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Albano D, Viglino U, Esposito F, Rizzo A, Messina C, Gitto S, Fusco S, Serpi F, Kamp B, Müller-Lutz A, D’Ambrosi R, Sconfienza LM, Sewerin P. Quantitative and Compositional MRI of the Articular Cartilage: A Narrative Review. Tomography 2024; 10:949-969. [PMID: 39058044 PMCID: PMC11280587 DOI: 10.3390/tomography10070072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 06/01/2024] [Accepted: 06/11/2024] [Indexed: 07/28/2024] Open
Abstract
This review examines the latest advancements in compositional and quantitative cartilage MRI techniques, addressing both their potential and challenges. The integration of these advancements promises to improve disease detection, treatment monitoring, and overall patient care. We want to highlight the pivotal task of translating these techniques into widespread clinical use, the transition of cartilage MRI from technical validation to clinical application, emphasizing its critical role in identifying early signs of degenerative and inflammatory joint diseases. Recognizing these changes early may enable informed treatment decisions, thereby facilitating personalized medicine approaches. The evolving landscape of cartilage MRI underscores its increasing importance in clinical practice, offering valuable insights for patient management and therapeutic interventions. This review aims to discuss the old evidence and new insights about the evaluation of articular cartilage through MRI, with an update on the most recent literature published on novel quantitative sequences.
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Affiliation(s)
- Domenico Albano
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (C.M.); (S.G.); (S.F.); (F.S.); (R.D.); (L.M.S.)
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università degli Studi di Milano, 20122 Milan, Italy
| | - Umberto Viglino
- Unit of Radiology, Ospedale Evangelico Internazionale, 16100 Genova, Italy;
| | - Francesco Esposito
- Division of Radiology, Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, 80138 Naples, Italy;
| | - Aldo Rizzo
- Postgraduate School of Diagnostic and Interventional Radiology, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, Italy;
| | - Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (C.M.); (S.G.); (S.F.); (F.S.); (R.D.); (L.M.S.)
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20122 Milan, Italy
| | - Salvatore Gitto
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (C.M.); (S.G.); (S.F.); (F.S.); (R.D.); (L.M.S.)
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20122 Milan, Italy
| | - Stefano Fusco
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (C.M.); (S.G.); (S.F.); (F.S.); (R.D.); (L.M.S.)
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20122 Milan, Italy
| | - Francesca Serpi
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (C.M.); (S.G.); (S.F.); (F.S.); (R.D.); (L.M.S.)
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20122 Milan, Italy
| | - Benedikt Kamp
- Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany; (B.K.); (A.M.-L.)
| | - Anja Müller-Lutz
- Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany; (B.K.); (A.M.-L.)
| | - Riccardo D’Ambrosi
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (C.M.); (S.G.); (S.F.); (F.S.); (R.D.); (L.M.S.)
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20122 Milan, Italy
| | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (C.M.); (S.G.); (S.F.); (F.S.); (R.D.); (L.M.S.)
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20122 Milan, Italy
| | - Philipp Sewerin
- Rheumazentrum Ruhrgebiet, Ruhr University Bochum, 44649 Herne, Germany;
- Department and Hiller-Research-Unit for Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany
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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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Sui H, Li J, Liu L, Lv Z, Zhang Y, Dai Y, Mo Z. Accelerating Knee MRI: 3D Modulated Flip-Angle Technique in Refocused Imaging with an Extended Echo Train and Compressed Sensing. J Pain Res 2022; 15:577-590. [PMID: 35241934 PMCID: PMC8887673 DOI: 10.2147/jpr.s345210] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 01/28/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose The three-dimensional (3D) sequence of magnetic resonance imaging (MRI) plays a critical role in the imaging of musculoskeletal joints; however, its long acquisition time limits its clinical application. In such conditions, compressed sensing (CS) is introduced to accelerate MRI in clinical practice. We aimed to investigate the feasibility of an isotropic 3D variable-flip-angle fast spin echo (FSE) sequence with CS technique (CS-MATRIX) compared to conventional 2D sequences in knee imaging. Methods Images from different sequences of both the accelerated CS-MATRIX and the corresponding conventional acquisitions were prospectively analyzed and compared. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the structures within the knees were measured for quantitative analysis. The subjective image quality and diagnostic agreement were compared between CS-MATRIX and conventional 2D sequences. Quantitative and subjective image quality scores were statistically analyzed with the paired t-test and Wilcoxon signed-rank test, respectively. Diagnostic agreements of knee substructure were assessed using Cohen’s weighted kappa statistic. Results For quantitative analysis, images from the CS-MATRIX sequence showed a significantly higher SNR than T2-fs 2D sequences for visualizing cartilage, menisci, and ligaments, as well as a higher SNR than proton density (pd) 2D sequences for visualizing menisci and ligaments. There was no significant difference between CS-MATRIX and 2D T2-fs sequences in subjective image quality assessment. The diagnostic agreement was rated as moderate to very good between CS-MATRIX and 2D sequences. Conclusion This study demonstrates the feasibility and clinical potential of the CS-MATRIX sequence technique for detecting knee lesions The CS-MATRIX sequence allows for faster knee imaging than conventional 2D sequences, yielding similar image quality to 2D sequences.
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Affiliation(s)
- He Sui
- China-Japan Union Hospital of Jilin University, Changchun, People’s Republic of China
| | - Jin Li
- Jilin Province People’s Hospital, Changchun, People’s Republic of China
- The Department of Trauma Surgery, Shanghai Oriental Hospital, Shanghai, People's Republic of China
| | - Lin Liu
- China-Japan Union Hospital of Jilin University, Changchun, People’s Republic of China
| | - Zhongwen Lv
- China-Japan Union Hospital of Jilin University, Changchun, People’s Republic of China
| | - Yunfei Zhang
- Central Research Institute, United Imaging Healthcare, Shanghai, 201800, People’s Republic of China
| | - Yongming Dai
- Central Research Institute, United Imaging Healthcare, Shanghai, 201800, People’s Republic of China
| | - Zhanhao Mo
- China-Japan Union Hospital of Jilin University, Changchun, People’s Republic of China
- Correspondence: Zhanhao Mo, China-Japan Union Hospital of Jilin University, No. 126 Xiantai Street, Erdao District, Changchun, People’s Republic of China, Email
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Alsayyad MAI, Ali Shehata KA, Khattab RT. Role of adding T2 mapping sequence to the routine MR imaging protocol in the assessment of articular knee cartilage in osteoarthritis. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2021. [DOI: 10.1186/s43055-021-00453-w] [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 aims at elucidating the role of adding complementary T2 mapping to the routine 1.5 Tesla MRI protocol in the articular knee cartilage assessment for early detection of osteoarthritis, and also, comparing the articular cartilage thickness and T2 relaxation times between the case and control groups regarding knee compartments affection.
Results
Both sensitivities and specificities were 73.3% and 100%, respectively, for the standard MR protocol alone and 96.7% and 90% after adding the T2 mapping to the standard MR protocol that leads to significant sensitivity improvement. A comparison between patients and controls as regards T2 values showed a highly statistically significant difference (independent T test, p <0.001).
Conclusion
A combination of both morphological and T2 mapping MRI, together with clinical evaluation represents a desirable multimodal approach to the diagnosis of osteoarthritis. In the early detection of osteoarthritis, adding T2 mapping sequence to the standard MR protocol at 1.5 Tesla improved sensitivity from 73.3 to 96.7%.
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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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Hayashi D, Roemer FW, Guermazi A. How to effectively utilize imaging in disease-modifying treatments for osteoarthritis clinical trials: the radiologist's perspective. Expert Rev Mol Diagn 2021; 21:673-684. [PMID: 34015975 DOI: 10.1080/14737159.2021.1933444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Introduction: One of the reasons for failures of disease-modifying osteoarthritis drug clinical trials has been the radiography-based definition of structural eligibility criteria. Imaging, particularly MRI, has a critical role in planning and conducting clinical trials of osteoarthritis.Areas covered: A literature search was performed using keywords including 'osteoarthritis,' 'knee,' 'MRI,' 'intra-articular injection,' 'semiquantitative scoring,' 'clinical trial,' and other specific terms where relevant. The core concepts of using MRI in osteoarthritis clinical trials are explained focusing on knee osteoarthritis, including its role in determining patient eligibility and inclusion/exclusion criteria as well as outcome measures from the expert musculoskeletal radiologist's perspective. A brief overview of statistical analyses that should be deployed in clinical trials utilizing semiquantitative MRI analyses is discussed.Expert opinion: In order to increase chances to detect measurable efficacy effects, investigators should consider utilizing MRI from screening to outcome assessment. Recognition of several phenotypes of osteoarthritis helps in participant stratification and will lead to more targeted clinical trials. Inclusion and exclusion criteria need to be defined using not only radiography but also MRI. Correct intra-articular injection of investigational compounds is critically important if intra-articular drug delivery is required, and such procedure should be performed and documented using appropriate imaging guidance.
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Affiliation(s)
- Daichi Hayashi
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA.,Department of Radiology, Stony Brook University, Renaissance School of Medicine, State University of New York, Stony Brook, NY, USA
| | - Frank W Roemer
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA.,Department of Radiology, Friedrich-Alexander University Erlangen-Nuremberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Ali Guermazi
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA.,Department of Radiology, Veterans Affairs Boston Healthcare System, Boston, MA, USA
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Del Grande F, Rashidi A, Luna R, Delcogliano M, Stern SE, Dalili D, Fritz J. Five-Minute Five-Sequence Knee MRI Using Combined Simultaneous Multislice and Parallel Imaging Acceleration: Comparison with 10-Minute Parallel Imaging Knee MRI. Radiology 2021; 299:635-646. [PMID: 33825510 DOI: 10.1148/radiol.2021203655] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background Rapid knee MRI using combined simultaneous multislice (SMS) technique and parallel imaging (PI) acceleration can add value through reduced acquisition time but requires validation of clinical efficacy. Purpose To evaluate the performance of clinical fourfold SMS-PI-accelerated, 5-minute, five-sequence, multicontrast knee MRI protocols compared with standard twofold PI-accelerated, 10-minute knee MRI protocols. Materials and Methods Adults with painful knee conditions were prospectively enrolled from April 2018 to October 2019. Participants underwent fourfold SMS-PI-accelerated, 5-minute, turbo spin-echo (TSE) knee MRI and standard-of-care twofold PI-accelerated, 10-minute, TSE knee MRI at either 1.5 T or 3.0 T. Three radiologists independently evaluated the knee MRI studies for meniscal, tendinous, ligamentous, and osseocartilaginous injuries. Statistical analyses included k-based intermethod agreements and diagnostic performance testing. P < .05 was considered indicative of a statistically significant difference. Results A total of 252 adults were evaluated (mean age ± standard deviation, 47 years ± 17; 134 men). Among the participants, 104 (mean age, 42 years ± 18; 57 women) were in the 1.5-T arm and 148 (mean age, 46 years ± 17; 87 men) were in the 3.0-T arm. Twenty-nine participants (mean age, 38 years ± 12; 15 men) in the 1.5-T arm and 42 (mean age, 41 years ± 16; 24 men) in the 3.0-T arm underwent arthroscopy a mean of 45 days ± 31 and 45 days ± 22 after MRI, respectively. Intermethod agreements were good at 1.5 T (κ >0.71 [95% CI: 0.56, 0.83]) and very good at 3.0 T (κ >0.85 [95% CI: 0.69, 0.96]). The diagnostic performances of corresponding 5-minute and 10-minute MRI protocols were similar for 1.5 T, with areas under the receiver operating characteristic curve (AUCs) greater than 0.78 (95% CI: 0.71, 0.84) (P > .32), and 3.0 T, with AUCs greater than 0.83 (95% CI: 0.78, 0.88) (P > .32). Conclusion Comparisons of 5-minute five-sequence simultaneous multislice- and parallel imaging (PI)-accelerated and 10-minute five-sequence PI-accelerated turbo spin-echo MRI of the knee suggest similar performances at 1.5 and 3.0 T. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Subhas in this issue.
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Affiliation(s)
- Filippo Del Grande
- From the Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Md (F.D.G., A.R., R.L., D.D.); Department of Radiology, Ospedale Regionale di Lugano, Lugano, Switzerland (F.D.G.), Department of Orthopedic Surgery, Ospedale Regionale di Lugano, Lugano, Ticino, Switzerland (M.D.); Centre for Data Analytics, Bond University, Gold Coast, Australia (S.E.S.); Nuffield Orthopedic Center, Oxford University Hospitals NHS Foundation Trust, Oxford, England (D.D.); and Department of Radiology, Grossman School of Medicine, New York University, 660 1st Ave, 3rd Floor, Room 313, New York, NY 10016 (J.F.)
| | - Ali Rashidi
- From the Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Md (F.D.G., A.R., R.L., D.D.); Department of Radiology, Ospedale Regionale di Lugano, Lugano, Switzerland (F.D.G.), Department of Orthopedic Surgery, Ospedale Regionale di Lugano, Lugano, Ticino, Switzerland (M.D.); Centre for Data Analytics, Bond University, Gold Coast, Australia (S.E.S.); Nuffield Orthopedic Center, Oxford University Hospitals NHS Foundation Trust, Oxford, England (D.D.); and Department of Radiology, Grossman School of Medicine, New York University, 660 1st Ave, 3rd Floor, Room 313, New York, NY 10016 (J.F.)
| | - Rodrigo Luna
- From the Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Md (F.D.G., A.R., R.L., D.D.); Department of Radiology, Ospedale Regionale di Lugano, Lugano, Switzerland (F.D.G.), Department of Orthopedic Surgery, Ospedale Regionale di Lugano, Lugano, Ticino, Switzerland (M.D.); Centre for Data Analytics, Bond University, Gold Coast, Australia (S.E.S.); Nuffield Orthopedic Center, Oxford University Hospitals NHS Foundation Trust, Oxford, England (D.D.); and Department of Radiology, Grossman School of Medicine, New York University, 660 1st Ave, 3rd Floor, Room 313, New York, NY 10016 (J.F.)
| | - Marco Delcogliano
- From the Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Md (F.D.G., A.R., R.L., D.D.); Department of Radiology, Ospedale Regionale di Lugano, Lugano, Switzerland (F.D.G.), Department of Orthopedic Surgery, Ospedale Regionale di Lugano, Lugano, Ticino, Switzerland (M.D.); Centre for Data Analytics, Bond University, Gold Coast, Australia (S.E.S.); Nuffield Orthopedic Center, Oxford University Hospitals NHS Foundation Trust, Oxford, England (D.D.); and Department of Radiology, Grossman School of Medicine, New York University, 660 1st Ave, 3rd Floor, Room 313, New York, NY 10016 (J.F.)
| | - Steven E Stern
- From the Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Md (F.D.G., A.R., R.L., D.D.); Department of Radiology, Ospedale Regionale di Lugano, Lugano, Switzerland (F.D.G.), Department of Orthopedic Surgery, Ospedale Regionale di Lugano, Lugano, Ticino, Switzerland (M.D.); Centre for Data Analytics, Bond University, Gold Coast, Australia (S.E.S.); Nuffield Orthopedic Center, Oxford University Hospitals NHS Foundation Trust, Oxford, England (D.D.); and Department of Radiology, Grossman School of Medicine, New York University, 660 1st Ave, 3rd Floor, Room 313, New York, NY 10016 (J.F.)
| | - Danoob Dalili
- From the Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Md (F.D.G., A.R., R.L., D.D.); Department of Radiology, Ospedale Regionale di Lugano, Lugano, Switzerland (F.D.G.), Department of Orthopedic Surgery, Ospedale Regionale di Lugano, Lugano, Ticino, Switzerland (M.D.); Centre for Data Analytics, Bond University, Gold Coast, Australia (S.E.S.); Nuffield Orthopedic Center, Oxford University Hospitals NHS Foundation Trust, Oxford, England (D.D.); and Department of Radiology, Grossman School of Medicine, New York University, 660 1st Ave, 3rd Floor, Room 313, New York, NY 10016 (J.F.)
| | - Jan Fritz
- From the Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Md (F.D.G., A.R., R.L., D.D.); Department of Radiology, Ospedale Regionale di Lugano, Lugano, Switzerland (F.D.G.), Department of Orthopedic Surgery, Ospedale Regionale di Lugano, Lugano, Ticino, Switzerland (M.D.); Centre for Data Analytics, Bond University, Gold Coast, Australia (S.E.S.); Nuffield Orthopedic Center, Oxford University Hospitals NHS Foundation Trust, Oxford, England (D.D.); and Department of Radiology, Grossman School of Medicine, New York University, 660 1st Ave, 3rd Floor, Room 313, New York, NY 10016 (J.F.)
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Chaudhari AS, Kogan F, Pedoia V, Majumdar S, Gold GE, Hargreaves BA. Rapid Knee MRI Acquisition and Analysis Techniques for Imaging Osteoarthritis. J Magn Reson Imaging 2020; 52:1321-1339. [PMID: 31755191 PMCID: PMC7925938 DOI: 10.1002/jmri.26991] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 10/22/2019] [Accepted: 10/22/2019] [Indexed: 12/16/2022] Open
Abstract
Osteoarthritis (OA) of the knee is a major source of disability that has no known treatment or cure. Morphological and compositional MRI is commonly used for assessing the bone and soft tissues in the knee to enhance the understanding of OA pathophysiology. However, it is challenging to extend these imaging methods and their subsequent analysis techniques to study large population cohorts due to slow and inefficient imaging acquisition and postprocessing tools. This can create a bottleneck in assessing early OA changes and evaluating the responses of novel therapeutics. The purpose of this review article is to highlight recent developments in tools for enhancing the efficiency of knee MRI methods useful to study OA. Advances in efficient MRI data acquisition and reconstruction tools for morphological and compositional imaging, efficient automated image analysis tools, and hardware improvements to further drive efficient imaging are discussed in this review. For each topic, we discuss the current challenges as well as potential future opportunities to alleviate these challenges. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY STAGE: 3.
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Affiliation(s)
| | - Feliks Kogan
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Valentina Pedoia
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- Center of Digital Health Innovation (CDHI), University of California San Francisco, San Francisco, California, USA
| | - Sharmila Majumdar
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- Center of Digital Health Innovation (CDHI), University of California San Francisco, San Francisco, California, USA
| | - Garry E. Gold
- Department of Radiology, Stanford University, Stanford, California, USA
- Department of Orthopaedic Surgery, Stanford University, Stanford, California, USA
- Department of Bioengineering, Stanford University, Stanford, California, USA
| | - Brian A. Hargreaves
- Department of Radiology, Stanford University, Stanford, California, USA
- Department of Bioengineering, Stanford University, Stanford, California, USA
- Department of Electrical Engineering, Stanford University, Stanford, California, USA
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Tawfik AI, Kamr WH, Taman SE. Comparison of 2D Fat Suppressed Proton Density (FS-PD) and 3D (WATS-c) MRI pulse sequences in evaluation of chondromalacia patellae. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2019. [DOI: 10.1186/s43055-019-0102-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Comparing the diagnostic performance of widely used 2D FSE technique (fat-suppressed proton density; FS-PD) and the 3D technique (water-selective cartilage scan; WATS-c) in evaluation of the chondromalacia patella by using arthroscopy as reference standard
Results
Seventy-five adult patients were enrolled in this study. They underwent MRI examinations then arthroscopy done in 2–4 days after it. MRI was done using 2D (FS-PD) and 3D (WATS-c) sequences and MR images were compared by two radiologists separately, then grading of the cartilage lesions was performed according to modified Noyes grading system and comparison between grade 0–1, 2, and 3 lesions was done using arthroscopic findings as a reference. A false-negative result is considered if there was undergrading of chondromalacia and false-positive result if chondromalacia was overgraded. Each sequence sensitivity, specificity, and accuracy was calculated by both readers.
For reader 1, the sensitivity is 69% for WATS-c and 80% for FS-PD and the accuracy is 90% for WATS-c and 92% for FS-PD and for reader 2, the sensitivity is 56% for WATS-c and 84% for FS-PD and the accuracy is 88% for WATS-c and 94% for FS-PD.
Conclusion
2D FS-PD images showed better diagnostic performance than 3D WATS-c images for evaluating chondromalacia patella.
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Chaudhari AS, Stevens KJ, Sveinsson B, Wood JP, Beaulieu CF, Oei EH, Rosenberg JK, Kogan F, Alley MT, Gold GE, Hargreaves BA. Combined 5-minute double-echo in steady-state with separated echoes and 2-minute proton-density-weighted 2D FSE sequence for comprehensive whole-joint knee MRI assessment. J Magn Reson Imaging 2019; 49:e183-e194. [PMID: 30582251 PMCID: PMC7850298 DOI: 10.1002/jmri.26582] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 11/01/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Clinical knee MRI protocols require upwards of 15 minutes of scan time. PURPOSE/HYPOTHESIS To compare the imaging appearance of knee abnormalities depicted with a 5-minute 3D double-echo in steady-state (DESS) sequence with separate echo images, with that of a routine clinical knee MRI protocol. A secondary goal was to compare the imaging appearance of knee abnormalities depicted with 5-minute DESS paired with a 2-minute coronal proton-density fat-saturated (PDFS) sequence. STUDY TYPE Prospective. SUBJECTS Thirty-six consecutive patients (19 male) referred for a routine knee MRI. FIELD STRENGTH/SEQUENCES DESS and PDFS at 3T. ASSESSMENT Five musculoskeletal radiologists evaluated all images for the presence of internal knee derangement using DESS, DESS+PDFS, and the conventional imaging protocol, and their associated diagnostic confidence of the reading. STATISTICAL TESTS Differences in positive and negative percent agreement (PPA and NPA, respectively) and 95% confidence intervals (CIs) for DESS and DESS+PDFS compared with the conventional protocol were calculated and tested using exact McNemar tests. The percentage of observations where DESS or DESS+PDFS had equivalent confidence ratings to DESS+Conv were tested with exact symmetry tests. Interreader agreement was calculated using Krippendorff's alpha. RESULTS DESS had a PPA of 90% (88-92% CI) and NPA of 99% (99-99% CI). DESS+PDFS had increased PPA of 99% (95-99% CI) and NPA of 100% (99-100% CI) compared with DESS (both P < 0.001). DESS had equivalent diagnostic confidence to DESS+Conv in 94% of findings, whereas DESS+PDFS had equivalent diagnostic confidence in 99% of findings (both P < 0.001). All readers had moderate concordance for all three protocols (Krippendorff's alpha 47-48%). DATA CONCLUSION Both 1) 5-minute 3D-DESS with separated echoes and 2) 5-minute 3D-DESS paired with a 2-minute coronal PDFS sequence depicted knee abnormalities similarly to a routine clinical knee MRI protocol, which may be a promising technique for abbreviated knee MRI. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018.
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Affiliation(s)
- Akshay S. Chaudhari
- Department of Radiology, Stanford University, Stanford, California, USA
- Department of Bioengineering, Stanford University, Stanford, California, USA
| | - Kathryn J. Stevens
- Department of Radiology, Stanford University, Stanford, California, USA
- Department of Orthopaedic Surgery, Stanford University, Stanford, California, USA
| | - Bragi Sveinsson
- Department of Radiology, Stanford University, Stanford, California, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Radiology, Harvard Medical School, Boston, Massachusetts, USA
| | - Jeff P. Wood
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Christopher F. Beaulieu
- Department of Radiology, Stanford University, Stanford, California, USA
- Department of Orthopaedic Surgery, Stanford University, Stanford, California, USA
| | - Edwin H.G. Oei
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | | | - Feliks Kogan
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Marcus T. Alley
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Garry E. Gold
- Department of Radiology, Stanford University, Stanford, California, USA
- Department of Bioengineering, Stanford University, Stanford, California, USA
- Department of Orthopaedic Surgery, Stanford University, Stanford, California, USA
| | - Brian A. Hargreaves
- Department of Radiology, Stanford University, Stanford, California, USA
- Department of Bioengineering, Stanford University, Stanford, California, USA
- Department of Electrical Engineering, Stanford University, Stanford, California, USA
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11
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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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Chaudhari AS, Fang Z, Kogan F, Wood J, Stevens KJ, Gibbons EK, Lee JH, Gold GE, Hargreaves BA. Super-resolution musculoskeletal MRI using deep learning. Magn Reson Med 2018; 80:2139-2154. [PMID: 29582464 PMCID: PMC6107420 DOI: 10.1002/mrm.27178] [Citation(s) in RCA: 196] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 02/14/2018] [Accepted: 02/22/2018] [Indexed: 12/22/2022]
Abstract
PURPOSE To develop a super-resolution technique using convolutional neural networks for generating thin-slice knee MR images from thicker input slices, and compare this method with alternative through-plane interpolation methods. METHODS We implemented a 3D convolutional neural network entitled DeepResolve to learn residual-based transformations between high-resolution thin-slice images and lower-resolution thick-slice images at the same center locations. DeepResolve was trained using 124 double echo in steady-state (DESS) data sets with 0.7-mm slice thickness and tested on 17 patients. Ground-truth images were compared with DeepResolve, clinically used tricubic interpolation, and Fourier interpolation methods, along with state-of-the-art single-image sparse-coding super-resolution. Comparisons were performed using structural similarity, peak SNR, and RMS error image quality metrics for a multitude of thin-slice downsampling factors. Two musculoskeletal radiologists ranked the 3 data sets and reviewed the diagnostic quality of the DeepResolve, tricubic interpolation, and ground-truth images for sharpness, contrast, artifacts, SNR, and overall diagnostic quality. Mann-Whitney U tests evaluated differences among the quantitative image metrics, reader scores, and rankings. Cohen's Kappa (κ) evaluated interreader reliability. RESULTS DeepResolve had significantly better structural similarity, peak SNR, and RMS error than tricubic interpolation, Fourier interpolation, and sparse-coding super-resolution for all downsampling factors (p < .05, except 4 × and 8 × sparse-coding super-resolution downsampling factors). In the reader study, DeepResolve significantly outperformed (p < .01) tricubic interpolation in all image quality categories and overall image ranking. Both readers had substantial scoring agreement (κ = 0.73). CONCLUSION DeepResolve was capable of resolving high-resolution thin-slice knee MRI from lower-resolution thicker slices, achieving superior quantitative and qualitative diagnostic performance to both conventionally used and state-of-the-art methods.
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Affiliation(s)
- Akshay S. Chaudhari
- Department of Radiology, Stanford University, Stanford, California, USA
- Department of Bioengineering, Stanford University, Stanford, California, USA
| | | | - Feliks Kogan
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Jeff Wood
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Kathryn J Stevens
- Department of Radiology, Stanford University, Stanford, California, USA
- Department of Orthopaedic Surgery, Stanford University, Stanford, California, USA
| | - Eric K. Gibbons
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Jin Hyung Lee
- Department of Bioengineering, Stanford University, Stanford, California, USA
- LVIS Corporation, Palo Alto, California, USA
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, California, USA
- Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Garry E. Gold
- Department of Radiology, Stanford University, Stanford, California, USA
- Department of Bioengineering, Stanford University, Stanford, California, USA
- Department of Orthopaedic Surgery, Stanford University, Stanford, California, USA
| | - Brian A. Hargreaves
- Department of Radiology, Stanford University, Stanford, California, USA
- Department of Bioengineering, Stanford University, Stanford, California, USA
- Department of Electrical Engineering, Stanford University, Stanford, California, USA
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14
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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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15
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Bratke G, Rau R, Weiss K, Kabbasch C, Sircar K, Morelli JN, Persigehl T, Maintz D, Giese D, Haneder S. Accelerated MRI of the Lumbar Spine Using Compressed Sensing: Quality and Efficiency. J Magn Reson Imaging 2018; 49:e164-e175. [PMID: 30267462 DOI: 10.1002/jmri.26526] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 09/10/2018] [Accepted: 09/12/2018] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Decreasing MRI scan time is a key factor to increase patient comfort and compliance as well as the productivity of MRI scanners. PURPOSE/HYPOTHESIS Compressed sensing (CS) should significantly accelerate 3D scans. This study evaluated the clinical application and cost effectiveness of accelerated 3D T2 sequences of the lumbar spine. STUDY TYPE Prospective, cross-sectional, observational. POPULATION Twenty healthy volunteers and 10 patients. FIELD STRENGTH/SEQUENCE A 3D T2 TSE sequence, identical 3D sequences with three different parallel imaging and CS accelerating factors, and 2D TSE sequences as a clinical reference were obtained on a 3T scanner. ASSESSMENT Three readers evaluated the sequences for delineation of anatomical structures and image quality. A quantitative analysis consisting of root mean square error, structural similarity index, signal-to-noise ratio, and contrast-to-noise ratio were performed. The scan times were used to calculate cost differences for each sequence. STATISTICAL TESTS An analysis of variance with repeated measurements and the Friedman test were used to test for potential differences between the sequences. Post-hoc analysis was made with the chi-squared and Tukey-Kramer test. RESULTS CS with factor 4.5 results in unchanged image quality compared to the T2 TSE for volunteers and patients (overall image impression: 4.75 vs. 4.20 [P = 0.73] and 4.90 vs. 4.47 [P = 0.44]). The CS 4.5 scan is 167 seconds (-39%) faster than the 3D and 216.5 seconds (-45%) faster than the 2D sequences. No significant differences was found for the diagnostic certainty in the volunteers and patients between 2D TSE and 3D CS 4.5 (P = 0.89 and P = 0.43). A reduction of scan time to 148 seconds (CS 8) was still rated acceptable for most diagnosis. DATA CONCLUSION CS accelerates the 3D T2 without compromising image quality. The 3D sequences offer comparable diagnostic quality to the clinical 2D standard with less scan time (-45%), potentially increasing the productivity of MRI scanners. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 6 J. Magn. Reson. Imaging 2019;49:e164-e175.
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Affiliation(s)
- Grischa Bratke
- Department of Radiology, University Hospital Cologne, Cologne, Germany
| | - Robert Rau
- Department of Radiology, University Hospital Cologne, Cologne, Germany
| | | | | | - Krishnan Sircar
- Department of Orthopedics, University Hospital Cologne, Cologne, Germany
| | | | | | - David Maintz
- Department of Radiology, University Hospital Cologne, Cologne, Germany
| | - Daniel Giese
- Department of Radiology, University Hospital Cologne, Cologne, Germany
| | - Stefan Haneder
- Department of Radiology, University Hospital Cologne, Cologne, Germany
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16
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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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17
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Altahawi F, Subhas N. 3D MRI in Musculoskeletal Imaging: Current and Future Applications. CURRENT RADIOLOGY REPORTS 2018. [DOI: 10.1007/s40134-018-0287-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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18
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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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Sample SJ, Racette MA, Hans EC, Volstad NJ, Holzman G, Bleedorn JA, Schaefer SL, Waller KR, Hao Z, Block WF, Muir P. Radiographic and magnetic resonance imaging predicts severity of cruciate ligament fiber damage and synovitis in dogs with cranial cruciate ligament rupture. PLoS One 2017; 12:e0178086. [PMID: 28575001 PMCID: PMC5456057 DOI: 10.1371/journal.pone.0178086] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Accepted: 05/07/2017] [Indexed: 11/19/2022] Open
Abstract
Cruciate ligament rupture (CR) and associated osteoarthritis (OA) is a common condition in dogs. Dogs frequently develop a second contralateral CR. This study tested the hypothesis that the degree of stifle synovitis and cranial cruciate ligament (CrCL) matrix damage in dogs with CR is correlated with non-invasive diagnostic tests, including magnetic resonance (MR) imaging. We conducted a prospective cohort study of 29 client-owned dogs with an unstable stifle due to complete CR and stable contralateral stifle with partial CR. We evaluated correlation of stifle synovitis and CrCL fiber damage with diagnostic tests including bilateral stifle radiographs, 3.0 Tesla MR imaging, and bilateral stifle arthroscopy. Histologic grading and immunohistochemical staining for CD3+ T lymphocytes, TRAP+ activated macrophages and Factor VIII+ blood vessels in bilateral stifle synovial biopsies were also performed. Serum and synovial fluid concentrations of C-reactive protein (CRP) and carboxy-terminal telopeptide of type I collagen (ICTP), and synovial total nucleated cell count were determined. Synovitis was increased in complete CR stifles relative to partial CR stifles (P<0.0001), although total nucleated cell count in synovial fluid was increased in partial CR stifles (P<0.01). In partial CR stifles, we found that 3D Fast Spin Echo Cube CrCL signal intensity was correlated with histologic synovitis (SR = 0.50, P<0.01) and that radiographic OA was correlated with CrCL fiber damage assessed arthroscopically (SR = 0.61, P<0.001). Taken together, results of this study show that clinical diagnostic tests predict severity of stifle synovitis and cruciate ligament matrix damage in stable partial CR stifles. These data support use of client-owned dogs with unilateral complete CR and contralateral partial CR as a clinical trial model for investigation of disease-modifying therapy for partial CR.
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Affiliation(s)
- Susannah J. Sample
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Molly A. Racette
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Eric C. Hans
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Nicola J. Volstad
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Gerianne Holzman
- UW Veterinary Care Hospital, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Jason A. Bleedorn
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Susan L. Schaefer
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Kenneth R. Waller
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Zhengling Hao
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Walter F. Block
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Peter Muir
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- * E-mail:
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Comparison of a Fast 5-Minute Shoulder MRI Protocol With a Standard Shoulder MRI Protocol: A Multiinstitutional Multireader Study. AJR Am J Roentgenol 2017; 208:W146-W154. [DOI: 10.2214/ajr.16.17041] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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21
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Chaudhari AS, Sveinsson B, Moran CJ, McWalter EJ, Johnson EM, Zhang T, Gold GE, Hargreaves BA. Imaging and T 2 relaxometry of short-T 2 connective tissues in the knee using ultrashort echo-time double-echo steady-state (UTEDESS). Magn Reson Med 2017; 78:2136-2148. [PMID: 28074498 DOI: 10.1002/mrm.26577] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 10/26/2016] [Accepted: 11/19/2016] [Indexed: 12/15/2022]
Abstract
PURPOSE To develop a radial, double-echo steady-state (DESS) sequence with ultra-short echo-time (UTE) capabilities for T2 measurement of short-T2 tissues along with simultaneous rapid, signal-to-noise ratio (SNR)-efficient, and high-isotropic-resolution morphological knee imaging. METHODS THe 3D radial UTE readouts were incorporated into DESS, termed UTEDESS. Multiple-echo-time UTEDESS was used for performing T2 relaxometry for short-T2 tendons, ligaments, and menisci; and for Dixon water-fat imaging. In vivo T2 estimate repeatability and SNR efficiency for UTEDESS and Cartesian DESS were compared. The impact of coil combination methods on short-T2 measurements was evaluated by means of simulations. UTEDESS T2 measurements were compared with T2 measurements from Cartesian DESS, multi-echo spin-echo (MESE), and fast spin-echo (FSE). RESULTS UTEDESS produced isotropic resolution images with high SNR efficiency in all short-T2 tissues. Simulations and experiments demonstrated that sum-of-squares coil combinations overestimated short-T2 measurements. UTEDESS measurements of meniscal T2 were comparable to DESS, MESE, and FSE measurements while the tendon and ligament measurements were less biased than those from Cartesian DESS. Average UTEDESS T2 repeatability variation was under 10% in all tissues. CONCLUSION The T2 measurements of short-T2 tissues and high-resolution morphological imaging provided by UTEDESS makes it promising for studying the whole knee, both in routine clinical examinations and longitudinal studies. Magn Reson Med 78:2136-2148, 2017. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Akshay S Chaudhari
- Department of Radiology, Stanford University, Stanford, California, USA.,Department of Bioengineering, Stanford University, Stanford, California, USA
| | - Bragi Sveinsson
- Department of Radiology, Stanford University, Stanford, California, USA.,Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Catherine J Moran
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Emily J McWalter
- Department of Mechanical Engineering, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Ethan M Johnson
- Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Tao Zhang
- Department of Radiology, Stanford University, Stanford, California, USA.,Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Garry E Gold
- Department of Radiology, Stanford University, Stanford, California, USA.,Department of Bioengineering, Stanford University, Stanford, California, USA
| | - Brian A Hargreaves
- Department of Radiology, Stanford University, Stanford, California, USA.,Department of Bioengineering, Stanford University, Stanford, California, USA.,Department of Electrical Engineering, Stanford University, Stanford, California, USA
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22
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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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23
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A Current Review of the Meniscus Imaging: Proposition of a Useful Tool for Its Radiologic Analysis. Radiol Res Pract 2016; 2016:8329296. [PMID: 27057352 PMCID: PMC4766355 DOI: 10.1155/2016/8329296] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 01/05/2016] [Accepted: 01/12/2016] [Indexed: 01/07/2023] Open
Abstract
The main objective of this review was to present a synthesis of the current literature in order to provide a useful tool to clinician in radiologic analysis of the meniscus. All anatomical descriptions were clearly illustrated by MRI, arthroscopy, and/or drawings. The value of standard radiography is extremely limited for the assessment of meniscal injuries but may be indicated to obtain a differential diagnosis such as osteoarthritis. Ultrasound is rarely used as a diagnostic tool for meniscal pathologies and its accuracy is operator-dependent. CT arthrography with multiplanar reconstructions can detect meniscus tears that are not visible on MRI. This technique is also useful in case of MRI contraindications, in postoperative assessment of meniscal sutures and the condition of cartilage covering the articular surfaces. MRI is the most accurate and less invasive method for diagnosing meniscal lesions. MRI allows confirming and characterizing the meniscal lesion, the type, the extension, its association with a cyst, the meniscal extrusion, and assessing cartilage and subchondral bone. New 3D-MRI in three dimensions with isotropic resolution allows the creation of multiplanar reformatted images to obtain from an acquisition in one sectional plane reconstructions in other spatial planes. 3D MRI should further improve the diagnosis of meniscal tears.
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Abstract
OBJECTIVE Unenhanced MRI, indirect MR arthrography, and direct MR arthrography have been used in the radiologic evaluation of patients with suspected labral tears and chondral lesions of the hip. The purpose of this article is to examine the existing evidence for the use of these techniques in patients with hip pain and suspected labral or chondral abnormalities. CONCLUSION Evidence from a review of the radiologic literature supports the use of direct MR arthrography over unenhanced MRI and indirect MR arthrography for the detection of labral and cartilage abnormalities in the hip. Although high-resolution unenhanced 3-T MRI appears promising, limited information in the literature supports its use in the detection and characterization of chondrolabral lesions.
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25
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Evaluation of the Articular Cartilage of the Knee Joint Using an Isotropic Resolution 3D Fast Spin-Echo Sequence With Conventional and Radial Reformatted Images. AJR Am J Roentgenol 2015. [DOI: 10.2214/ajr.14.14265] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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26
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Keenan KE, Besier TF, Pauly JM, Smith RL, Delp SL, Beaupre GS, Gold GE. T1ρ Dispersion in Articular Cartilage: Relationship to Material Properties and Macromolecular Content. Cartilage 2015; 6:113-22. [PMID: 26069714 PMCID: PMC4462251 DOI: 10.1177/1947603515569529] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE This study assessed T1ρ relaxation dispersion, measured by magnetic resonance imaging (MRI), as a tool to noninvasively evaluate cartilage material and biochemical properties. The specific objective was to answer two questions: (1) does cartilage initial elastic modulus (E 0) correlate with T1ρ dispersion effects and (2) does collagen or proteoglycan content correlate with T1ρ dispersion effects? DESIGN Cadaveric patellae with and without visible cartilage damage on conventional MR were included. T2 and T1ρ relaxation times at 500 and 1000 Hz spin-lock field amplitudes were measured. We estimated T1ρ dispersion effects by measuring T1ρ relaxation time at 500 and 1000 Hz and T2 relaxation time and using a new tool, the ratio T1ρ/T2. Cartilage initial elastic modulus, E 0, was measured from initial response of mechanical indentation creep tests. Collagen and proteoglycan contents were measured at the indentation test sites; proteoglycan content was measured by their covalently linked sulfated glycosaminoglycans (sGAG). Pearson correlation coefficients were determined, taking into account the clustering of multiple samples within a single patella specimen. RESULTS Cartilage initial elastic modulus, E 0, increased with decreasing values of T1ρ/T2 measurements at both 500 Hz (P = 0.034) and 1000 Hz (P = 0.022). 1/T1ρ relaxation time (500 Hz) increased with increasing sGAG content (P = 0.041). CONCLUSIONS T1ρ/T2 ratio, a new tool, and cartilage initial elastic modulus are both measures of water-protein interactions, are dependent on the cartilage structure, and were correlated in this study.
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Affiliation(s)
- Kathryn E. Keenan
- Department of Mechanical Engineering, Stanford University, Stanford, CA, USA
| | - Thor F. Besier
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - John M. Pauly
- Magnetic Resonance Systems Research Laboratory, Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | - R. Lane Smith
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA,Rehabilitation R&D Musculoskeletal Research Laboratory, Department of Veterans Affairs, Palo Alto, CA, USA
| | - Scott L. Delp
- Department of Mechanical Engineering, Stanford University, Stanford, CA, USA,Department of Bioengineering, Stanford University, Stanford, CA, USA
| | - Gary S. Beaupre
- Rehabilitation R&D Musculoskeletal Research Laboratory, Department of Veterans Affairs, Palo Alto, CA, USA
| | - Garry E. Gold
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA,Department of Bioengineering, Stanford University, Stanford, CA, USA,Department of Radiology, Stanford University, Stanford, CA, USA
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27
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Huang M, Schweitzer ME. The role of radiology in the evolution of the understanding of articular disease. Radiology 2015; 273:S1-22. [PMID: 25340431 DOI: 10.1148/radiol.14140270] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Both the clinical practice of radiology and the journal Radiology have had an enormous effect on our understanding of articular disease. Early descriptions of osteoarthritis (OA) appeared in Radiology. More recently, advanced physiologic magnetic resonance (MR) techniques have furthered our understanding of the early prestructural changes in patients with OA. Sodium imaging, delayed gadolinium-enhanced MR imaging of cartilage, and spin-lattice relaxation in the rotating frame (or T1ρ) sequences have advanced understanding of the pathophysiology and pathoanatomy of OA. Many pioneering articles on rheumatoid arthritis (RA) also have been published in Radiology. In the intervening decades, our understanding of the natural history of RA has been altered by these articles. Many of the first descriptions of crystalline arthropathies, including gout, calcium pyrophosphate deposition, and hydroxyapatite deposition disease, appeared in Radiology.
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Affiliation(s)
- Mingqian Huang
- From the Department of Radiology, University of Stony Brook, HSC Level 4, Room 120, Stony Brook, NY 11746
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28
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Shapiro LM, Matzat SJ, Gold GE. Functional magnetic resonance imaging. Rheumatology (Oxford) 2015. [DOI: 10.1016/b978-0-323-09138-1.00041-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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29
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Kloth JK, Winterstein M, Akbar M, Meyer E, Paul D, Kauczor HU, Weber MA. Comparison of 3D turbo spin-echo SPACE sequences with conventional 2D MRI sequences to assess the shoulder joint. Eur J Radiol 2014; 83:1843-9. [PMID: 25082477 DOI: 10.1016/j.ejrad.2014.06.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 05/20/2014] [Accepted: 06/16/2014] [Indexed: 11/29/2022]
Abstract
PURPOSE To determine the accuracy and reliability of three-dimensional (3D) T1- and proton density (PD)-weighted turbo spin-echo (TSE) sampling perfection with application-optimized contrasts using different flip-angle evolution (SPACE) compared with conventional 2D sequences in assessment of the shoulder-joint. MATERIALS AND METHODS Ninety-three subjects were examined on a 3-T MRI system with both conventional 2D-TSE sequences in T1-, T2- and PD-weighting and 3D SPACE sequences in T1- and PD-weighting. All examinations were assessed independently by two reviewers for common pathologies of the shoulder-joint. Agreement between 2D- and 3D-sequences and inter-observer-agreement was evaluated using kappa-statistics. RESULTS Using conventional 2D TSE sequences as standard of reference, sensitivity, specificity, and accuracy values of 3D SPACE were 81.8%, 95.1%, and 93.5% for injuries of the supraspinatus-tendon (SSP), 81.3%, 93.5%, and 91.4% for the cartilage layer and 82.4%, 98.5%, and 97.5% for the long biceps tendon. Concordance between 2D and 3D was almost perfect for tendinopathies of the SSP (κ=0.85), osteoarthritis (κ=1), luxation of the biceps tendon (κ=1) and adjacent bone marrow (κ=0.92). Inter-observer-agreement was generally higher for conventional 2D TSE sequences (κ, 0.23-1.0), when compared to 3D SPACE sequences (κ, -0.33 to 1.0) except for disorders of the long biceps tendon and supraspinatus tendon rupture. CONCLUSION Because of substantial and almost perfect concordance with conventional 2D TSE sequences for common shoulder pathologies, MRI examination-time can be reduced by nearly 40% (up to 11 min) using 3D-SPACE without loss of information.
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Affiliation(s)
- Jost Karsten Kloth
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany.
| | - Marianne Winterstein
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany.
| | - Michael Akbar
- Orthopedic and Trauma Surgery, University Hospital Heidelberg, Schlierbacher Landstraße 200a, D-69118 Heidelberg, Germany.
| | | | | | - Haus-Ulrich Kauczor
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany.
| | - Marc-André Weber
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany.
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30
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Shapiro LM, McWalter EJ, Son MS, Levenston M, Hargreaves BA, Gold GE. Mechanisms of osteoarthritis in the knee: MR imaging appearance. J Magn Reson Imaging 2014; 39:1346-56. [PMID: 24677706 DOI: 10.1002/jmri.24562] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Accepted: 07/14/2013] [Indexed: 01/15/2023] Open
Abstract
Osteoarthritis has grown to become a widely prevalent disease that has major implications in both individual and public health. Although originally considered to be a degenerative disease driven by "wear and tear" of the articular cartilage, recent evidence has led to a consensus that osteoarthritis pathophysiology should be perceived in the context of the entire joint and multiple tissues. MRI is becoming an increasingly more important modality for imaging osteoarthritis, due to its excellent soft tissue contrast and ability to acquire morphological and biochemical data. This review will describe the pathophysiology of osteoarthritis as it is associated with various tissue types, highlight several promising MR imaging techniques for osteoarthritis and illustrate the expected appearance of osteoarthritis with each technique.
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Affiliation(s)
- Lauren M Shapiro
- Department of Radiology, Stanford University, Stanford, California, USA
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31
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Al saleh H, Hernandez L, Lee KS, Rosas HG, Block WF, Kijowski R. Rapid isotropic resolution cartilage assessment using radial alternating repetition time balanced steady-state free-precession imaging. J Magn Reson Imaging 2013; 40:796-803. [PMID: 24151247 DOI: 10.1002/jmri.24425] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 08/27/2013] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To compare a balanced steady-state free-precession sequence with a radial k-space trajectory and alternating repetition time fat suppression (Radial-ATR) with other currently used fat-suppressed 3D sequences for evaluating the articular cartilage of the knee joint at 3.0T. MATERIALS AND METHODS Radial-ATR, fast spin-echo (FSE-Cube), gradient recall-echo acquired in the steady-state (GRASS), and spoiled gradient recall-echo (SPGR) sequences with similar voxel volumes and identical scan times were performed at 3.0T on both knee joints of five volunteers. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) measurements were performed for all sequences using a double acquisition method and compared using Mann-Whitney Wilcoxon tests. Radial-ATR sequences with 0.3 mm and 0.4 mm isotropic resolution were also performed on the knee joints of seven volunteers and three patients with osteoarthritis. RESULTS Average SNR values for cartilage, synovial fluid, and bone marrow were 54.7, 153.3, and 12.9, respectively, for Radial ATR, 30.8, 44.1, and 1.9, respectively, for FSE-Cube, 13.3, 46.9, and 3.3, respectively, for GRASS, and 19.1, 8.1, and 2.1, respectively, for SPGR. Average CNR values between cartilage and synovial fluid and between cartilage and bone marrow were 98.6 and 41.8, respectively, for VIPR-ATR, 13.4 and 28.8, respectively, for FSE-Cube, 33.6 and 10.0, respectively, for GRASS, and 11.0 and 16.9, respectively, for SPGR. Radial-ATR had significantly higher (P < 0.001) cartilage, synovial fluid, and bone marrow SNR and significantly higher (P < 0.01) CNR between cartilage and synovial fluid and between cartilage and bone marrow than FSE-Cube, GRASS, and SPGR. Radial-ATR provided excellent visualization of articular cartilage at high isotropic resolution with no image degradation due to off-resonance banding artifacts. CONCLUSION Radial-ATR had superior SNR efficiency to other fat-suppressed 3D cartilage imaging sequences and produced high isotropic resolution images of the knee joint which could be used for evaluating articular cartilage at 3.0T.
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Affiliation(s)
- Habib Al saleh
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin, USA
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32
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Bultman EM, Klaers J, Johnson KM, François CJ, Schiebler ML, Reeder SB, Block WF. Non-contrast enhanced 3D SSFP MRA of the renal allograft vasculature: a comparison between radial linear combination and Cartesian inflow-weighted acquisitions. Magn Reson Imaging 2013; 32:190-5. [PMID: 24246390 DOI: 10.1016/j.mri.2013.10.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 09/03/2013] [Accepted: 10/07/2013] [Indexed: 11/20/2022]
Abstract
Renal transplant patients often require imaging to ensure appropriate graft placement, to assess integrity of transplant vessel anastomosis and to evaluate for stenosis that can be a cause of graft failure. Because there is risk for nephrogenic systemic fibrosis in the setting of renal insufficiency, the use of non-contrast MRA in these patients is helpful. In this study, the ability of two non-contrast MRA methods - 3D radial linear combination balanced SSFP (VIPR-SSFP) and inflow-weighted Cartesian SSFP (IFIR) - to visualize the transplant renal vessels is compared. Twenty-one renal transplant patients were scanned using the VIPR-SSFP and IFIR sequences. Diagnostic efficacy of the sequences was scored using a four point Likert scale according to the following criteria: overall image quality, fat suppression, and arterial/venous visualization quality. Average scores for each criterion were compared using the Wilcoxon signed-rank test. In addition to significantly improved venous visualization, the VIPR-SSFP sequence provided significantly improved fat suppression quality (p<0.03) compared to IFIR. VIPR-SSFP also identified several pathologies such as renal arterial pseudoaneurysm that were not visible on the IFIR images. However, IFIR afforded superior quality of arterial visualization (p<0.005). These two methods of non-contrast MR imaging each have significant strengths and are complementary to each other in evaluating the vasculature of renal allografts.
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Affiliation(s)
- Eric M Bultman
- Department of Biomedical Engineering, University of Wisconsin, Madison, WI.
| | - Jessica Klaers
- Department of Medical Physics, University of Wisconsin, Madison, WI
| | - Kevin M Johnson
- Department of Medical Physics, University of Wisconsin, Madison, WI
| | | | | | - Scott B Reeder
- Department of Biomedical Engineering, University of Wisconsin, Madison, WI; Department of Medical Physics, University of Wisconsin, Madison, WI; Department of Radiology, University of Wisconsin, Madison, WI; Department of Medicine, University of Wisconsin, Madison, WI
| | - Walter F Block
- Department of Biomedical Engineering, University of Wisconsin, Madison, WI; Department of Medical Physics, University of Wisconsin, Madison, WI; Department of Radiology, University of Wisconsin, Madison, WI
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Kudo H, Inaoka T, Kitamura N, Nakatsuka T, Kasuya S, Kasai R, Tozawa M, Nakagawa K, Terada H. Clinical value of routine use of thin-section 3D MRI using 3D FSE sequences with a variable flip angle technique for internal derangements of the knee joint at 3T. Magn Reson Imaging 2013; 31:1309-17. [DOI: 10.1016/j.mri.2013.02.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Revised: 01/20/2013] [Accepted: 02/20/2013] [Indexed: 10/26/2022]
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Rosas H, Kijowski R. Volumetric magnetic resonance imaging of the musculoskeletal system. Semin Roentgenol 2013; 48:140-7. [PMID: 23452461 DOI: 10.1053/j.ro.2012.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Humberto Rosas
- Department of Radiology, Musculoskeletal Division, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792-3252, USA.
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35
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Braun HJ, Dragoo JL, Hargreaves BA, Levenston ME, Gold GE. Application of advanced magnetic resonance imaging techniques in evaluation of the lower extremity. Radiol Clin North Am 2013; 51:529-45. [PMID: 23622097 PMCID: PMC3639445 DOI: 10.1016/j.rcl.2012.12.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
This article reviews current magnetic resonance imaging (MR imaging) techniques for imaging the lower extremity, focusing on imaging of the knee, ankle, and hip joints. Recent advancements in MR imaging include imaging at 7 T, using multiple receiver channels, T2* imaging, and metal suppression techniques, allowing more detailed visualization of complex anatomy, evaluation of morphologic changes within articular cartilage, and imaging around orthopedic hardware.
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Affiliation(s)
- Hillary J. Braun
- Department of Radiology, Stanford University
- Department of Orthopaedic Surgery, Stanford University
| | | | - Brian A. Hargreaves
- Department of Radiology, Stanford University
- Department of Bioengineering, Stanford University
| | | | - Garry E. Gold
- Department of Radiology, Stanford University
- Department of Orthopaedic Surgery, Stanford University
- Department of Bioengineering, Stanford University
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36
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Kijowski R, Blankenbaker DG, Munoz Del Rio A, Baer GS, Graf BK. Evaluation of the Articular Cartilage of the Knee Joint: Value of Adding a T2 Mapping Sequence to a Routine MR Imaging Protocol. Radiology 2013; 267:503-13. [PMID: 23297335 DOI: 10.1148/radiol.12121413] [Citation(s) in RCA: 127] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Richard Kijowski
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Clinical Science Center-E3/311, Madison, WI 53792-3252, USA.
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37
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Jung JY, Yoon YC, Kim HR, Choe BK, Wang JH, Jung JY. Knee derangements: comparison of isotropic 3D fast spin-echo, isotropic 3D balanced fast field-echo, and conventional 2D fast spin-echo MR imaging. Radiology 2013; 268:802-13. [PMID: 23533289 DOI: 10.1148/radiol.13121990] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To compare diagnostic performance, subjective image quality, and artifacts of isotropic three-dimensional (3D) intermediate-weighted (IW) fast spin-echo (SE), isotropic 3D balanced fast field-echo (FFE), and conventional two-dimensional (2D) fast SE 3.0-T MR sequences in evaluation of cartilage, ligaments, menisci, and osseous knee structures in symptomatic patients. MATERIALS AND METHODS Institutional review board approval and waiver of informed consent were obtained for this HIPAA-compliant study. One hundred MR studies, each with three data sets (3D IW fast SE, 3D balanced FFE, 2D fast SE), were reviewed retrospectively. Two radiologists independently evaluated images for cartilaginous defects, anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial meniscus (MM), lateral meniscus (LM) tears, subchondral bone marrow signal abnormalities, subjective image quality, and image artifacts. Arthroscopic results were the reference standard. Statistical analysis was performed to calculate interobserver agreement and compare diagnostic performance of sequences. RESULTS Sensitivity and specificity were greater than 85% for all lesions. For cartilaginous defects, sensitivity of 3D IW fast SE was significantly greater than that of 3D balanced FFE (95.5% vs 89.7%). Sensitivity of 3D IW fast SE and 2D fast SE for MM, LM, and ACL tears tended to be greater than that of 3D balanced FFE. IW fast SE had a higher detection rate for subchondral bone marrow signal abnormality than did 3D balanced FFE (34% vs 21%); it also had the best image quality and fewest artifacts, followed by 2D fast SE and 3D balanced FFE. Interobserver agreement was excellent for evaluation of all intraarticular structures (κ = 0.85-1) and good to excellent for detection of subchondral bone marrow signal abnormality (κ = 0.76-0.91). CONCLUSION The performance of IW fast SE is superior to that of balanced FFE in evaluation of cartilaginous defects, with no significant difference in performance between 2D fast SE, 3D IW fast SE, and 3D balanced FFE in evaluation of meniscal and ligament tears. Subchondral bone marrow signal abnormality is more easily seen on 3D IW fast SE images, with better subjective image quality and fewer artifacts, than on images obtained with other techniques.
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Affiliation(s)
- Jin Young Jung
- Department of Radiology, Dongtan Sacred Heart Hospital, Hallym University, Hwaseong, Gyeonggi-do, Korea
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Moran CJ, Brodsky EK, Bancroft LH, Reeder SB, Yu H, Kijowski R, Engel D, Block WF. High-resolution 3D radial bSSFP with IDEAL. Magn Reson Med 2013; 71:95-104. [PMID: 23504943 DOI: 10.1002/mrm.24633] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Revised: 12/16/2012] [Accepted: 12/18/2012] [Indexed: 12/19/2022]
Abstract
Radial trajectories facilitate high-resolution balanced steady state free precession (bSSFP) because the efficient gradients provide more time to extend the trajectory in k-space. A number of radial bSSFP methods that support fat-water separation have been developed; however, most of these methods require an environment with limited B0 inhomogeneity. In this work, high-resolution bSSFP with fat-water separation is achieved in more challenging B0 environments by combining a 3D radial trajectory with the IDEAL chemical species separation method. A method to maintain very high resolution within the timing constraints of bSSFP and IDEAL is described using a dual-pass pulse sequence. The sampling of a unique set of radial lines at each echo time is investigated as a means to circumvent the longer scan time that IDEAL incurs as a multiecho acquisition. The manifestation of undersampling artifacts in this trajectory and their effect on chemical species separation are investigated in comparison to the case in which each echo samples the same set of radial lines. This new bSSFP method achieves 0.63 mm isotropic resolution in a 5-min scan and is demonstrated in difficult in vivo imaging environments, including the breast and a knee with ACL reconstruction hardware at 1.5 T.
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Affiliation(s)
- Catherine J Moran
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin, USA
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Park SY, Park JS, Jin W, Rhyu KH, Ryu KN. Diagnosis of acetabular labral tears: comparison of three-dimensional intermediate-weighted fast spin-echo MR arthrography with two-dimensional MR arthrography at 3.0 T. Acta Radiol 2013; 54:75-82. [PMID: 23093725 DOI: 10.1258/ar.2012.120338] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Magnetic resonance (MR) arthrography is the ideal imaging modality for the acetabular labrum. Three-dimensional (3D) fast spin-echo (FSE) sequences have similar diagnostic performance as two-dimensional (2D) conventional MR imaging for ligaments, menisci, or bone marrow edema in the knee. PURPOSE To compare the diagnostic accuracy and inter-observer reliability of 3D intermediate-weighted FSE sequence and 2D FSE sequences for the diagnosis of acetabular labral tears. MATERIAL AND METHODS Institutional review board approval was obtained and informed consent was waived for 45 patients (47 hips) who underwent 3D and 2D MR arthrography and subsequent arthroscopic surgery. The 3D sequences were performed using volumetric intermediate-weighted fast spin-echo imaging with fat suppression (voxel size, 0.6 × 0.6 × 1.2 mm; imaging time, 6 min 38 s). Labral tear was retrospectively and independently evaluated by two radiologists in four areas of the labrum (anterosuperior, posterosuperior, anteroinferior, and posteroinferior) on 3D and 2D FSE sequences. Statistical differences between the sensitivity and specificity of the methods were analyzed with the McNemar test, using arthroscopic findings as the reference standard. Inter-observer agreement was calculated using kappa statistics. RESULTS Arthroscopic findings confirmed labral tears at 40 anterosuperior, 23 posterosuperior, 0 anteroinferior, and 2 posteroinferior quadrants. Sensitivity and specificity were 74% and 89% for 2D FSE sequences, and 78% and 92% for 3D FSE sequences, respectively. Sensitivities and specificities for the methods were not different statistically (P > 0.05). Inter-observer agreement for labral tear was substantial for 2D FSE sequences (κ = 0.774) and almost perfect for 3D FSE sequences (κ = 0.842). CONCLUSION 3D intermediate-weighted FSE MR arthrography is excellent for diagnosing acetabular labral tears. Sensitivity, specificity, and inter-observer reliability were similar to conventional 2D MR arthrography. For evaluation of the labrum, 3D FSE MR arthrography is more time-efficient than 2D FSE MR arthrography.
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Affiliation(s)
- So Young Park
- Department of Radiology, Kyung Hee University Hospital at Gangdong, Seoul
| | - Ji Seon Park
- Department of Radiology, Kyung Hee University Medical Center, Seoul
| | - Wook Jin
- Department of Radiology, Kyung Hee University Hospital at Gangdong, Seoul
| | - Kee Hyung Rhyu
- Department of Orthopedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Kyung Nam Ryu
- Department of Radiology, Kyung Hee University Medical Center, Seoul
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Guermazi A, Roemer FW, Haugen IK, Crema MD, Hayashi D. MRI-based semiquantitative scoring of joint pathology in osteoarthritis. Nat Rev Rheumatol 2013; 9:236-51. [DOI: 10.1038/nrrheum.2012.223] [Citation(s) in RCA: 101] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Abstract
OBJECTIVE The purposes of this review are to describe commonly available 3D MRI techniques and to discuss the literature to date regarding the utility of such techniques in the assessment of internal derangement of joints. CONCLUSION Long acquisition and postprocessing times and limited contrast characteristics have generally prohibited routine use of 3D MRI in clinical practice. However, technical advances, including higher-field-strength MRI systems, high performance gradients, high-resolution multichannel coils, and pulse sequences with shorter acquisition times, have made feasible 3D isotropic MRI with reasonable acquisition times.
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Abstract
Osteoarthritis (OA) is a chronic, debilitating joint disease characterized by degenerative changes to the bones, cartilage, menisci, ligaments, and synovial tissue. Imaging modalities such as radiography, magnetic resonance imaging (MRI), optical coherence tomography (OCT), and ultrasound (US) permit visualization of these structures and can evaluate disease onset and progression. Radiography is primarily useful for the assessment of bony structures, while OCT is used for evaluation of articular cartilage and US for ligaments and the synovium. MRI permits visualization of all intraarticular structures and pathologies, though US or OCT may be preferential in some circumstances. As OA is a disease of the whole joint, a combination of imaging techniques may be necessary in order to gain the most comprehensive picture of the disease state. This article is part of a Special Issue entitled "Osteoarthritis".
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Milewski MD, Smitaman E, Moukaddam H, Katz LD, Essig DA, Medvecky MJ, Haims AH. Comparison of 3D vs. 2D fast spin echo imaging for evaluation of articular cartilage in the knee on a 3T system scientific research. Eur J Radiol 2012; 81:1637-43. [DOI: 10.1016/j.ejrad.2011.04.072] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Accepted: 04/21/2011] [Indexed: 11/28/2022]
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Preliminary Study of 1.5-T MR Arthrography of the Shoulder With 3D Isotropic Intermediate-Weighted Turbo Spin Echo. AJR Am J Roentgenol 2012; 199:W107-13. [DOI: 10.2214/ajr.11.7544] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Han Y, Kurzencwyg D, Hart A, Powell T, Martineau PA. Measuring the anterior cruciate ligament's footprints by three-dimensional magnetic resonance imaging. Knee Surg Sports Traumatol Arthrosc 2012; 20:986-95. [PMID: 21987362 DOI: 10.1007/s00167-011-1690-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Accepted: 09/20/2011] [Indexed: 02/06/2023]
Abstract
PURPOSE The purpose of this study was to compare 3D MR imaging and open cadaveric measurements of the ACL's footprints to see whether 3D MR imaging measurements are accurate enough to be used for preoperative templating in anatomic ACL reconstruction. METHODS Eight formalin-injected cadaveric knees were scanned by rapid acquisition isotropic 3D MR imaging. The femoral and tibial footprints were measured on MR imaging and compared with cadaveric dissection. Bland-Altman plots were used to assess the level of agreement. RESULTS The AM and PL bundles were clearly appreciated in each specimen by 3D MR imaging and cadaveric dissection. The average paired difference in the femoral and tibial footprint measurements was 2, 1, 2, and 2 mm for the femoral footprint length, femoral footprint width, tibial footprint length, and tibial footprint width, respectively. The individual paired measurements were all within the mean difference ± two standard deviations of the difference in the Bland-Altman plot showing strong agreement. CONCLUSION Measuring the ACL's footprint by 3D MR imaging or open cadaveric dissection has strong agreement and can be used interchangeably. 3D MR imaging has the potential to allow surgeons to: (1) tailor ACL reconstruction technique or graft choice based on ACL footprint size, (2) plan for selective bundle ACL reconstruction for partial tears, and (3) preoperatively template tunnel position according to the patient's individual anatomy.
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Affiliation(s)
- Yung Han
- Department of Orthopaedic Surgery, McGill University, Montreal, QC, Canada.
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Meniscal tear configurations: categorization with 3D isotropic turbo spin-echo MRI compared with conventional MRI at 3 T. AJR Am J Roentgenol 2012; 198:W173-80. [PMID: 22268208 DOI: 10.2214/ajr.11.6979] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The purpose of our study was to compare the accuracy of 3D fat-suppressed isotropic turbo spin-echo (TSE) sequences using sampling perfection with application-optimized contrasts using different flip angle evolution (SPACE) with 2D conventional MRI at 3 T in determining meniscal tear types. MATERIALS AND METHODS Sixty-nine patients with arthroscopically confirmed meniscal tears underwent MRI with 2D sequences and 3D TSE SPACE. Images were retrospectively analyzed by two reviewers and correlated with arthroscopic findings. Meniscal tears were classified into one of eight types: horizontal, longitudinal, radial, root, flap, oblique, complex, and bucket-handle. For every type of tear, sensitivity, specificity, and interobserver agreement were calculated. RESULTS Mean sensitivities and specificities on 3D TSE SPACE versus 2D sequences were as follows: for radial tears, 77% and 93% versus 68% and 90%; for flap tears, 73% and 96% versus 54% and 85%; for horizontal tears, 85% and 91% versus 78% versus 87%; for longitudinal tears, 50% and 97% versus 72% and 96%; and for root tears, 88% and 99% versus 81% and 99%. The specificity for flap tears was statistically higher on 3D TSE SPACE than 2D sequences. Interobserver agreements were higher on 3D TSE SPACE than 2D sequences for radial, flap, and longitudinal tears. CONCLUSION In categorizing meniscal tears, 3D TSE SPACE has higher specificity for flap tears than 2D conventional sequences. However, there is no significant difference between 2D conventional sequences and 3D TSE SPACE except for flap tears.
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Notohamiprodjo M, Kuschel B, Horng A, Paul D, Baer P, Li G, Garcia del Olmo JMR, Reiser MF, Glaser C. 3D-MRI of the Ankle With Optimized 3D-SPACE. Invest Radiol 2012; 47:231-9. [DOI: 10.1097/rli.0b013e31823d7946] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Carl M, Koch K, Du J. MR imaging near metal with undersampled 3D radial UTE-MAVRIC sequences. Magn Reson Med 2012; 69:27-36. [PMID: 22374824 DOI: 10.1002/mrm.24219] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Revised: 01/13/2012] [Accepted: 01/29/2012] [Indexed: 01/02/2023]
Abstract
Recently developed techniques such as the multiple acquisition with variable resonance image combination and slice encoding for metal artifact correction techniques have improved the ability of clinical magnetic resonance scanners to image near metal implants. These sequences are based on fast spin echo sequences which preclude detection of short T(2) tissues such as tendons, ligaments, and cortical bone. Ultrashort echo time sequences have the potential to detect signals from these tissues. In this study, we investigate the potential of combining ultrashort echo time with multiple acquisition with variable resonance image combination to image short T(2) musculoskeletal tissues adjacent to metallic implants. Different radio frequency excitation pulse types and spectral binning strategies were studied. We found that ultrashort echo time-multiple acquisition with variable resonance image combination sequences were able to significantly reduce typical artifacts near metal, as well as detect very short T(2) signals that are usually not visualized using clinical pulse sequences.
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Affiliation(s)
- Michael Carl
- GE Healthcare, University of California, San Diego, California 92103-8226, USA.
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Bone bruise of the knee associated with the lesions of anterior cruciate ligament and menisci on magnetic resonance imaging. VOJNOSANIT PREGL 2011; 68:762-6. [PMID: 22046881 DOI: 10.2298/vsp1109762j] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIM Bone bruise is a common finding in acutely injured knee examined by magnetic resonance (MR). The aim of the study was to determine the association of bone bruise frequency with postinjury lesions of anterior cruciate ligament (ACL) and menisci. Bone bruise involves posttraumatic bone marrow change with hemorrhages, edema and microtrabecular fractures without disruption of adjacent cortices or articular cartilage. MR imaging is a method of choice for detecting bone bruises which can not be seen on conventional radiographic techniques. METHODS A representative review of 120 MR examinations for the acute knee trauma was conducted. All the patients were examined within one month of trauma. All MR examinations were performed by using a 0.3T MR unit. RESULTS Posttraumatic bone bruise was seen in 39 (32.5%) patients out of 120. Three patients had fracture of the cortex, so-called "occult" fracture (not seen on plain radiography). We analyzed only bone bruises without these fractures of the cortex. Bone bruise was associated with the lesion of ACL in 27 (69%) patients. In 28 (72%) patients bone bruise was in combination with the lesion of menisci. Only two patients with bone bruise had neither ACL nor menisci lesions. There were 78 patients without bone bruise but 33 (43%) of them had lesions of ACL and 49 (63%) had lesions of menisci. CONCLUSION Bone bruise is best seen in STIR (Short TI Inversion Recovery) images and is very often found in acute knee trauma. Very often it is associated with posttraumatic lesions of ACL and menisci, so attention must be paid to this when bone bruise is seen. The difference in frequency of internal structures of the knee lesions in patients with bone bruise is highly statistically significant as compared to patients with no bone bruise.
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Value of sagittal fat-suppressed proton-density fast-spin-echo of the knee joint as a limited protocol in evaluating internal knee derangements. J Comput Assist Tomogr 2011; 35:653-61. [PMID: 21926865 DOI: 10.1097/rct.0b013e3182251016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of the study was to determine the accuracy and observer agreement in the assessment of internal knee derangement using sagittal fat-suppressed proton-density fast-spin-echo (FS PD-FSE) compared with combined sagittal T1-weighted spin-echo, dual-proton-density, and T2-weighted spin-echo sequences and with arthroscopy. METHODS One hundred eighteen patients undergoing routine knee magnetic resonance (MR) imaging had additional imaging with sagittal FS PD-FSE sequences. Menisci, cruciate ligaments, extensor tendons (ETs), bone marrow, osteoarthritic changes, soft tissue edema, joint effusion, and incidental tumors were analyzed. Magnetic resonance images were independently reviewed by 2 radiologists. Fifty patients underwent knee arthroscopy. Statistical analysis compared both imaging protocols with each other and with arthroscopy. Intrareader and interreader agreements were evaluated using κ analysis. Both protocols were compared with arthroscopy. RESULTS Intrareader agreement was very high except for readings of the posterior cruciate ligament, ETs, and cartilage. Intrareader agreement did not differ significantly between the 2 readers except for ETs, bone marrow, and cartilage. Interreader percent agreements were high using both protocols and were not significantly different between the 2 readers except for posterior cruciate ligament. Compared with arthroscopy, both methods showed almost identical results regarding sensitivity, specificity, positive predictive value, and negative predictive value, except for cartilage where FS PD-FSE had increased sensitivity, whereas the combined protocol had increased specificity. CONCLUSIONS Sagittal FS PD-FSE is comparable to our regular MR protocol in assessing internal knee derangement with an overall agreement of at least 93% on all sites except cartilage. It was also comparable to arthroscopy in assessing the cruciate ligaments and menisci, but had a low specificity for cartilaginous derangements. It can replace our 3 sagittal series comprising T1- and T2-weighted and proton-density-spin-echo sequences, hence saving time and cost.
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