao Paulo, SP, Brazil
| | - J R Negrao
- Department of Radiology, Universidade de Federal de Sao Paulo (UNIFESP), Sao Paulo, SP, Brazil
| | | | - E T I Sakuma
- Department of Radiology, Universidade de Campinas (UNICAMP), Campinas, SP, Brazil
| | - A R C Fernandes
- Department of Radiology, Universidade de Federal de Sao Paulo (UNIFESP), Sao Paulo, SP, Brazil
| | - N Zhang
- Department of Radiology, Beijing Children's Hospital, Beijing, China
| | - A Huo
- Department of Radiology, Beijing Children's Hospital, Beijing, China
| | - Y-J Li
- Department of Radiology, Nanfang Hospital, Guangzhou, China
| | - F Zhou
- Department of Radiology, Nanfang Hospital, Guangzhou, China
| | - B M Rodrigues
- Institute of Radiology, Universidade de Sao Paulo (USP), Sao Paulo, SP, Brazil
| | - A Mohanta
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.,Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - V S Blanchette
- Department of Hematology & Oncology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - A S Doria
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.,Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
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Diagnosis of Internal Derangement of the Knee: Volume Isotropic Turbo Spin-Echo Acquisition MRI With Fat Suppression Versus Without Fat Suppression. AJR Am J Roentgenol 2017; 208:1304-1311. [DOI: 10.2214/ajr.16.17217] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Abdulaal OM, Rainford L, MacMahon P, Kavanagh E, Galligan M, Cashman J, McGee A. 3T MRI of the knee with optimised isotropic 3D sequences: Accurate delineation of intra-articular pathology without prolonged acquisition times. Eur Radiol 2017; 27:4563-4570. [DOI: 10.1007/s00330-017-4816-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 02/15/2017] [Accepted: 03/17/2017] [Indexed: 12/22/2022]
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Nacey NC, Geeslin MG, Miller GW, Pierce JL. Magnetic resonance imaging of the knee: An overview and update of conventional and state of the art imaging. J Magn Reson Imaging 2017; 45:1257-1275. [PMID: 28211591 DOI: 10.1002/jmri.25620] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 11/04/2016] [Indexed: 12/28/2022] Open
Abstract
Magnetic resonance imaging (MRI) has become the preferred modality for imaging the knee to show pathology and guide patient management and treatment. The knee is one of the most frequently injured joints, and knee pain is a pervasive difficulty that can affect all age groups. Due to the diverse pathology, complex anatomy, and a myriad of injury mechanisms of the knee, the MRI knee protocol and sequences should ensure detection of both soft tissue and osseous structures in detail and with accuracy. The knowledge of knee anatomy and the normal or injured MRI appearance of these key structures are critical for precise diagnosis. Advances in MRI technology provide the imaging necessary to obtain high-resolution images to evaluate menisci, ligaments, and tendons. Furthermore, recent advances in MRI techniques allow for improved imaging in the postoperative knee and metal artifact reduction, tumor imaging, cartilage evaluation, and visualization of nerves. As treatment and operative management techniques evolve, understanding the correct application of these advancements in MRI of the knee will prove to be valuable to clinical practice. LEVEL OF EVIDENCE 5 J. MAGN. RESON. IMAGING 2017;45:1257-1275.
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Affiliation(s)
- Nicholas C Nacey
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia, USA
| | - Matthew G Geeslin
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia, USA
| | - Grady Wilson Miller
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia, USA
| | - Jennifer L Pierce
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia, USA
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Altahawi FF, Blount KJ, Morley NP, Raithel E, Omar IM. Comparing an accelerated 3D fast spin-echo sequence (CS-SPACE) for knee 3-T magnetic resonance imaging with traditional 3D fast spin-echo (SPACE) and routine 2D sequences. Skeletal Radiol 2017; 46:7-15. [PMID: 27744578 DOI: 10.1007/s00256-016-2490-8] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 08/19/2016] [Accepted: 09/14/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE To compare a faster, new, high-resolution accelerated 3D-fast-spin-echo (3D-FSE) acquisition sequence (CS-SPACE) to traditional 2D and high-resolution 3D sequences for knee 3-T magnetic resonance imaging (MRI). MATERIALS AND METHODS Twenty patients received knee MRIs that included routine 2D (T1, PD ± FS, T2-FS; 0.5 × 0.5 × 3 mm3; ∼10 min), traditional 3D FSE (SPACE-PD-FS; 0.5 × 0.5 × 0.5 mm3; ∼7.5 min), and accelerated 3D-FSE prototype (CS-SPACE-PD-FS; 0.5 × 0.5 × 0.5 mm3; ∼5 min) acquisitions on a 3-T MRI system (Siemens MAGNETOM Skyra). Three musculoskeletal radiologists (MSKRs) prospectively and independently reviewed the studies with graded surveys comparing image and diagnostic quality. Tissue-specific signal-to-noise ratios (SNR) and contrast-to-noise ratios (CNR) were also compared. RESULTS MSKR-perceived diagnostic quality of cartilage was significantly higher for CS-SPACE than for SPACE and 2D sequences (p < 0.001). Assessment of diagnostic quality of menisci and synovial fluid was higher for CS-SPACE than for SPACE (p < 0.001). CS-SPACE was not significantly different from SPACE but had lower assessments than 2D sequences for evaluation of bones, ligaments, muscles, and fat (p ≤ 0.004). 3D sequences had higher spatial resolution, but lower overall assessed contrast (p < 0.001). Overall image quality from CS-SPACE was assessed as higher than SPACE (p = 0.007), but lower than 2D sequences (p < 0.001). Compared to SPACE, CS-SPACE had higher fluid SNR and CNR against all other tissues (all p < 0.001). CONCLUSIONS The CS-SPACE prototype allows for faster isotropic acquisitions of knee MRIs over currently used protocols. High fluid-to-cartilage CNR and higher spatial resolution over routine 2D sequences may present a valuable role for CS-SPACE in the evaluation of cartilage and menisci.
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Affiliation(s)
- Faysal F Altahawi
- Department of Radiology, Northwestern University Feinberg School of Medicine, 676 N Saint Clair St Suite 800, Chicago, IL, 60611, USA.
| | - Kevin J Blount
- Department of Radiology, Northwestern University Feinberg School of Medicine, 676 N Saint Clair St Suite 800, Chicago, IL, 60611, USA
| | | | | | - Imran M Omar
- Department of Radiology, Northwestern University Feinberg School of Medicine, 676 N Saint Clair St Suite 800, Chicago, IL, 60611, USA
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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]
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38
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Yi J, Cha JG, Lee YK, Lee BR, Jeon CH. MRI of the anterior talofibular ligament, talar cartilage and os subfibulare: Comparison of isotropic resolution 3D and conventional 2D T2-weighted fast spin-echo sequences at 3.0 T. Skeletal Radiol 2016; 45:899-908. [PMID: 26992909 DOI: 10.1007/s00256-016-2367-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 03/03/2016] [Accepted: 03/07/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE To determine the accuracy of a three-dimensional (3D) T2-weighted fast spin-echo (FSE) magnetic resonance (MR) sequence compared with two-dimensional (2D) sequence for diagnosing anterior talofibular ligament (ATFL) tears, chondral lesion of the talus (CLT) and os subfibulare/avulsion fracture of the distal fibula (OSF). MATERIALS AND METHODS Thirty-five patients were included, who had undergone ankle MRI with 3D T2-weighted FSE and 2D T2-weighted FSE sequences, as well as subsequent ankle arthroscopy, between November 2013 and July 2014. Each MR imaging sequence was independently scored by two readers retrospectively for the presence of ATFL tears, CLT and OSF. The area under the receiver operating curve (AUC) was compared to determine the discriminatory power of the two image sequences. Interobserver agreement was expressed as unweighted kappa value. RESULTS Arthroscopic findings confirmed 21 complete tears of the ATFL, 14 partial tears of the ATFL, 17 CLTs and 7 OSFs. There were no significant differences in the diagnoses of ATFL tears (p = 0.074-0.501), CLT (p = 0.090-0.450) and OSF (p = 0.317) obtained from the 2D and 3D sequences by either reader. The interobserver agreement rates between two readers using the 3D T2-weighted FSE sequence versus those obtained with the 2D sequence were substantial (κ = 0.659) versus moderate (κ = 0.553) for ATFL tears, moderate (κ = 0.499) versus substantial (κ = 0.676) for CLT and substantial (κ = 0.621) versus substantial (κ = 0.689) for OSF. CONCLUSION Three-dimensional isotropic T2-weighted FSE MRI of the ankle resulted in no statistically significant difference in diagnostic performance compared to two-dimensional T2-weighted FSE MRI in the evaluation of ATFL tears, CLTs and OSFs.
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Affiliation(s)
- Jisook Yi
- Department of Radiology, Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon-si, 14584, Korea
| | - Jang Gyu Cha
- Department of Radiology, Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon-si, 14584, Korea.
| | - Young Koo Lee
- Department of Orthopedics, Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon-si, 14584, Korea
| | - Bo Ra Lee
- Department of Biomedical Statistics, Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon-si, 14584, Korea
| | - Chan Hong Jeon
- Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon-si, 14584, Korea
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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]
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Verdonk R, Madry H, Shabshin N, Dirisamer F, Peretti GM, Pujol N, Spalding T, Verdonk P, Seil R, Condello V, Di Matteo B, Zellner J, Angele P. The role of meniscal tissue in joint protection in early osteoarthritis. Knee Surg Sports Traumatol Arthrosc 2016; 24:1763-74. [PMID: 27085362 DOI: 10.1007/s00167-016-4069-2] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 02/23/2016] [Indexed: 01/05/2023]
Abstract
It is widely accepted that partial meniscectomy leads to early onset of osteoarthritis (OA). A strong correlation exists between the amount and location of the resected meniscus and the development of degenerative changes in the knee. On the other hand, osteoarthritic changes of the joint alter the structural and functional integrity of meniscal tissue. These alterations might additionally compromise the limited healing capacity of the meniscus. In young, active patients without cartilage damage, meniscus therapy including partial meniscectomy, meniscus suture, and meniscus replacement has proven beneficial effects in long-term studies. Even in an early osteoarthritic milieu, there is a relevant regenerative potential of the meniscus and the surrounding cartilage. This potential should be taken into account, and meniscal surgery can be performed with the correct timing and the proper indication even in the presence of early OA.
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Affiliation(s)
- Rene Verdonk
- Ghent University, De Pintelaan 185, 9000, Ghent, Belgium
| | - Henning Madry
- Department of Orthopaedic Surgery, Saarland University Medical Center, Kirrberger Strasse 100, Building 37-38, 66421, Homburg, Saarland, Germany
| | - Nogah Shabshin
- Department of Radiology, Carmel Medical Center, Haifa, Israel.,Department of Radiology, Hospital of University of Pennsylvania, Philadelphia, PA, USA
| | - Florian Dirisamer
- Orthopädie und Sportchirurgie, Schloss Puchenau, Karl-Leitl-Str. 1, 4048, Linz-Puchenau, Austria
| | - Giuseppe M Peretti
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Nicolas Pujol
- Centre hospitalier de Versailles, 177, rue de Versailles, 78150, Le Chesnay, France
| | - Tim Spalding
- Department of Orthopaedics, University Hospital of Coventry and Warwickshire, Rugby, UK
| | - Peter Verdonk
- Antwerp Orthopedic Center, Monica Hospitals, Antwerp, Belgium
| | - Romain Seil
- Clinique d'Eich and Sports Medicine Research Laboratory, Department of Orthopaedic Surgery, Centre Hospitalier Luxembourg, Luxembourg Institute of Health, 78 rue d'Eich, 1460, Luxembourg, Luxembourg
| | - Vincenzo Condello
- Dipartimento di Ortopedia - Responsabile di Struttura Semplice di Traumatologia dello, Sport Knee Surgery and Sports Traumatology Ospedale Sacro Cuore - Don Calabria Via Don, Sempreboni, 5, 37024, Negrar Verona, Italy
| | - Berardo Di Matteo
- II Orthopaedic Clinic and Biomechanics Lab, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Johannes Zellner
- Department of Trauma Surgery, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, 93042, Regensburg, Germany
| | - Peter Angele
- Department of Trauma Surgery, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, 93042, Regensburg, Germany. .,Sporthopaedicum Regensburg, Hildegard von Bingen Strasse 1, 93053, Regensburg, Germany.
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Fernandes ADRC. Are 3D FSE MRI sequences of the knee at 1.5 T effective in the detection of meniscal and ligament tears? How useful are they? Radiol Bras 2016; 49:V-VI. [PMID: 27141144 PMCID: PMC4851472 DOI: 10.1590/0100-3984.2016.49.2e1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Lim D, Han Lee Y, Kim S, Song HT, Suh JS. Clinical value of fat-suppressed 3D volume isotropic spin-echo (VISTA) sequence compared to 2D sequence in evaluating internal structures of the knee. Acta Radiol 2016; 57:66-73. [PMID: 25585850 DOI: 10.1177/0284185114567560] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 12/16/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND Although many three-dimensional (3D) magnetic resonance imaging (MRI) sequences have been used in the clinical field, there are no studies on fat-suppressed (FS) 3D sequences for the diagnosis of knee abnormalities. PURPOSE To evaluate the usefulness of FS 3D volume isotropic turbo spin echo acquisition (VISTA) imaging for diagnosis of internal structures of knee. MATERIAL AND METHODS In 137 patients with 138 knee MRI examinations who had undergone both FS 3D VISTA MRI and two-dimensional (2D) MRI of the knee at 3.0 T, arthroscopic surgery was subsequently performed. Multiplanar reformations (MPR) of FS 3D VISTA images and their MPR sequences were compared with 2D MR images of axial T1-weighted (T1W) images, axial FS T2-weighted (T2W) images, coronal FS T2W images, and sagittal T2W images. Two musculoskeletal radiologists reviewed the images independently. RESULTS Arthroscopy revealed 33 anterior cruciate ligament tears, three posterior cruciate ligament tears, 42 lateral meniscus tears, and 68 medial meniscus tears. Five medial collateral ligament tears were clinically confirmed. Image acquisition time was shorter for FS 3D VISTA imaging than 2D imaging. There were no significant differences in diagnostic values between FS 3D VISTA and 2D imaging (P > 0.05). There were excellent inter-observer agreements for both FS 3D VISTA and 2D imaging (κ > 0.84). CONCLUSION FS 3D VISTA imaging could replace 2D imaging because of equal diagnostic ability and shorter scan time.
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Affiliation(s)
- Daekeon Lim
- Department of Radiology, Research Institute of Radiological Science, Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Radiology, Catholic Kwandong University International St. Mary’s Hospital, Incheon, Republic of Korea
| | - Young Han Lee
- Department of Radiology, Research Institute of Radiological Science, Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sungjun Kim
- Department of Radiology, Research Institute of Radiological Science, Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ho-Taek Song
- Department of Radiology, Research Institute of Radiological Science, Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jin-Suck Suh
- Department of Radiology, Research Institute of Radiological Science, Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
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Pass B, Robinson P, Hodgson R, Grainger AJ. Can a single isotropic 3D fast spin echo sequence replace three-plane standard proton density fat-saturated knee MRI at 1.5 T? Br J Radiol 2015; 88:20150189. [PMID: 26067920 DOI: 10.1259/bjr.20150189] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To assess whether a single isotropic three-dimensional (3D) fast spin echo (FSE) proton density fat-saturated (PD FS) sequence reconstructed in three planes could replace the three PD (FS) sequences in our standard protocol at 1.5 T (Siemens Avanto, Erlangen, Germany). METHODS A 3D FSE PD water excitation sequence was included in the protocol for 95 consecutive patients referred for routine knee MRI. This was used to produce offline reconstructions in axial, sagittal and coronal planes. Two radiologists independently assessed each case twice, once using the standard MRI protocol and once replacing the standard PD (FS) sequences with reconstructions from the 3D data set. Following scoring, the observer reviewed the 3D data set and performed multiplanar reformats to see if this altered confidence. The menisci, ligaments and cartilage were assessed, and statistical analysis was performed using the standard sequence as the reference standard. RESULTS The reporting accuracy was as follows: medial meniscus (MM) = 90.9%, lateral meniscus (LM) = 93.7%, anterior cruciate ligament (ACL) = 98.9% and cartilage surfaces = 85.8%. Agreement among the readers was for the standard protocol: MM kappa = 0.91, LM = 0.89, ACL = 0.98 and cartilage = 0.84; and for the 3D protocol: MM = 0.86, LM = 0.77, ACL = 0.94 and cartilage = 0.64. CONCLUSION A 3D PD FSE sequence reconstructed in three planes gives reduced accuracy and decreased concordance among readers compared with conventional sequences when evaluating the menisci and cartilage with a 1.5-T MRI scanner. ADVANCES IN KNOWLEDGE Using the existing 1.5-T MR systems, a 3D FSE sequence should not replace two-dimensional sequences.
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Affiliation(s)
- B Pass
- 1 Musculoskeletal Centre X-Ray Department, Leeds Teaching Hospitals Trust, Chapel Allerton Hospital, Leeds, UK
| | - P Robinson
- 1 Musculoskeletal Centre X-Ray Department, Leeds Teaching Hospitals Trust, Chapel Allerton Hospital, Leeds, UK.,2 Leeds Musculoskeletal Biomedical Research Unit, University of Leeds, Leeds, UK
| | - R Hodgson
- 3 Centre for Imaging Sciences, University of Manchester, Manchester, UK
| | - A J Grainger
- 1 Musculoskeletal Centre X-Ray Department, Leeds Teaching Hospitals Trust, Chapel Allerton Hospital, Leeds, UK.,2 Leeds Musculoskeletal Biomedical Research Unit, University of Leeds, Leeds, UK
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Morphological MR imaging of the articular cartilage of the knee at 3 T-comparison of standard and novel 3D sequences. Insights Imaging 2015; 6:285-93. [PMID: 25855564 PMCID: PMC4444789 DOI: 10.1007/s13244-015-0405-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 03/05/2015] [Accepted: 03/08/2015] [Indexed: 12/22/2022] Open
Abstract
Objectives This study sought to compare various 3D cartilage sequences and to evaluate the usefulness of ultrashort TE (UTE) imaging, a new technique to isolate signal from the osteochondral junction. Methods Twenty knees were examined at 3 T with 3D spoiled GRE (FLASH), double-echo steady-state (DESS), balanced SSFP, 3D turbo spin-echo (TSE), and a prototype UTE sequence. Two radiologists independently evaluated all images. Consensus readings of all sequences were the reference standard. Statistical analysis included Friedman and pairwise Wilcoxon tests. Retrospective analysis of UTE morphology of osteochondral tissue in normal and abnormal cartilage seen at conventional MR was also performed. Results Three-dimensional TSE was superior to other sequences for detecting cartilage lesions. FLASH and DESS performed best in the subjective quality analysis. On UTE images, normal cartilage exhibited a high-intensity linear signal near the osteochondral junction. Retrospective analysis revealed abnormal UTE morphology of the osteochondral junction in 50 % of cartilage lesions diagnosed at conventional MR. Conclusions Cartilage imaging of the knee at 3 T can be reliably performed using 3D TSE, showing high accuracy when compared to standard sequences. Although UTE depicts signal from the deep cartilage layer, further studies are needed to establish its role for assessment of cartilage. Main Messages • MRI is the best available imaging method for assessment of knee cartilage. • Cartilage imaging can be reliably performed using 3D TSE. • UTE cannot be used as a single sequence to assess cartilage.
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Is Dedicated Extremity 1.5-T MRI Equivalent to Standard Large-Bore 1.5-T MRI for Foot and Knee Examinations? AJR Am J Roentgenol 2014; 203:1293-302. [DOI: 10.2214/ajr.14.12738] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Gondim Teixeira PA, Balaj C, Marie B, Lecocq S, Louis M, Braun M, Blum A. Linear signal hyperintensity adjacent to the subchondral bone plate at the knee on T2-weighted fat-saturated sequences: imaging aspects and association with structural lesions. Skeletal Radiol 2014; 43:1589-98. [PMID: 25117554 DOI: 10.1007/s00256-014-1973-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 07/01/2014] [Accepted: 07/28/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe the association between linear T2 signal abnormalities in the subchondral bone and structural knee lesions. MATERIALS AND METHODS MR studies of patients referred for the evaluation of knee pain were retrospectively evaluated and 133 of these patients presented bone marrow edema pattern (BMEP) (study group) and while 61 did not (control group). The presence of linear anomalies of the subchondral bone on T2-weighted fat-saturated sequences was evaluated. The findings were correlated to the presence of structural knee lesions and to the duration of the patient's symptoms. Histologic analysis of a cadaveric specimen was used for anatomic correlation. RESULTS Linear T2 hyperintensities at the subchondral bone were present in 41% of patients with BMEP. None of the patients in the control group presented this sign. When a subchondral linear hyperintensity was present, the prevalence of radial or root tears was high and that of horizontal tears was low (71.4 and 4.8%, respectively). Sixty-nine percent of the patients with a subchondral insufficiency fracture presented a subchondral linear hyperintensity. It was significantly more prevalent in patients with acute or sub-acute symptoms (p < 0.0001). CONCLUSIONS The studied linear T2 hyperintensity is located at the subchondral spongiosa and can be secondary to local or distant joint injuries. Its presence should evoke acute and sub-acute knee injuries. This sign is closely related to subchondral insufficiency fractures and meniscal tears with a compromise in meniscal function.
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Abstract
MRI has been established as an essential tool for accurate diagnosis in patients with musculoskeletal trauma. Its major advantages include excellent soft tissue contrast, high spatial resolution and lack of ionizing radiation. Although plain radiographs remain the basic tool for diagnosis and treatment planning in bone fractures assisted by CT in pelvic, spine and large joints injuries, there are specific circumstances that require MRI. For instance, tendinous, ligamentous, intraarticular structures such as the cartilage and menisci, and intramedullary injury are seen mostly with MRI. Volumetric 3D techniques are now commercially available and provide higher spatial resolution which improves anatomic detail, allows multiplanar reformations and reduces the acquisition time. Newer applications on quantitative rather than morphologic imaging, such as relaxometry and diffusion tensor imaging, may be of paramount importance in treatment planning in the near future. Software improvements reduce metal induced artefacts, allowing thus imaging of the postoperative patient with metallic implants. A tendency towards a structured reporting pattern and standardised medical communication needs to be further explored for the benefit of orthopaedic surgeons, radiologists and patients.
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