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Mohana-Borges AVR, Chung CB. Imaging of Rheumatic Diseases Affecting the Lower Limb. Rheum Dis Clin North Am 2024; 50:463-482. [PMID: 38942580 DOI: 10.1016/j.rdc.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2024]
Abstract
Imaging methods capable of detecting inflammation, such as MR imaging and ultrasound, are of paramount importance in rheumatic disease management, not only for diagnostic purposes but also for monitoring disease activity and treatment response. However, more advanced stages of arthritis, characterized by findings of cumulative structural damage, have traditionally been accomplished by radiographs and computed tomography. The purpose of this review is to provide an overview of imaging of some of the most prevalent inflammatory rheumatic diseases affecting the lower limb (osteoarthritis, rheumatoid arthritis, and gout) and up-to-date recommendations regarding imaging diagnostic workup.
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Affiliation(s)
| | - Christine B Chung
- Department of Radiology, University of California San Diego, 9427 Health Sciences Drive, La Jolla, CA 92093, USA; Department of Radiology, VA San Diego, 3350 La Jolla Village Drive, La Jolla, CA 92161, USA.
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2
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Imaging of Rheumatic Diseases Affecting the Lower Limb. Radiol Clin North Am 2023; 61:345-360. [PMID: 36739149 DOI: 10.1016/j.rcl.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Imaging methods capable of detecting inflammation, such as MR imaging and ultrasound, are of paramount importance in rheumatic disease management, not only for diagnostic purposes but also for monitoring disease activity and treatment response. However, more advanced stages of arthritis, characterized by findings of cumulative structural damage, have traditionally been accomplished by radiographs and computed tomography. The purpose of this review is to provide an overview of imaging of some of the most prevalent inflammatory rheumatic diseases affecting the lower limb (osteoarthritis, rheumatoid arthritis, and gout) and up-to-date recommendations regarding imaging diagnostic workup.
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Comparison of meniscal T1rho- and T2*-relaxation times in professional female volleyball players and healthy controls using 3T MRI: A pilot study. Eur J Radiol 2022; 155:110503. [DOI: 10.1016/j.ejrad.2022.110503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 08/22/2022] [Accepted: 08/24/2022] [Indexed: 11/19/2022]
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Periodical assessment of four horns of knee meniscus using MR T2 mapping imaging in volunteers before and after amateur marathons. Sci Rep 2022; 12:12093. [PMID: 35840688 PMCID: PMC9287294 DOI: 10.1038/s41598-022-16000-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/04/2022] [Indexed: 11/08/2022] Open
Abstract
To observe the changes and recovery of T2 values of menisci in amateur marathon participants at different times, and to examine the effect of marathon exercise on meniscal microstructure. Twelve healthy marathon volunteers were recruited continuously, including 5 males and 7 females, with mean (± SD) age of 27.5 ± 5.2 years. The body mass indices (BMIs) ranged from 17.6 to 27.2 kg/m2, with a mean of 21.9 ± 2.5 kg/m2. The 24 knee joints were scanned using a 3 T MR scanner at 1 week before the event, and at 12 h and 2 months after the event. T2 values of the anterior horn of the medial meniscus (MMAH), posterior horn of the medial meniscus (MMPH), anterior horn of the lateral meniscus (LMAH), and posterior horn of the lateral meniscus (LMPH) were measured by drawing the regions of interest (ROIs) on the T2 map images. Wilcoxon sign rank test was used to compare the T2 values between 1 week before and 12 h after the event, and between 1 week before and 2 months after the event in each anatomical region, respectively. The T2 values of the menisci at 12 h after the event were significantly higher (P < 0.05) than those at 1 week before the event. No statistically significant differences in the T2 values of the menisci were found between 2 months after and 1 week before the event (P > 0.05). The T2 values of MMAH, MMPH, LMAH, and LMPH showed a trend of "increasing first and then decreasing" over time, suggesting that the T2 values may reflect meniscal microstructure in amateur marathon runner.
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T 2 MRI at 3T of cartilage and menisci in patients with hyperuricemia: initial findings. Skeletal Radiol 2022; 51:607-618. [PMID: 34287675 DOI: 10.1007/s00256-021-03861-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/30/2021] [Accepted: 06/30/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To compare and evaluate T2 values of compartmental femorotibial cartilage and subregional menisci in patients with hyperuricemia at 3T. MATERIALS AND METHODS Thirty-two subjects were included in this study and subdivided into two subgroups: 15 healthy controls (3 females, 12 males; mean age = 45.3 ± 10.9 years), 17 patients with hyperuricemia (2 females, 15 males; mean age = 44.4 ± 12.7 years). All subjects were assessed on a 3T MR scanner using an 8-channel phased-array knee coil (transmit-receive). Wilcoxon rank sum test and analysis of covariance (ANCOVA) were performed to determine whether there were any statistically significant differences in T2 values of compartmental femorotibial cartilage and subregional menisci between the two subgroups. RESULTS Lateral tibial cartilage (48.6 ± 3.5 ms) in healthy subgroup had significantly lower (p < 0.05) T2 values than all subcompartments of femorotibial cartilage in hyperuricemia subgroup. Medial tibial cartilage (56.5 ± 4.3 ms) in hyperuricemia subgroup had significantly higher (p < 0.05) T2 values than all subcompartments of femorotibial cartilage except medial tibial cartilage in healthy subgroup. Medial anterior horn of meniscus (39.4 ± 2.9 ms) in healthy subgroup had significantly lower (p < 0.05) T2 values than all subregional menisci except both medial anterior horn and medial body segment of meniscus in hyperuricemia subgroup. CONCLUSION T2 values in certain compartmental femorotibial cartilage and subregional menisci in patients with hyperuricemia are evidently and abnormally heightened compared with those in healthy subjects, to which special attention should be paid when diagnosing and treating the patients with hyperuricemia in the clinical setting. The LT cartilage had significantly lower T2 values (48.6 ± 3.5 ms) in healthy subgroup compared to all compartmental femorotibial cartilage in cohort with HU. MF cartilage had significantly lower T2 values (51.6 ± 2.9 ms) in healthy subgroup compared to both LF (54.4 ± 4.1 ms) and MT (56.5 ± 4.3 ms) in cohort with HU. MT cartilage had significantly higher T2 values (56.5 ± 4.3 ms) in cohort with HU subgroup compared to LF (52.5 ± 3.0 ms) in healthy subgroup. T2 mapping may be promising and potential sensitive discriminator of understanding and examining the early compositional and structural change in proteoglycan-collagen matrix of human femorotibial cartilage in patients with hyperuricemia.
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Seyedpour SM, Nafisi S, Nabati M, Pierce DM, Reichenbach JR, Ricken T. Magnetic Resonance Imaging-based biomechanical simulation of cartilage: A systematic review. J Mech Behav Biomed Mater 2021; 126:104963. [PMID: 34894500 DOI: 10.1016/j.jmbbm.2021.104963] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 10/30/2021] [Accepted: 11/06/2021] [Indexed: 11/19/2022]
Abstract
MRI-based mathematical and computational modeling studies can contribute to a better understanding of the mechanisms governing cartilage's mechanical performance and cartilage disease. In addition, distinct modeling of cartilage is needed to optimize artificial cartilage production. These studies have opened up the prospect of further deepening our understanding of cartilage function. Furthermore, these studies reveal the initiation of an engineering-level approach to how cartilage disease affects material properties and cartilage function. Aimed at researchers in the field of MRI-based cartilage simulation, research articles pertinent to MRI-based cartilage modeling were identified, reviewed, and summarized systematically. Various MRI applications for cartilage modeling are highlighted, and the limitations of different constitutive models used are addressed. In addition, the clinical application of simulations and studied diseases are discussed. The paper's quality, based on the developed questionnaire, was assessed, and out of 79 reviewed papers, 34 papers were determined as high-quality. Due to the lack of the best constitutive models for various clinical conditions, researchers may consider the effect of constitutive material models on the cartilage disease simulation. In the future, research groups may incorporate various aspects of machine learning into constitutive models and MRI data extraction to further refine the study methodology. Moreover, researchers should strive for further reproducibility and rigorous model validation and verification, such as gait analysis.
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Affiliation(s)
- S M Seyedpour
- Institute of Mechanics, Structural Analysis and Dynamics, Faculty of Aerospace Engineering and Geodesy, University of Stuttgart, Pfaffenwaldring 27, 70569 Stuttgart, Germany; Biomechanics Lab, Institute of Mechanics, Structural Analysis and Dynamics, Faculty of Aerospace Engineering and Geodesy, University of Stuttgart, Pfaffenwaldring 27, 70569 Stuttgart, Germany
| | - S Nafisi
- Faculty of Pharmacy, Istinye University, Maltepe, Cirpici Yolu B Ck. No. 9, 34010 Zeytinburnu, Istanbul, Turkey
| | - M Nabati
- Department of Mechanical Engineering, Faculty of Engineering, Boğaziçi University, 34342 Bebek, Istanbul, Turkey
| | - D M Pierce
- Department of Mechanical Engineering, University of Connecticut, 191 Auditorium Road, Unit 3139, Storrs, CT, 06269, USA; Department of Biomedical Engineering, University of Connecticut, 260 Glenbrook Road, Unit 3247, Storrs, CT, 06269, USA
| | - J R Reichenbach
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital-Friedrich Schiller University Jena, Jena, Germany; Center of Medical Optics and Photonics, Friedrich Schiller University Jena, Germany; Michael Stifel Center for Data-driven and Simulation Science Jena, Friedrich Schiller University Jena, Germany
| | - T Ricken
- Institute of Mechanics, Structural Analysis and Dynamics, Faculty of Aerospace Engineering and Geodesy, University of Stuttgart, Pfaffenwaldring 27, 70569 Stuttgart, Germany; Biomechanics Lab, Institute of Mechanics, Structural Analysis and Dynamics, Faculty of Aerospace Engineering and Geodesy, University of Stuttgart, Pfaffenwaldring 27, 70569 Stuttgart, Germany.
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Bansal S, Meadows KD, Miller LM, Saleh KS, Patel JM, Stoeckl BD, Lemmon EA, Hast MW, Zgonis MH, Scanzello CR, Elliott DM, Mauck RL. Six-Month Outcomes of Clinically Relevant Meniscal Injury in a Large-Animal Model. Orthop J Sports Med 2021; 9:23259671211035444. [PMID: 34796238 PMCID: PMC8593308 DOI: 10.1177/23259671211035444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 05/04/2021] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The corrective procedures for meniscal injury are dependent on tear type, severity, and location. Vertical longitudinal tears are common in young and active individuals, but their natural progression and impact on osteoarthritis (OA) development are not known. Root tears are challenging and they often indicate poor outcomes, although the timing and mechanisms of initiation of joint dysfunction are poorly understood, particularly in large-animal and human models. PURPOSE/HYPOTHESIS In this study, vertical longitudinal and root tears were made in a large-animal model to determine the progression of joint-wide dysfunction. We hypothesized that OA onset and progression would depend on the extent of injury-based load disruption in the tissue, such that root tears would cause earlier and more severe changes to the joint. STUDY DESIGN Controlled laboratory study. METHODS Sham surgeries and procedures to create either vertical longitudinal or root tears were performed in juvenile Yucatan mini pigs through randomized and bilateral arthroscopic procedures. Animals were sacrificed at 1, 3, or 6 months after injury and assessed at the joint and tissue level for evidence of OA. Functional measures of joint load transfer, cartilage indentation mechanics, and meniscal tensile properties were performed, as well as histological evaluation of the cartilage, meniscus, and synovium. RESULTS Outcomes suggested a progressive and sustained degeneration of the knee joint and meniscus after root tear, as evidenced by histological analysis of the cartilage and meniscus. This occurred in spite of spontaneous reattachment of the root, suggesting that this reattachment did not fully restore the function of the native attachment. In contrast, the vertical longitudinal tear did not cause significant changes to the joint, with only mild differences compared with sham surgery at the 6-month time point. CONCLUSION Given that the root tear, which severs circumferential connectivity and load transfer, caused more intense OA compared with the circumferentially stable vertical longitudinal tear, our findings suggest that without timely and mechanically competent fixation, root tears may cause irreversible joint damage. CLINICAL RELEVANCE More generally, this new model can serve as a test bed for experimental surgical, scaffold-based, and small molecule-driven interventions after injury to prevent OA progression.
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Affiliation(s)
- Sonia Bansal
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA.,Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kyle D. Meadows
- Department of Biomedical Engineering, University of Delaware, Newark, Delaware, USA
| | - Liane M. Miller
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA
| | - Kamiel S. Saleh
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA
| | - Jay M. Patel
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA
| | - Brendan D. Stoeckl
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA
| | - Elisabeth A. Lemmon
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA
| | - Michael W. Hast
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA.,Biedermann Lab for Orthopaedic Research, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Miltiadis H. Zgonis
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA
| | - Carla R. Scanzello
- Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA.,Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Dawn M. Elliott
- Biedermann Lab for Orthopaedic Research, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Robert L. Mauck
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA.,Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Robert L. Mauck, PhD, Department of Orthopedic Surgery, University of Pennsylvania, 3450 Hamilton Walk, 371 Stemmler Hall, Philadelphia, PA 19104, USA () (Twitter: @MauckLab)
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8
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Fedje-Johnston W, Johnson CP, Tóth F, Carlson CS, Ellingson AM, Albersheim M, Lewis J, Bechtold J, Ellermann J, Rendahl A, Tompkins M. A pilot study to assess the healing of meniscal tears in young adult goats. Sci Rep 2021; 11:14181. [PMID: 34244551 PMCID: PMC8270994 DOI: 10.1038/s41598-021-93405-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 06/18/2021] [Indexed: 11/09/2022] Open
Abstract
Meniscal tears are a common orthopedic injury, yet their healing is difficult to assess post-operatively. This impedes clinical decisions as the healing status of the meniscus cannot be accurately determined non-invasively. Thus, the objectives of this study were to explore the utility of a goat model and to use quantitative magnetic resonance imaging (MRI) techniques, histology, and biomechanical testing to assess the healing status of surgically induced meniscal tears. Adiabatic T1ρ, T2, and T2* relaxation times were quantified for both operated and control menisci ex vivo. Histology was used to assign healing status, assess compositional elements, and associate healing status with compositional elements. Biomechanical testing determined the failure load of healing lesions. Adiabatic T1ρ, T2, and T2* were able to quantitatively identify different healing states. Histology showed evidence of diminished proteoglycans and increased vascularity in both healed and non-healed menisci with surgically induced tears. Biomechanical results revealed that increased healing (as assessed histologically and on MRI) was associated with greater failure load. Our findings indicate increased healing is associated with greater meniscal strength and decreased signal differences (relative to contralateral controls) on MRI. This indicates that quantitative MRI may be a viable method to assess meniscal tears post-operatively.
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Affiliation(s)
- William Fedje-Johnston
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA.,Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN, USA
| | - Casey P Johnson
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN, USA.,Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Ferenc Tóth
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN, USA
| | - Cathy S Carlson
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN, USA
| | - Arin M Ellingson
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA.,Divisions of Physical Therapy and Rehabilitation Science, Department of Rehabilitation Science, University of Minnesota, Minneapolis, MN, USA
| | - Melissa Albersheim
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Jack Lewis
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Joan Bechtold
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Jutta Ellermann
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Aaron Rendahl
- Department of Veterinary and Biomedical Sciences, University of Minnesota, St. Paul, MN, USA
| | - Marc Tompkins
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA. .,Tria Orthopedic Center, Bloomington, MN, USA.
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Zhu J, Hu N, Hou J, Liang X, Wang Y, Zhang H, Wang P, Chen T, Chen W, Wang L. T 1rho mapping of cartilage and menisci in patients with hyperuricaemia at 3 T: a preliminary study. Clin Radiol 2021; 76:710.e1-710.e8. [PMID: 34016388 DOI: 10.1016/j.crad.2021.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 04/14/2021] [Accepted: 04/27/2021] [Indexed: 11/16/2022]
Abstract
AIM To compare and assess T1rho values of the femorotibial cartilage compartments and subregional menisci in patients with hyperuricaemia at 3 T. MATERIALS AND METHODS Thirty-two patients were enrolled in the study and were subdivided into two subgroups: 15 healthy controls (three women, 12 men; mean age = 45.3 ± 10.9 years, age range 25-72 years) and 17 patients with asymptomatic hyperuricaemia (two women, 15 men; mean age = 44.4 ± 12.7 years, age range 26-77 years). All patients were evaluated using 3 T magnetic resonance imaging (MRI) using an eight-channel phased-array knee coil (transmit-receive). Wilcoxon's rank sum test and analysis of covariance (ANCOVA) were conducted to determine whether there were any statistically significant differences in the T1rho values of the femorotibial cartilage compartments and subregional menisci between the two subgroups. RESULTS Lateral tibial cartilage (45.8 ± 2.9 ms) in the healthy subgroup had significantly lower (p<0.05) T1rho values than those of all subcompartments of the femorotibial cartilage in the hyperuricaemia subgroup. The lateral femoral cartilage (LF) in hyperuricaemia (54.6 ± 3.9 ms) subgroup had significantly higher (p<0.05) T1rho values than those of all subcompartments of the femorotibial cartilage except the LF in the healthy subgroup. Significantly higher (p<0.05) T1rho values existed in the LF of the healthy (54.6 ± 4.7 ms) subgroup in comparison with those of all subcompartments of femorotibial cartilage except the LF in hyperuricaemia subgroup. CONCLUSIONS T1rho values in certain compartments of the femorotibial cartilage in patients with hyperuricaemia are elevated compared to those in healthy patients presumably due to reduced proteoglycan content, to which particular attention should be paid when diagnosing and treating the patients with hyperuricaemia in a clinical setting.
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Affiliation(s)
- J Zhu
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215004, China
| | - N Hu
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215004, China
| | - J Hou
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong Special Administrative Region, China
| | - X Liang
- Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, Australia; Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Y Wang
- Department of Radiation Physics, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, 310022, China
| | - H Zhang
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong Special Administrative Region, China
| | - P Wang
- Vanderbilt University Institute of Imaging Science, 1161 21st Avenue South, MCN AA-1105, Nashville, TN, 37232-2310, USA
| | - T Chen
- Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215004, China
| | - W Chen
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong Special Administrative Region, China
| | - L Wang
- Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions; School of Radiation Medicine and Protection, Medical College of Soochow University; School for Radiological and Interdisciplinary Sciences (RAD-X), Soochow University, Suzhou, Jiangsu, 215123, China.
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10
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Ukai T, Ebihara G, Omura H, Watanabe M. Evaluation of muscle volume and degeneration after total hip arthroplasty: a comparison of the posterolateral approach and the anterolateral supine approach. J Orthop Surg Res 2021; 16:145. [PMID: 33602277 PMCID: PMC7890623 DOI: 10.1186/s13018-021-02291-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 02/10/2021] [Indexed: 12/03/2022] Open
Abstract
Background Muscle strength around the hip after total hip arthroplasty (THA) is crucial for preventing dislocation and limping. This study aimed to assess and compare muscle volume and degeneration after THA using the posterolateral (PL) and anterolateral (AL) approaches. Methods Sixty-four hips in 64 patients who underwent primary THA were retrospectively analyzed. Patients were segregated into the PL group (35 hips) and AL group (29 hips) for evaluating pre- and postoperative muscle volumes and degeneration around the hip. Computed tomography (CT) examinations were performed preoperatively and 6 months post THA. The muscle volume and Hounsfield units (HU) of the gluteus maximus (G-max), gluteus medius (G-med), tensor fasciae latae, internal obturator muscle, and external obturator muscle were measured. Results In the PL group, the postoperative muscle volume of the G-max significantly increased than the preoperative muscle volume. In contrast, the postoperative muscle volume of the internal obturator muscle was significantly lower than the preoperative muscle volume. The postoperative HU of the internal and external obturator muscles were significantly lower than the preoperative HU. In the AL group, the postoperative muscle volumes of the G-max, G-med, and tensor fasciae latae significantly increased than their preoperative muscle volumes. The postoperative HU of the G-med and tensor fasciae latae were significantly higher than the preoperative HU values. Conclusion The PL approach can lead to degeneration of the internal and external obturator. The AL approach is more beneficial for recovering the G-med, tensor fasciae latae, and internal obturator muscle than the PL approach.
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Affiliation(s)
- Taku Ukai
- Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259 1193, Japan.
| | - Goro Ebihara
- Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259 1193, Japan
| | - Haruka Omura
- Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259 1193, Japan
| | - Masahiko Watanabe
- Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259 1193, Japan
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11
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Ozeki N, Kohno Y, Kushida Y, Watanabe N, Mizuno M, Katano H, Masumoto J, Koga H, Sekiya I. Synovial mesenchymal stem cells promote the meniscus repair in a novel pig meniscus injury model. J Orthop Res 2021; 39:177-183. [PMID: 32886427 PMCID: PMC7821148 DOI: 10.1002/jor.24846] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 08/20/2020] [Accepted: 09/02/2020] [Indexed: 02/04/2023]
Abstract
Stem cell therapy has potential for the treatment of degenerative meniscus injuries; however, an optimal animal model has not been established. Basic and clinical research show that synovial mesenchymal stem cells (MSCs) promote meniscus repair. The purposes of this study were to create a novel meniscus injury model in microminipigs and to investigate the effectiveness of synovial MSCs on meniscus healing in this model. The posterior portion of the medial meniscus in microminipigs was punctuated 200 times with a 23G needle. Allogenic synovial MSC suspension was placed on the injury site for 10 min for transplantation. The meniscus was evaluated histologically and via sagittal magnetic resonance imaging (MRI), radial MRI reconstructed in three dimensional, and T2 mapping at 1 and 8 weeks. Proteoglycan content stained with safranin-o disappeared 1 week after treatment in both the MSC and control groups but increased at 8 weeks only in the MSC group. Histological scores at 8 weeks were significantly higher in the MSC group than in the control group (n = 6). At 8 weeks, the T2 values of the MSC group were significantly closer to those of a normal meniscus than were those of the control group. High signal intensity areas of the MRIs and positive areas stained with picrosirius red coincided with meniscal lesions. In conclusion, we created a novel meniscus injury model in microminipigs. Evaluation via histology, MRIs, and polarized microscopy showed that transplantation of synovial MSCs improved meniscus healing.
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Affiliation(s)
- Nobutake Ozeki
- Center for Stem Cell and Regenerative MedicineTokyo Medical and Dental UniversityTokyoJapan
| | - Yuji Kohno
- Center for Stem Cell and Regenerative MedicineTokyo Medical and Dental UniversityTokyoJapan
| | - Yoshihisa Kushida
- Center for Stem Cell and Regenerative MedicineTokyo Medical and Dental UniversityTokyoJapan
| | - Naoto Watanabe
- Center for Stem Cell and Regenerative MedicineTokyo Medical and Dental UniversityTokyoJapan
| | - Mitsuru Mizuno
- Center for Stem Cell and Regenerative MedicineTokyo Medical and Dental UniversityTokyoJapan
| | - Hisako Katano
- Center for Stem Cell and Regenerative MedicineTokyo Medical and Dental UniversityTokyoJapan
| | | | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityTokyoJapan
| | - Ichiro Sekiya
- Center for Stem Cell and Regenerative MedicineTokyo Medical and Dental UniversityTokyoJapan
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Functional MRI Mapping of Human Meniscus Functionality and its Relation to Degeneration. Sci Rep 2020; 10:2499. [PMID: 32051526 PMCID: PMC7016001 DOI: 10.1038/s41598-020-59573-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 01/10/2020] [Indexed: 12/24/2022] Open
Abstract
Meniscus pathology may promote early osteoarthritis. This study assessed human meniscus functionality (i.e. its response to loading) ex vivo based on quantitative T1, T1ρ, and T2 mapping as a function of histological degeneration and loading. Forty-five meniscus samples of variable degeneration were harvested from the lateral meniscus body region of 45 patients during total knee arthroplasties. Samples underwent serial mapping on a 3.0-T MRI scanner (Achieva, Philips) using a force-controlled and torque-inducing compressive loading device. Samples were measured at three loading positions, i.e. unloaded, loaded to 2 bar (compression force 37 N) and 4 bar (69 N). Histology (Pauli classification) and biomechanics (Elastic Modulus) served as references. Based on histology, samples were trichotomized as grossly intact (n = 14), mildly degenerative (n = 16), and moderate-to-severely degenerative (n = 15) and analyzed using appropriate parametric and non-parametric tests. For T1, we found loading-induced decreases in all samples, irrespective of degeneration. For T1ρ, zonal increases in intact (apex) and decreases in degenerative samples (base) were found, while for T2, changes were ambiguous. In conclusion, force-controlled loading and serial MR imaging reveal response-to-loading patterns in meniscus. Zonal T1ρ response-to-loading patterns are most promising in differentiating degeneration, while T1 and T2 aren’t clearly related to degeneration.and may provide an imaging-based indication of functional tissue properties.
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Zhu J, Hu N, Liang X, Li X, Guan J, Wang Y, Wang L. T2 mapping of cartilage and menisci at 3T in healthy subjects with knee malalignment: initial experience. Skeletal Radiol 2019; 48:753-763. [PMID: 30712122 DOI: 10.1007/s00256-019-3164-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 12/10/2018] [Accepted: 01/14/2019] [Indexed: 02/02/2023]
Abstract
PURPOSE To assess the relationship between knee alignment and T2 values of femorotibial cartilage and menisci in healthy subjects at 3 T. MATERIALS AND METHODS Thirty-six healthy subjects divided into three subgroups of 12 neutral, 12 varus, and 12 valgus alignment of the femorotibial joint were investigated on 3-T MR scanner using a 2D multi-echo turbo spin-echo (TSE) sequence for T2 mapping. Wilcoxon signed-rank test and analysis of covariance (ANCOVA) were performed to determine any statistically significant differences in subregional T2 values of femorotibial cartilage and menisci among the three subgroups of healthy subjects. RESULTS Lateral femoral anterior cartilage subregion (52 ± 3 ms, mean ± standard deviation; 53 ± 2 ms) had significantly higher T2 values (p < 0.05) than medial femoral anterior cartilage subregion (51 ± 2 ms; 51 ± 2 ms) in varus and valgus groups, respectively. There were statistically significant differences (p < 0.05) in T2 values of tibial central cartilage subregion between lateral and medical compartment among varus, valgus, and neutral subgroups. Lateral body segment of meniscus (41 ± 3 ms) had significantly higher (p < 0.05) T2 values than medial body segment (40 ± 2 ms) in the varus subgroup. CONCLUSIONS Some degree of correlation between knee alignment and subregional T2 values of femorotibial cartilage and menisci exists in healthy subjects. These findings indicate that T2 mapping may be sensitive in assessing the load distribution pattern of human cartilage and menisci with knee alignment abnormality, which may be used as reference baseline when understanding the occurrence and progression of knee osteoarthritis.
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Affiliation(s)
- Jiangtao Zhu
- Department of Radiology, The Second Affiliated Hospital of Soochow University, 1055 San Xiang Road, Suzhou, 215004, Jiangsu Province, China.
| | - Ningfan Hu
- Department of Radiology, The Second Affiliated Hospital of Soochow University, 1055 San Xiang Road, Suzhou, 215004, Jiangsu Province, China
| | - Xiaoyun Liang
- Florey Institute of Neuroscience and Mental Health, 245 Burgundy Street, Heidelberg, VIC, 3084, Australia
| | - Xiaojing Li
- Department of Radiology, The Second Affiliated Hospital of Soochow University, 1055 San Xiang Road, Suzhou, 215004, Jiangsu Province, China
| | - Jian Guan
- Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Bldg. 402, 199 Ren Ai Road, Suzhou Industrial Park, Suzhou, 215123, Jiangsu Province, China.,School of Radiation Medicine and Protection, Medical College of Soochow University, Bldg. 402, 199 Ren Ai Road, Suzhou Industrial Park, Suzhou, 215123, Jiangsu Province, China.,School for Radiological and Interdisciplinary Sciences (RAD-X), Soochow University, Bldg. 402, 199 Ren Ai Road, Suzhou Industrial Park, Suzhou, 215123, Jiangsu Province, China
| | - Yajuan Wang
- Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Bldg. 402, 199 Ren Ai Road, Suzhou Industrial Park, Suzhou, 215123, Jiangsu Province, China.,School of Radiation Medicine and Protection, Medical College of Soochow University, Bldg. 402, 199 Ren Ai Road, Suzhou Industrial Park, Suzhou, 215123, Jiangsu Province, China.,School for Radiological and Interdisciplinary Sciences (RAD-X), Soochow University, Bldg. 402, 199 Ren Ai Road, Suzhou Industrial Park, Suzhou, 215123, Jiangsu Province, China
| | - Ligong Wang
- Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Bldg. 402, 199 Ren Ai Road, Suzhou Industrial Park, Suzhou, 215123, Jiangsu Province, China.,School of Radiation Medicine and Protection, Medical College of Soochow University, Bldg. 402, 199 Ren Ai Road, Suzhou Industrial Park, Suzhou, 215123, Jiangsu Province, China.,School for Radiological and Interdisciplinary Sciences (RAD-X), Soochow University, Bldg. 402, 199 Ren Ai Road, Suzhou Industrial Park, Suzhou, 215123, Jiangsu Province, China
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14
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Olsson E, Folkesson E, Peterson P, Önnerfjord P, Tjörnstrand J, Hughes HV, Englund M, Svensson J. Ultra-high field magnetic resonance imaging parameter mapping in the posterior horn of ex vivo human menisci. Osteoarthritis Cartilage 2019; 27:476-483. [PMID: 30552967 PMCID: PMC7610687 DOI: 10.1016/j.joca.2018.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 11/26/2018] [Accepted: 12/03/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the relationship between meniscus magnetic resonance (MR) relaxation parameters and meniscus degradation through quantitative imaging of ex vivo posterior horns of menisci from subjects with and without knee osteoarthritis (OA). DESIGN We sampled medial and lateral menisci from ten medial compartment knee OA patients (mean age 63 years) undergoing total knee replacement and from ten deceased donors (references, mean age 51 years). MR relaxation parameters T2*, T2 and T1 of the posterior horn were measured at a 9.4 T scanner. Comparisons were made between OA patients and references (with adjustment for age) as well as between medial and lateral menisci from the same knees. RESULTS Mean values (standard deviation) of mean T2* were 13 (3.8), 6.9 (2.3), 7.2 (1.9) and 7.2 (1.7) ms for the medial and lateral patient menisci and the medial and lateral reference menisci, respectively. Corresponding values were 17 (3.7), 9.0 (2.2), 12 (4) and 9.0 (1.3) ms for T2 and 1810 (150), 1630 (30), 1580 (90) and 1560 (50) ms for T1. All three relaxation times were significantly longer in medial OA menisci compared to the other groups. Among medial reference menisci, relaxation times (mainly T1) tended to increase with age. CONCLUSIONS MR relaxation times T2*, T2 and T1 in the posterior horn are longer in the medial menisci of patients with end-stage medial compartment knee OA compared to the corresponding lateral menisci and to reference menisci. The meniscus seems to undergo intrasubstance alterations related to both OA and ageing.
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Affiliation(s)
- E Olsson
- Medical Radiation Physics, Department of Translational Medicine, Lund University, Malmö, Sweden,Clinical Epidemiology Unit, Orthopedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - E Folkesson
- Clinical Epidemiology Unit, Orthopedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden,Rheumatology and Molecular Skeletal Biology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - P Peterson
- Medical Radiation Physics, Department of Translational Medicine, Lund University, Malmö, Sweden
| | - P Önnerfjord
- Rheumatology and Molecular Skeletal Biology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - J Tjörnstrand
- Orthopedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden,Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
| | - HV Hughes
- Clinical Epidemiology Unit, Orthopedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - M Englund
- Clinical Epidemiology Unit, Orthopedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - J Svensson
- Medical Radiation Physics, Department of Translational Medicine, Lund University, Malmö, Sweden,Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
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15
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Baboli R, Sharafi A, Chang G, Regatte RR. Biexponential T 1ρ relaxation mapping of human knee menisci. J Magn Reson Imaging 2019; 50:824-835. [PMID: 30614152 DOI: 10.1002/jmri.26631] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Revised: 12/10/2018] [Accepted: 12/11/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Measuring T1ρ in the knee menisci can potentially be used as noninvasive biomarkers in detecting early-stage osteoarthritis (OA). PURPOSE To demonstrate the feasibility of biexponential T1ρ relaxation mapping of human knee menisci. STUDY TYPE Prospective. POPULATION Eight healthy volunteers with no known inflammation, trauma, or pain in the knee and three symptomatic subjects with early knee OA. FIELD STRENGTH/SEQUENCE Customized Turbo-FLASH sequence to acquire 3D-T1ρ -weighted images on a 3 T MRI scanner. ASSESSMENT T1ρ relaxation values were assessed in 11 meniscal regions of interest (ROIs) using monoexponential and biexponential models. STATISTICAL TESTS Nonparametric rank-sum tests, Kruskal-Wallis test, and coefficient of variation. RESULTS The mean monoexponential T1ρ relaxation in the lateral menisci were 28.05 ± 4.2 msec and 37.06 ± 10.64 msec for healthy subjects and early knee OA patients, respectively, while the short and long components were 8.07 ± 0.5 msec and 72.35 ± 3.2 msec for healthy subjects and 2.63 ± 2.99 msec and 55.27 ± 24.76 msec for early knee OA patients, respectively. The mean monoexponential T1ρ relaxation in the medial menisci were 34.30 ± 3.8 msec and 37.26 ± 11.38 msec for healthy and OA patients, respectively, while the short and long components were 7.76 ± 0.7 msec and 72.19 ± 4.2 msec for healthy subjects and 3.06 ± 3.24 msec and 55.27 ± 24.59 msec for OA patients, respectively. Statistically significant (P ≤ 0.05) differences were observed in the monoexponential relaxation between some of the ROIs. The T1ρ,short was significantly lower (P = 0.02) in the patients than controls. The rmsCV% ranges were 1.51-16.6%, 3.59-14.3%, and 4.91-15.6% for T1ρ -mono, T1ρ -short, and T1ρ -long, respectively. DATA CONCLUSION Our results showed that in all ROIs, T1ρ relaxation times of outer zones (red zones) were less than inner zones (white zones). Monoexponential T1ρ was increased in medial, lateral, and body menisci of early OA while the biexponential numbers were decreased in early OA patients. LEVEL OF EVIDENCE 2 Technical Efficacy Stage: 1 J. Magn. Reson. Imaging 2019. J. Magn. Reson. Imaging 2019;50:824-835.
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Affiliation(s)
- Rahman Baboli
- From the Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Azadeh Sharafi
- From the Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Gregory Chang
- From the Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Ravinder R Regatte
- From the Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
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Cheng Q, Zhao FC. Comparison of 1.5- and 3.0-T magnetic resonance imaging for evaluating lesions of the knee: A systematic review and meta-analysis (PRISMA-compliant article). Medicine (Baltimore) 2018; 97:e12401. [PMID: 30235710 PMCID: PMC6160024 DOI: 10.1097/md.0000000000012401] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND With conflicting results in the literature, it remains unclear whether a higher field strength automatically increases the sensitivity and specificity of magnetic resonance imaging (MRI) for detecting pathological lesions in the knee. Therefore, we performed a systematic review and meta-analysis of studies comparing the diagnostic accuracy of 1.5- and 3.0-T MRI for lesions within the knee. METHODS Sixteen studies were included in the meta-analysis of the diagnostic accuracy of MRI for lesions of the knee joint, and areas under the curve (AUC) derived from the summary receiver operating characteristic curve analysis were determined for comparison of the diagnostic accuracy with differing magnetic field strength as well as for lesions in different tissues of the knee. Separate meta-analyses were performed for the diagnosis of lesions within articular cartilage, ligaments, and meniscus. RESULTS For lesions within the articular cartilage, the AUC for 1.5-T MRI differed significantly from that for 3.0-T MRI (Z = 3.4, P < .05). However, for lesions within the ligaments and meniscus, the AUC values for 1.5-T MRI did not differ significantly from those for 3.0-T MRI (Z = 0.32, P > .05, and Z = 0.33, P > .05, respectively). CONCLUSION Our results indicate that both 1.5-T and 3.0-T MRI offer high diagnostic accuracy and clinical relevance for knee injuries involving the meniscus or a ligament. However, the present meta-analysis indicates that 3.0-T MRI does offer greater diagnostic accuracy than 1.5-T MRI for articular cartilage lesions.
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McPhee KC, Wilman AH. Limitations of skipping echoes for exponential T2fitting. J Magn Reson Imaging 2018; 48:1432-1440. [DOI: 10.1002/jmri.26052] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 03/27/2018] [Indexed: 12/20/2022] Open
Affiliation(s)
- Kelly C. McPhee
- Department of Physics; University of Alberta; Edmonton Alberta Canada
- Department of Biomedical Engineering; University of Alberta; Edmonton Alberta Canada
| | - Alan H. Wilman
- Department of Physics; University of Alberta; Edmonton Alberta Canada
- Department of Biomedical Engineering; University of Alberta; Edmonton Alberta Canada
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