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Wilms LM, Radke KL, Abrar DB, Frahm J, Voit D, Thelen S, Klee D, Grunz JP, Müller-Lutz A, Nebelung S. Dynamic assessment of scapholunate ligament status by real-time magnetic resonance imaging: an exploratory clinical study. Skeletal Radiol 2024; 53:791-800. [PMID: 37819279 PMCID: PMC10858828 DOI: 10.1007/s00256-023-04466-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/25/2023] [Accepted: 09/25/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVE Clinical-standard MRI is the imaging modality of choice for the wrist, yet limited to static evaluation, thereby potentially missing dynamic instability patterns. We aimed to investigate the clinical benefit of (dynamic) real-time MRI, complemented by automatic analysis, in patients with complete or partial scapholunate ligament (SLL) tears. MATERIAL AND METHODS Both wrists of ten patients with unilateral SLL tears (six partial, four complete tears) as diagnosed by clinical-standard MRI were imaged during continuous active radioulnar motion using a 1.5-T MRI scanner in combination with a custom-made motion device. Following automatic segmentation of the wrist, the scapholunate and lunotriquetral joint widths were analyzed across the entire range of motion (ROM). Mixed-effects model analysis of variance (ANOVA) followed by Tukey's posthoc test and two-way ANOVA were used for statistical analysis. RESULTS With the increasing extent of SLL tear, the scapholunate joint widths in injured wrists were significantly larger over the entire ROM compared to those of the contralateral healthy wrists (p<0.001). Differences between partial and complete tears were most pronounced at 5°-15° ulnar abduction (p<0.001). Motion patterns and trajectories were altered. Complete SLL deficiency resulted in complex alterations of the lunotriquetral joint widths. CONCLUSION Real-time MRI may improve the functional diagnosis of SLL insufficiency and aid therapeutic decision-making by revealing dynamic forms of dissociative instability within the proximal carpus. Static MRI best differentiates SLL-injured wrists at 5°-15° of ulnar abduction.
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Affiliation(s)
- Lena Marie Wilms
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstrasse 5, D-40225, Dusseldorf, Germany.
| | - Karl Ludger Radke
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstrasse 5, D-40225, Dusseldorf, Germany
| | - Daniel Benjamin Abrar
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstrasse 5, D-40225, Dusseldorf, Germany
| | - Jens Frahm
- Biomedical NMR, Max Planck Institute for Multidisciplinary Sciences, D-37077, Goettingen, Germany
| | - Dirk Voit
- Biomedical NMR, Max Planck Institute for Multidisciplinary Sciences, D-37077, Goettingen, Germany
| | - Simon Thelen
- Department of Orthopaedics and Trauma Surgery, Medical Faculty, University Dusseldorf, D-40225, Dusseldorf, Germany
| | - Dirk Klee
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstrasse 5, D-40225, Dusseldorf, Germany
- Department of General Pediatrics, University Dusseldorf, Medical Faculty, University Children's Hospital, Heinrich-Heine-University Dusseldorf, Moorenstrasse 5, Düsseldorf, Germany
| | - Jan-Peter Grunz
- Department of Diagnostic and Interventional Radiology, University Hospital Wurzburg, D-97080, Würzburg, Germany
| | - Anja Müller-Lutz
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstrasse 5, D-40225, Dusseldorf, Germany
| | - Sven Nebelung
- Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Moorenstrasse 5, D-40225, Dusseldorf, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Aachen, D-52074, Aachen, Germany
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Tian Y, Nayak KS. Real-time water/fat imaging at 0.55T with spiral out-in-out-in sampling. Magn Reson Med 2024; 91:649-659. [PMID: 37815020 PMCID: PMC10841523 DOI: 10.1002/mrm.29885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/23/2023] [Accepted: 09/21/2023] [Indexed: 10/11/2023]
Abstract
PURPOSE To develop an efficient and flexible water/fat separated real-time MRI (RT-MRI) method using spiral out-in-out-in (OIOI) sampling and balanced SSFP (bSSFP) at 0.55T. METHODS A bSSFP sequence with golden-angle spiral OIOI readout was developed, capturing three echoes to allow water/fat separation. A low-latency reconstruction that combines all echoes was available for online visualization. An offline reconstruction provided water and fat RT-MRI in two steps: (1) image reconstruction with spatiotemporally constrained reconstruction (STCR) and (2) water/fat separation with hierarchical iterative decomposition of water and fat with echo asymmetry and least-squares estimation (HIDEAL). In healthy volunteers, spiral OIOI was acquired in the wrist during a radial-to-ulnar deviation maneuver, in the heart without breath-hold and cardiac gating, and in the lower abdomen during free-breathing for visualizing small bowel motility. RESULTS We demonstrate successful water/fat separated RT-MRI for all tested applications. In the wrist, resulting images provided clear depiction of ligament gaps and their interactions during the radial-to-ulnar deviation maneuver. In the heart, water/fat RT-MRI depicted epicardial fat, provided improved delineation of epicardial coronary arteries, and provided high blood-myocardial contrast for ventricular function assessment. In the abdomen, water-only RT-MRI captured small bowel mobility clearly with improved water-fat contrast. CONCLUSIONS We have demonstrated a novel and flexible bSSFP spiral OIOI sequence at 0.55T that can provide water/fat separated RT-MRI with a variety of application-specific temporal resolution and spatial resolution requirements.
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Affiliation(s)
- Ye Tian
- Ming Hsieh Department of Electrical and Computer Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA
| | - Krishna S. Nayak
- Ming Hsieh Department of Electrical and Computer Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA
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Huddleston HP, Connors K, Levy KH, Kurtzman JS, Hayes WT, Koehler SM. Proximal Row Carpectomy Does Not Alter Contact Pressures of the Lunate Fossa: A Cadaveric Study. Hand (N Y) 2024; 19:82-89. [PMID: 35815611 PMCID: PMC10786110 DOI: 10.1177/15589447221105542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
BACKGROUND Previous studies have suggested that proximal row carpectomy (PRC) results in increased contact pressures and decreased contact areas in the radiocarpal joint. Such experiments, however, used older technologies that may be associated with considerable measurement errors. The purpose of this study was to determine whether there was a significant difference in contact pressure and contact area before and after PRC using Tekscan, a newer pressure sensing technology. METHODS Ten nonpaired cadaveric specimens were dissected proximal to the carpal row and potted. An ultra-thin Tekscan sensor was secured in the lunate fossa of the radius. The wrists were loaded with 200 N of force for 60 seconds to simulate clenched-fist grip; contact pressure and area was assessed before and after PRC. RESULTS Performing a PRC did not significantly increase mean contact pressure at the lunate fossa compared to the native state (mean increase of 17.4 ± 43.2 N/cm2, P = .184). Similarly, the PRC did not significantly alter peak contact pressures at the lunate fossa (intact: 617.2 ± 233.46 N/cm2, median = 637.5 N/cm2; PRC: 707.8 ± 156.6 N/cm2, median = 728.5 N/cm2; P = .169). In addition, the PRC (0.46 ± 0.15 cm2, median = 0.48 cm2) and intact states (0.49 ± 0.25 cm2, median = 0.44 cm2) demonstrated similar contact areas (P = .681). CONCLUSIONS In contrast to prior studies that demonstrated significant increases in contact pressure and decreases in contact area after PRC, our findings propose that performing a PRC does not significantly alter the contact pressures or area of the lunate fossa of the radiocarpal joint.
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Chaudhari AJ, Lim Y, Cui SX, Bayne CO, Szabo RM, Boutin RD, Nayak KS. Real-time MRI of the moving wrist at 0.55 tesla. Br J Radiol 2023; 96:20230298. [PMID: 37750944 PMCID: PMC10607422 DOI: 10.1259/bjr.20230298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/26/2023] [Accepted: 07/30/2023] [Indexed: 09/27/2023] Open
Abstract
OBJECTIVES Magnetic resonance imaging (MRI) using 1.5T or 3.0T systems is routinely employed for assessing wrist pathology; however, due to off-resonance artifacts and high power deposition, these high-field systems have drawbacks for real-time (RT) imaging of the moving wrist. Recently, high-performance 0.55T MRI systems have become available. In this proof-of-concept study, we tested the hypothesis that RT-MRI during continuous, active, and uninterrupted wrist motion is feasible with a high-performance 0.55T system at temporal resolutions below 100 ms and that the resulting images provide visualization of tissues commonly interrogated for assessing dynamic wrist instability. METHODS Participants were scanned during uninterrupted wrist radial-ulnar deviation and clenched fist maneuvers. Resulting images (nominal temporal resolution of 12.7-164.6 ms per image) were assessed for image quality. Feasibility of static MRI to supplement RT-MRI acquisition was also tested. RESULTS The RT images with temporal resolutions < 100 ms demonstrated low distortion and image artifacts, and higher reader assessment scores. Static MRI scans showed the ability to assess anatomical structures of interest in the wrist. CONCLUSION RT-MRI of the wrist at a high temporal resolution, coupled with static MRI, is feasible with a high-performance 0.55T system, and may enable improved assessment of wrist dynamic dysfunction and instability. ADVANCES IN KNOWLEDGE Real-time MRI of the moving wrist is feasible with high-performance 0.55T and may improve the evaluation of dynamic dysfunction of the wrist.
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Affiliation(s)
- Abhijit J Chaudhari
- Department of Radiology, University of California, Davis, Sacramento, CA, USA
| | - Yongwan Lim
- Ming Hsieh Department of Electrical and Computer Engineering, University of Southern California, Los Angeles, CA, USA
| | - Sophia X. Cui
- Siemens Medical Solutions USA Inc., Malvern, PA, USA
| | - Christopher O. Bayne
- Department of Orthopaedic Surgery, University of California Davis, Sacramento, CA, USA
| | - Robert M. Szabo
- Department of Orthopaedic Surgery, University of California Davis, Sacramento, CA, USA
| | - Robert D. Boutin
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA
| | - Krishna S Nayak
- Ming Hsieh Department of Electrical and Computer Engineering, University of Southern California, Los Angeles, CA, USA
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Wang B, Walczyk J, Ahmed M, Elkowitz S, Daniels S, Brown R, Burke CJ. Extended and weightbearing wrist 3-T MRI using a novel harness and flexible 24-channel glove coil to evaluate carpal kinematics: a pilot study in 10 volunteers. Acta Radiol 2023; 64:2570-2577. [PMID: 37470466 DOI: 10.1177/02841851231188222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
BACKGROUND Wrist pain in the extended or extended weightbearing positions may be incompletely evaluated using standard magnetic resonance imaging (MRI) with standard rigid clamshell coils in the neutral position. PURPOSE To evaluate a flexible 24-channel glove coil and harness when imaging the wrist in neutral, dorsally extended, and weightbearing positions. MATERIAL AND METHODS Ten wrists in 10 asymptomatic volunteers (mean age = 29 years) were scanned. Participants underwent 3-T MRI using the harness and flexible glove coil, acquiring sagittal turbo spin echo (TSE) and half-Fourier acquisition single-shot turbo spin echo (HASTE) pulse sequences. Static TSE images were obtained in neutral, extended, and weightbearing positions using proton density parameters and independently evaluated by two radiologists for: dorsal radiocarpal ligament thickness; radiocapitate, radiolunate, and capitatolunate angles; palmar translation of the lunate on the radius; angulation of the extensor tendons; and distance from the distal extensor retinaculum to Lister's tubercle. Cine HASTE images were dynamically acquired between neutral-maximum extension to measure the radiocapitate angle. RESULTS Good reader agreement was observed (r > 0.73) for all measurements except palmar translation in the neutral position (r = 0.27). Significant increases in dorsal radiocarpal ligament thickness; radiocapitate, radiolunate and capitolunate angulation; and extensor tendon angulation were observed between the neutral and extended positions (P < 0.001). A further significant increase in these metrics between extended and weightbearing positions was also seen (P < 0.01). CONCLUSION Significant increases in dorsal radiocarpal ligament thickness, articular and tendon angulations occur during wrist extension, that further increase with dorsal weightbearing.
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Affiliation(s)
- Bili Wang
- Department of Radiology, New York University Langone Medical Center, New York, NY, USA
- Center for Advanced Imaging Innovation and Research, New York University Grossman School of Medicine, New York, NY, USA
| | - Jerzy Walczyk
- Department of Radiology, New York University Langone Medical Center, New York, NY, USA
- Center for Advanced Imaging Innovation and Research, New York University Grossman School of Medicine, New York, NY, USA
| | - Mohammad Ahmed
- Department of Radiology, New York University Langone Medical Center, New York, NY, USA
| | - Stuart Elkowitz
- Department of Orthopedic Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Steven Daniels
- Department of Radiology, New York University Langone Medical Center, New York, NY, USA
| | - Ryan Brown
- Department of Radiology, New York University Langone Medical Center, New York, NY, USA
- Center for Advanced Imaging Innovation and Research, New York University Grossman School of Medicine, New York, NY, USA
| | - Christopher J Burke
- Department of Radiology, New York University Langone Medical Center, New York, NY, USA
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Garetier M, Rousset J, Makki K, Brochard S, Rousseau F, Salem DB, Borotikar B. Assessment and comparison of image quality between two real-time sequences for dynamic MRI of distal joints at 3.0 Tesla. Acta Radiol 2023; 64:1093-1102. [PMID: 35616984 DOI: 10.1177/02841851221101889] [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: 11/15/2022]
Abstract
BACKGROUND Real-time sequences allow functional evaluation of various joint structures during a continuous motion and help understand the pathomechanics of underlying musculoskeletal diseases. PURPOSE To assess and compare the image quality of the two most frequently used real-time sequences for joint dynamic magnetic resonance imaging (MRI), acquired during finger and ankle joint motion. MATERIAL AND METHODS A real-time dynamic acquisition protocol, including radiofrequency (RF)-spoiled and balanced steady-state free precession (bSSFP) sequences, optimized for temporal resolution with similar spatial resolution, was performed using a 3.0-T MRI scanner on 10 fingers and 12 ankles from healthy individuals during active motion. Image quality criteria were evaluated on each time frame and compared between these two sequences. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were determined and compared from regions of interest placed on cortical bone, tendon, fat, and muscle. Visualization of anatomical structures and overall image quality appreciation were rated by two radiologists using a 0-10 grading scale. RESULTS Mean CNR was significantly higher with bSSFP sequence compared to RF-spoiled sequence. The grading score was in the range of 5-9.3 and was significantly higher with RF-spoiled sequence for bone and joint evaluation and overall image appreciation on the two joints. The standard deviation for SNR, CNR, and grading score during motion was smaller with RF-spoiled sequence for both the joints. The inter-reader reliability was excellent (>0.75) for evaluating anatomical structures in both sequences. CONCLUSION A RF-spoiled real-time sequence is recommended for the in vivo clinical evaluation of distal joints on a 3.0-T MRI scanner.
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Affiliation(s)
- Marc Garetier
- Department of Radiology, Military Teaching Hospital Clermont-Tonnerre, Brest, France
- Department of Radiology, University Hospital Morvan, Brest, France
- Laboratory of Medical Information Processing (LATIM), INSERM-UMR 1101, Brest, France
| | - Jean Rousset
- Department of Radiology, Military Teaching Hospital Clermont-Tonnerre, Brest, France
| | - Karim Makki
- INRIA Fluminance, Rennes, France
- 56498IFPEN, Rueil-Malmaison, France
| | - Sylvain Brochard
- Laboratory of Medical Information Processing (LATIM), INSERM-UMR 1101, Brest, France
- Department of Physical and Medical Rehabilitation, University Hospital Morvan, Brest, France
- Department of Paediatric Physical and Medical Rehabilitation, Fondation Ildys, Brest, France
- University of Western Brittany (UBO), Brest, France
| | - François Rousseau
- Laboratory of Medical Information Processing (LATIM), INSERM-UMR 1101, Brest, France
- 52826IMT Atlantique, UBL, Brest, France
| | - Douraïed Ben Salem
- Laboratory of Medical Information Processing (LATIM), INSERM-UMR 1101, Brest, France
- University of Western Brittany (UBO), Brest, France
- Department of Radiology, University Hospital La Cavale Blanche, Brest, France
| | - Bhushan Borotikar
- Laboratory of Medical Information Processing (LATIM), INSERM-UMR 1101, Brest, France
- Symbiosis Centre for Medical Image Analysis, 29630Symbiosis International University, Pune, India
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Minici R, Mercurio M, Iannò B, Galasso O, Gasparini G, Laganà D. Advantages of the Use of Axial Traction Magnetic Resonance Imaging (MRI) of the Shoulder in Patients with Suspected Rota-Tor Cuff Tears: An Exploratory Pilot Study. Healthcare (Basel) 2023; 11:healthcare11050724. [PMID: 36900729 PMCID: PMC10000934 DOI: 10.3390/healthcare11050724] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 02/23/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
Magnetic Resonance Imaging (MRI) with axial traction is a tool for the assessment of musculoskeletal pathology. Previous reports have demonstrated a better distribution of intra-articular contrast material. No investigations were performed to evaluate glenohumeral joint axial traction MRI in patients with suspected rotator cuff tears. This study aims to assess the morphological changes and the potential advantage of glenohumeral joint axial traction MRI without intra-articular contrast administration in patients with suspected rotator cuff tears. Eleven patients with clinical suspicion of rotator cuff tears underwent a shoulder MRI scan with and without axial traction. PD weighted images with SPAIR fat saturation technique and T1 weighted images with TSE technique were acquired in the oblique coronal, oblique sagittal and axial planes. Axial traction allowed a significant widening of the subacromial space (11.1 ± 1.5 mm vs. 11.3 ± 1.8 mm; p = 0.001) and inferior glenohumeral space (8.6 ± 3.8 mm vs. 8.9 ± 2.8 mm; p = 0.029). With axial traction, there was a significant decrease in measurements of the acromial angle (8.3 ± 10.8° vs. 6.4 ± 9.8°; p < 0.001) and gleno-acromial angle (81 ± 12.8° vs. 80.7 ± 11.5°; p = 0.020). Our investigation demonstrates for the first time significant morphological changes in the shoulder of patients with suspected rotator cuff tears who underwent a glenohumeral joint axial traction MRI.
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Affiliation(s)
- Roberto Minici
- Radiology Unit, Department of Experimental and Clinical Medicine, “Magna Græcia” University, Mater Domini University Hospital, 88100 Catanzaro, Italy
| | - Michele Mercurio
- Department of Orthopaedic and Trauma Surgery, “Magna Græcia” University, Mater Domini University Hospital, 88100 Catanzaro, Italy
| | - Bruno Iannò
- Department of Surgery, Division of Orthopedics and Trauma Surgery, “G. Jazzolino” Hospital, Piazza Fleming, 89900 Vibo Valentia, Italy
| | - Olimpio Galasso
- Department of Orthopaedic and Trauma Surgery, “Magna Græcia” University, Mater Domini University Hospital, 88100 Catanzaro, Italy
- Correspondence: ; Tel.: +39-09613647122
| | - Giorgio Gasparini
- Department of Orthopaedic and Trauma Surgery, “Magna Græcia” University, Mater Domini University Hospital, 88100 Catanzaro, Italy
| | - Domenico Laganà
- Radiology Unit, Department of Experimental and Clinical Medicine, “Magna Græcia” University, Mater Domini University Hospital, 88100 Catanzaro, Italy
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Dalili D, Fritz J, Isaac A. 3D MRI of the Hand and Wrist: Technical Considerations and Clinical Applications. Semin Musculoskelet Radiol 2021; 25:501-513. [PMID: 34547815 DOI: 10.1055/s-0041-1731652] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
In the last few years, major developments have been observed in the field of magnetic resonance imaging (MRI). Advances in both scanner hardware and software technologies have witnessed great leaps, enhancing the diagnostic quality and, therefore, the value of MRI. In musculoskeletal radiology, three-dimensional (3D) MRI has become an integral component of the diagnostic pathway at our institutions. This technique is particularly relevant in patients with hand and wrist symptoms, due to the intricate nature of the anatomical structures and the wide range of differential diagnoses for most presentations. We review the benefits of 3D MRI of the hand and wrist, commonly used pulse sequences, clinical applications, limitations, and future directions. We offer guidance for enhancing the image quality and tips for image interpretation of 3D MRI of the hand and wrist.
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Affiliation(s)
- Danoob Dalili
- Epsom and St Helier University Hospitals, London, United Kingdom
| | - Jan Fritz
- NYU Grossman School of Medicine, New York University, New York, New York
| | - Amanda Isaac
- Guy's and St. Thomas' Hospitals NHS Foundation Trust, London, United Kingdom.,School of Biomedical Engineering and Imaging Sciences, King's College London (KCL), London, United Kingdom
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Öztürk T, Burtaç Eren M. Is it really safe to evaluate symptomatic extensor carpi ulnaris tendon instability by magnetic resonance imaging (MRI)? Acta Orthop Belg 2021. [DOI: 10.52628/87.2.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The extensor carpi ulnaris (ECU) tendon is in the sixth extensor compartment of the wrist and is isolated from other tendons by a different sheath. Extensor carpi ulnaris pathologies are characterized by pain locally localized to the wrist ulnar side. Outpatient records and wrist MRI (magnetic resonance imaging) tests were retrospectively scanned between January 2018 and July 2019. By examining the anamnesis and examination notes of the patients in the outpatient clinic records, patients with wrist ulnar side pain, pain or sensitivity on the ulnar styloid and provocation test (synergy) were assigned to the first study group (Group 1).The second study group was composed of patients who underwent wrist MR for the diagnosis or differential diagnosis of a synovial cyst around the wrist, without ulnar side pain (Group 2).While evaluating MR images in the axial plane, the depth and width of the ulnar groove, thickness of the ECU tendon were measured. The position of the ECU tendon relative to the ulnar groove and the forearm rotation during the shooting were recorded.105 cases evaluated, there were 41 cases in the symptomatic subgroup and 64 cases in the asymptomatic subgroup. Among all patients, the mean patient age was 38.05.In the evaluation according to whether cases were symptomatic or not, there was no significant relationship between being symptomatic and the degree of instability and MR withdrawal position.
Our study suggests that ECU instability in MR is not a specific condition, and detection of MR in instability may not be associated with a patient’s symptoms.
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Kim JN, Kwon ST, Shin HD. Subluxation of the extensor carpi ulnaris on magnetic resonance imaging on neutral wrist position: correlation with tenosynovitis of the extensor carpi ulnaris and translation of the distal radioulnar joint. Skeletal Radiol 2021; 50:1593-1603. [PMID: 33432435 DOI: 10.1007/s00256-020-03705-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 12/23/2020] [Accepted: 12/27/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To identify the subluxation degrees of extensor carpi ulnaris (ECU) tendon on neutral wrist MRI in patients with ulnar-sided wrist pain and to evaluate the relationships of ECU subluxation with accompanying imaging findings such as ECU tenosynovitis, distal radioulnar joint (DRUJ) stability, and triangular fibrocartilage complex (TFCC) pathology. MATERIALS AND METHODS A total of 297 MRIs of 292 patients having ulnar side pain were reviewed retrospectively. Degrees of ECU subluxation was classified into four grades: grade 0, no subluxation; grade 1, tendon displacement < 50% of the tendon width; grade 2, tendon displacement 51 to 99% of the tendon width; and grade 3, tendon displacement of 100% of the tendon width. ECU tenosynovitis, ECU tendinosis, injuries of triangular fibrocartilage and distal radioulnar ligaments (DRUL), translation ratio of the DRUJ, rotation angle of the DRUJ, and the width, depth, and length of the ulnar groove were assessed on wrist MRI. The relationships between degree of ECU subluxation and these imaging findings were investigated. RESULTS Women had higher subluxation degrees of the ECU tendon (p = 0.001). Tenosynovitis of the ECU, sprain of the dorsal DRUL, dorsovolar translation ratio and rotation angle of the DRUJ, and depth and length of the ulnar groove were statistically significantly related to the subluxation degree of the ECU tendon (p = 0.000). CONCLUSION High-grade subluxation of the ECU tendon was strongly correlated with ECU tenosynovitis and DRUJ translation. Clinicians and radiologists should scrutinize imaging findings, particularly when patients with ulnar-sided wrist pain have high-grade subluxation of the ECU tendon.
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Affiliation(s)
- Ji Na Kim
- Department of Radiology, Kangbuk Samsung Hospital, 29 Saemunan-ro, Jongno-gu, 03181, Seoul, Republic of Korea
| | - Soon Tae Kwon
- Department of Radiology, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munwha-ro Jung-gu, 35015, Daejeon, Republic of Korea.
| | - Hyun Dae Shin
- Department of Orthopaedic Surgery, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munwha-ro Jung-gu, 35015, Daejeon, Republic of Korea
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Ratasvuori MS, Lindfors NC, Sormaala MJ. The clinical significance of magnetic resonance imaging of the hand: an analysis of 318 hand and wrist images referred by hand surgeons. J Plast Surg Hand Surg 2021; 56:69-73. [PMID: 34137663 DOI: 10.1080/2000656x.2021.1933993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Magnetic resonance imaging (MRI) is a common diagnostic tool in hand surgery. However, there is limited knowledge on the kind of findings that are relevant in treatment planning. We analysed the findings and utility of arm, wrist, metacarpal, and finger MRIs taken in a tertiary hand surgery clinic of 318 consecutive images from 316 patients referred by a hand surgeon or hand surgeon resident. Ganglions (28%), findings on the extensor carpi ulnaris tendon (18%) and on the triangular fibrocartilage (18%) were the most common findings and increased with patient age; the clinical significance of these findings was minimal. The correlation between the clinical scaphoid shift test or the fovea sign test and MRI was also non-significant. Despite findings on MRI, the diagnosis remained unsolved in 76 (24%) cases. However, MRI had a role in reassuring the patient, and in 70% of the cases, further follow-up was unnecessary. This study demonstrates that the indications for wrist and hand MRI must be considered thoroughly and interpretation of the MRI report requires knowledge.
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Affiliation(s)
- Maire Sofia Ratasvuori
- Department of Musculoskeletal and Plastic Surgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Nina Charlotta Lindfors
- Department of Musculoskeletal and Plastic Surgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Markus J Sormaala
- Department of Radiology, HUS Helsinki Medical Imaging Center, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
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Deep Learning-Based Post-Processing of Real-Time MRI to Assess and Quantify Dynamic Wrist Movement in Health and Disease. Diagnostics (Basel) 2021; 11:diagnostics11061077. [PMID: 34208361 PMCID: PMC8231139 DOI: 10.3390/diagnostics11061077] [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] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/06/2021] [Accepted: 06/09/2021] [Indexed: 12/20/2022] Open
Abstract
While morphologic magnetic resonance imaging (MRI) is the imaging modality of choice for the evaluation of ligamentous wrist injuries, it is merely static and incapable of diagnosing dynamic wrist instability. Based on real-time MRI and algorithm-based image post-processing in terms of convolutional neural networks (CNNs), this study aims to develop and validate an automatic technique to quantify wrist movement. A total of 56 bilateral wrists (28 healthy volunteers) were imaged during continuous and alternating maximum ulnar and radial abduction. Following CNN-based automatic segmentations of carpal bone contours, scapholunate and lunotriquetral gap widths were quantified based on dedicated algorithms and as a function of wrist position. Automatic segmentations were in excellent agreement with manual reference segmentations performed by two radiologists as indicated by Dice similarity coefficients of 0.96 ± 0.02 and consistent and unskewed Bland–Altman plots. Clinical applicability of the framework was assessed in a patient with diagnosed scapholunate ligament injury. Considerable increases in scapholunate gap widths across the range-of-motion were found. In conclusion, the combination of real-time wrist MRI and the present framework provides a powerful diagnostic tool for dynamic assessment of wrist function and, if confirmed in clinical trials, dynamic carpal instability that may elude static assessment using clinical-standard imaging modalities.
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13
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Dietrich TJ, Toms AP, Cerezal L, Omoumi P, Boutin RD, Fritz J, Schmitt R, Shahabpour M, Becce F, Cotten A, Blum A, Zanetti M, Llopis E, Bień M, Lalam RK, Afonso PD, Mascarenhas VV, Sutter R, Teh J, Pracoń G, de Jonge MC, Drapé JL, Mespreuve M, Bazzocchi A, Bierry G, Dalili D, Garcia-Elias M, Atzei A, Bain GI, Mathoulin CL, Del Piñal F, Van Overstraeten L, Szabo RM, Camus EJ, Luchetti R, Chojnowski AJ, Grünert JG, Czarnecki P, Corella F, Nagy L, Yamamoto M, Golubev IO, van Schoonhoven J, Goehtz F, Klich M, Sudoł-Szopińska I. Interdisciplinary consensus statements on imaging of scapholunate joint instability. Eur Radiol 2021; 31:9446-9458. [PMID: 34100996 PMCID: PMC8589813 DOI: 10.1007/s00330-021-08073-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 04/12/2021] [Accepted: 05/12/2021] [Indexed: 11/29/2022]
Abstract
Objectives The purpose of this agreement was to establish evidence-based consensus statements on imaging of scapholunate joint (SLJ) instability by an expert group using the Delphi technique. Methods Nineteen hand surgeons developed a preliminary list of questions on SLJ instability. Radiologists created statements based on the literature and the authors’ clinical experience. Questions and statements were revised during three iterative Delphi rounds. Delphi panellists consisted of twenty-seven musculoskeletal radiologists. The panellists scored their degree of agreement to each statement on an eleven-item numeric scale. Scores of ‘0’, ‘5’ and ‘10’ reflected complete disagreement, indeterminate agreement and complete agreement, respectively. Group consensus was defined as a score of ‘8’ or higher for 80% or more of the panellists. Results Ten of fifteen statements achieved group consensus in the second Delphi round. The remaining five statements achieved group consensus in the third Delphi round. It was agreed that dorsopalmar and lateral radiographs should be acquired as routine imaging work-up in patients with suspected SLJ instability. Radiographic stress views and dynamic fluoroscopy allow accurate diagnosis of dynamic SLJ instability. MR arthrography and CT arthrography are accurate for detecting scapholunate interosseous ligament tears and articular cartilage defects. Ultrasonography and MRI can delineate most extrinsic carpal ligaments, although validated scientific evidence on accurate differentiation between partially or completely torn or incompetent ligaments is not available. Conclusions Delphi-based agreements suggest that standardized radiographs, radiographic stress views, dynamic fluoroscopy, MR arthrography and CT arthrography are the most useful and accurate imaging techniques for the work-up of SLJ instability. Key Points • Dorsopalmar and lateral wrist radiographs remain the basic imaging modality for routine imaging work-up in patients with suspected scapholunate joint instability. • Radiographic stress views and dynamic fluoroscopy of the wrist allow accurate diagnosis of dynamic scapholunate joint instability. • Wrist MR arthrography and CT arthrography are accurate for determination of scapholunate interosseous ligament tears and cartilage defects.
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Affiliation(s)
- Tobias Johannes Dietrich
- Division of Radiology and Nuclear Medicine, Kantonsspital St. Gallen, Rorschacherstrasse 95, CH 9007, St. Gallen, Switzerland. .,Faculty of Medicine, University of Zurich, Pestalozzistrasse 3, 8091, Zurich, Switzerland.
| | - Andoni Paul Toms
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK
| | - Luis Cerezal
- Radiology Department, DMC-Diagnóstico Médico Cantabria, Castilla 6-Bajo, 39002, Santander, Spain
| | - Patrick Omoumi
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Robert Downey Boutin
- Department of Radiology, Stanford University School of Medicine, 300 Pasteur Drive, MC-5105, Stanford, CA, 94305, USA
| | - Jan Fritz
- Department of Radiology, New York University Grossman School of Medicine, NYU Langone Health, 660 First Avenue, New York, NY, 10016, USA
| | - Rainer Schmitt
- Klinikum der Ludwig-Maximilians-Universität München, Klinik und Poliklinik für Radiologie, Marchioninistraße 15, D-81377, München, Germany
| | - Maryam Shahabpour
- Department of Radiology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Fabio Becce
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Anne Cotten
- Service de Radiologie et Imagerie Musculosquelettique, CCIAL, CHU de Lille, 59800, Lille, France
| | - Alain Blum
- Guilloz Imaging Department, Central Hospital, University Hospital Center of Nancy, UDL, 29 avenue du Maréchal de Lattre de Tassigny, 54035, Nancy, France
| | - Marco Zanetti
- Faculty of Medicine, University of Zurich, Pestalozzistrasse 3, 8091, Zurich, Switzerland.,Department of Musculoskeletal Radiology, Clinic Hirslanden Zurich, Witellikerstrasse 40, 8008, Zurich, Switzerland
| | - Eva Llopis
- Hospital de la Ribera, IMSKE, Valencia, Paseo Ciudadela 13, 46003, Valencia, Spain
| | - Maciej Bień
- Gamma Medical Center, Broniewskiego 3, 01-785, Warsaw, Poland
| | - Radhesh Krishna Lalam
- Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK
| | - P Diana Afonso
- Musculoskeletal Imaging Unit, Imaging Center, Radiology Department, Hospital da Luz, Grupo Luz Saúde, Av. Lusiada 100, 1500-650, Lisbon, Portugal.,Hospital Particular da Madeira, HPA, Funchal, Madeira, Portugal
| | - Vasco V Mascarenhas
- Musculoskeletal Imaging Unit, Imaging Center, Radiology Department, Hospital da Luz, Grupo Luz Saúde, Av. Lusiada 100, 1500-650, Lisbon, Portugal.,AIRC, Advanced Imaging Research Consortium, Lisbon, Portugal
| | - Reto Sutter
- Faculty of Medicine, University of Zurich, Pestalozzistrasse 3, 8091, Zurich, Switzerland.,Radiology, Balgrist University Hospital, University of Zurich, Forchstrasse 340, CH-8008, Zurich, Switzerland
| | - James Teh
- Department of Radiology, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Grzegorz Pracoń
- Gamma Medical Center, Broniewskiego 3, 01-785, Warsaw, Poland.,Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartańska 1, 02-637, Warsaw, Poland
| | - Milko C de Jonge
- Department of Radiology, St. Antonius Hospital Utrecht, Utrecht, The Netherlands
| | - Jean-Luc Drapé
- Service de Radiologie B, Groupe Hospitalier Cochin, AP-HP Centre, Université de Paris, 75014, Paris, France
| | - Marc Mespreuve
- Department of Medical Imaging, University Hospital Ghent, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Via G. C. Pupilli 1, 40136, Bologna, Italy
| | - Guillaume Bierry
- MSK Imaging, University Hospital, 1 Avenue Molière, 67098, Strasbourg Cedex, France
| | - Danoob Dalili
- Epsom & St Helier University Hospitals NHS Trust Radiology Department, Dorking Road, Epsom, London, KT18 7EG, UK
| | - Marc Garcia-Elias
- Hand and Upper Extremity Surgery, Creu Blanca, P° Reina Elisenda 57, 08022, Barcelona, Spain
| | - Andrea Atzei
- Pro-Mano, Treviso, Italy and Ospedale Koelliker, Corso G. Ferraris 247, 10134, Torino, Italy
| | - Gregory Ian Bain
- Department of Orthopaedic Surgery, Flinders University, Bedford Park, Adelaide, South Australia, Australia
| | | | - Francisco Del Piñal
- Instituto de Cirugía Plástica y de la Mano, Serrano 58 1B, 28001, Madrid, Spain
| | - Luc Van Overstraeten
- Hand and Foot Surgery Unit (HFSU) SPRL, Rue Pierre Caille 9, 7500, Tournai, Belgium.,Department of Orthopaedics and Traumatology, Erasme University Hospital, Route de Lennik, 808, Brussels, Belgium
| | - Robert M Szabo
- Department of Orthopaedic Surgery, University of California Davis, Health System, 4800 Y Street, Sacramento, CA, 95817, USA
| | - Emmanuel J Camus
- Hand Surgery Unit, Clinique de Lille Sud, 96 Rue Gustave Delory, Lesquin, France
| | | | - Adrian Julian Chojnowski
- Orthopaedics and Trauma Department, Hand and Upper Limb Surgery, Norfolk and Norwich University NHS Trust Hospital, Colney Lane, Norwich, NR4 7UY, UK
| | - Jörg G Grünert
- Department of Hand, Plastic and Reconstructive Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Piotr Czarnecki
- Traumatology, Orthopaedics and Hand Surgery Department, Poznan University of Medical Sciences, ul. 28 Czerwca 1956r. nr 135/147, 61-545, Poznań, Poland
| | - Fernando Corella
- Orthopedic and Trauma Department, Hospital Universitario Infanta Leonor, C/ Gran Vía del Este N° 80, 28031, Madrid, Spain.,Hand Surgery Unit, Hospital Universitario Quirónsalud Madrid, Madrid, Spain.,Surgery Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Ladislav Nagy
- Faculty of Medicine, University of Zurich, Pestalozzistrasse 3, 8091, Zurich, Switzerland.,Division for Hand Surgery and Surgery of Peripheral Nerves, Balgrist University Hospital, University of Zurich, Forchstrasse, 340, 8008, Zurich, Switzerland
| | - Michiro Yamamoto
- Department of Hand Surgery, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya, Japan
| | - Igor O Golubev
- Hand and Microsurgery Division, National Medical Research Centre of Traumatology and Orthopaedic named after N.N. Priorov, Moscow, Russia
| | - Jörg van Schoonhoven
- Clinic for Hand Surgery, Rhön Medical Center, Campus Bad Neustadt, Von Guttenberg-Straße 11, 97616, Bad Neustadt/Saale, Germany
| | - Florian Goehtz
- Clinic for Hand Surgery, Rhön Medical Center, Campus Bad Neustadt, Von Guttenberg-Straße 11, 97616, Bad Neustadt/Saale, Germany
| | - Maciej Klich
- Department of Traumatology and Orthopaedics, Postgraduate Medical Center, A. Gruca Teaching Hospital, Otwock, Poland
| | - Iwona Sudoł-Szopińska
- Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartańska 1, 02-637, Warsaw, Poland
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Osseous Pathology on Wrist Magnetic Resonance Imaging. Top Magn Reson Imaging 2021; 29:245-261. [PMID: 33021576 DOI: 10.1097/rmr.0000000000000257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Advanced imaging of the osseous structures of the wrist by magnetic resonance imaging (MRI) yields powerful information regarding marrow composition and overall bone structure. Various forms of pathology, both benign and malignant, have unique marrow signal abnormalities that can be easily detected by MRI given its high sensitivity to radiographically occult processes. In particular, osseous pathology can be seen in the setting of traumatic, degenerative, congenital, infectious, and neoplastic conditions. The acuity or chronicity of these conditions can often be determined by imaging to aid in appropriate therapy. A thorough understanding of the breadth of pathology and corresponding MRI appearances can allow the interpreting radiologist to formulate a concise and accurate assessment of an examination.
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15
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Akhbari B, Morton AM, Moore DC, Crisco JJ. Biplanar Videoradiography to Study the Wrist and Distal Radioulnar Joints. J Vis Exp 2021:10.3791/62102. [PMID: 33616093 PMCID: PMC8182367 DOI: 10.3791/62102] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Accurate measurement of skeletal kinematics in vivo is essential for understanding normal joint function, the influence of pathology, disease progression, and the effects of treatments. Measurement systems that use skin surface markers to infer skeletal motion have provided important insight into normal and pathological kinematics, however, accurate arthrokinematics cannot be attained using these systems, especially during dynamic activities. In the past two decades, biplanar videoradiography (BVR) systems have enabled many researchers to directly study the skeletal kinematics of the joints during activities of daily living. To implement BVR systems for the distal upper extremity, videoradiographs of the distal radius and the hand are acquired from two calibrated X-ray sources while a subject performs a designated task. Three-dimensional (3D) rigid-body positions are computed from the videoradiographs via a best-fit registrations of 3D model projections onto to each BVR view. The 3D models are density-based image volumes of the specific bone derived from independently acquired computed-tomography data. Utilizing graphics processor units and high-performance computing systems, this model-based tracking approach is shown to be fast and accurate in evaluating the wrist and distal radioulnar joint biomechanics. In this study, we first summarized the previous studies that have established the submillimeter and subdegree agreement of BVR with an in vitro optical motion capture system in evaluating the wrist and distal radioulnar joint kinematics. Furthermore, we used BVR to compute the center of rotation behavior of the wrist joint, to evaluate the articulation pattern of the components of the implant upon one another, and to assess the dynamic change of ulnar variance during pronosupination of the forearm. In the future, carpal bones may be captured in greater detail with the addition of flat panel X-ray detectors, more X-ray sources (i.e., multiplanar videoradiography), or advanced computer vision algorithms.
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Affiliation(s)
| | - Amy M Morton
- Department of Orthopedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital
| | - Douglas C Moore
- Department of Orthopedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital
| | - Joseph J Crisco
- Center for Biomedical Engineering, Brown University; Department of Orthopedics, The Warren Alpert Medical School of Brown University and Rhode Island Hospital
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16
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Conconi M, Sancisi N, Parenti-Castelli V. Prediction of Individual Knee Kinematics From an MRI Representation of the Articular Surfaces. IEEE Trans Biomed Eng 2020; 68:1084-1092. [PMID: 32816671 DOI: 10.1109/tbme.2020.3018113] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The knowledge of individual joint motion may help to understand the articular physiology and to design better treatments and medical devices. Measurements of in-vivo individual motion are nowadays invasive/ionizing (fluoroscopy) or imprecise (skin markers). We propose a new approach to derive the individual knee natural motion from a three-dimensional representation of articular surfaces. METHODS We hypothesize that tissue adaptation shapes articular surfaces to optimize load distribution. Thus, the knee natural motion is obtained as the envelope of tibiofemoral positions and orientations that minimize peak contact pressure, i.e. that maximize joint congruence. We investigated four in-vitro and one in-vivo knees. Articular surfaces were reconstructed from a reference MRI. Natural motion was computed by congruence maximization and results were validated versus experimental data, acquired through bone implanted markers, in-vitro, and single-plane fluoroscopy, in-vivo. RESULTS In two cases, one of which in-vivo, maximum mean absolute error stays below 2.2° and 2.7 mm for rotations and translations, respectively. The remaining knees showed differences in joint internal rotation between the reference MRI and experimental motion at 0° flexion, possibly due to some laxity. The same difference is found in the model predictions, which, however, still replicate the individual knee motion. CONCLUSION The proposed approach allows the prediction of individual joint motion based on non-ionizing MRI data. SIGNIFICANCE This method may help to characterize healthy and, by comparison, pathological knee behavior. Moreover, it may provide an individual reference motion for the personalization of musculoskeletal models, opening the way to their clinical application.
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17
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Garetier M, Borotikar B, Makki K, Brochard S, Rousseau F, Ben Salem D. Dynamic MRI for articulating joint evaluation on 1.5 T and 3.0 T scanners: setup, protocols, and real-time sequences. Insights Imaging 2020; 11:66. [PMID: 32430739 PMCID: PMC7237553 DOI: 10.1186/s13244-020-00868-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Accepted: 04/02/2020] [Indexed: 01/31/2023] Open
Abstract
Dynamic magnetic resonance imaging (MRI) is a non-invasive method that can be used to increase the understanding of the pathomechanics of joints. Various types of real-time gradient echo sequences used for dynamic MRI acquisition of joints include balanced steady-state free precession sequence, radiofrequency-spoiled sequence, and ultra-fast gradient echo sequence. Due to their short repetition time and echo time, these sequences provide high temporal resolution, a good signal-to-noise ratio and spatial resolution, and soft tissue contrast. The prerequisites of the evaluation of joints with dynamic MRI include suitable patient installation and optimal positioning of the joint in the coil to allow joint movement, sometimes with dedicated coil support. There are currently few recommendations in the literature regarding appropriate protocol, sequence standardizations, and diagnostic criteria for the use of real-time dynamic MRI to evaluate joints. This article summarizes the technical parameters of these sequences from various manufacturers on 1.5 T and 3.0 T MRI scanners. We have reviewed pertinent details of the patient and coil positioning for dynamic MRI of various joints. The indications and limitations of dynamic MRI of joints are discussed.
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Affiliation(s)
- Marc Garetier
- Department of Radiology, Military Teaching Hospital Clermont-Tonnerre, Rue du colonel Fonferrier, 29240, Brest, Cedex 9, France. .,Department of Radiology, University Hospital Morvan, Brest, France. .,Laboratory of Medical Information Processing (LATIM), INSERM-UMR 1101, Brest, France.
| | - Bhushan Borotikar
- Laboratory of Medical Information Processing (LATIM), INSERM-UMR 1101, Brest, France.,University of Western Brittany (UBO), Brest, France.,University Hospital, Brest, France
| | - Karim Makki
- Laboratory of Medical Information Processing (LATIM), INSERM-UMR 1101, Brest, France.,IMT Atlantique, UBL, Brest, France
| | - Sylvain Brochard
- Laboratory of Medical Information Processing (LATIM), INSERM-UMR 1101, Brest, France.,University of Western Brittany (UBO), Brest, France.,Department of Physical and Medical Rehabilitation, University Hospital Morvan, Brest, France.,Department of Paediatric Physical and Medical Rehabilitation, Fondation Ildys, Brest, France
| | - François Rousseau
- Laboratory of Medical Information Processing (LATIM), INSERM-UMR 1101, Brest, France.,IMT Atlantique, UBL, Brest, France
| | - Douraïed Ben Salem
- Laboratory of Medical Information Processing (LATIM), INSERM-UMR 1101, Brest, France.,University of Western Brittany (UBO), Brest, France.,Department of Radiology, University Hospital La Cavale Blanche, Brest, France
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18
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Henrichon SS, Foster BH, Shaw C, Bayne CO, Szabo RM, Chaudhari AJ, Boutin RD. Dynamic MRI of the wrist in less than 20 seconds: normal midcarpal motion and reader reliability. Skeletal Radiol 2020; 49:241-248. [PMID: 31289900 PMCID: PMC6934906 DOI: 10.1007/s00256-019-03266-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 06/13/2019] [Accepted: 06/17/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe the normal motion pattern at the midcarpal compartment during active radial-ulnar deviation of the wrist using dynamic MRI, and to determine the observer performance for measurements obtained in asymptomatic volunteers. METHODS Dynamic MRI of 35 wrists in 19 asymptomatic volunteers (age mean 30.4 years, SD 8.6) was performed during active radial-ulnar deviation using a fast gradient-echo pulse sequence with 315 ms temporal resolution (acquisition time, 19 s). Two independent readers measured the transverse translation of the trapezium at the scaphotrapezium joint (STJ) and the capitate-to-triquetrum distance (CTD). Relationships between these measurements and laterality, sex, lunate type, and wrist kinematic pattern were evaluated. RESULTS At the STJ, the trapezium moved most in radial deviation, with an overall translation of 2.3 mm between ulnar and radial deviation. Mean CTD measurements were the greatest in ulnar deviation and varied 2.4 mm between ulnar and radial deviation. Mean CTD was greater in men than women in the neutral position (p = 0.019), and in wrists with type II lunate morphology during radial and ulnar deviation (p = 0.001, p = 0.014). There were no significant differences in trapezium translation or CTD with wrist laterality and kinematic pattern. Intraobserver and interobserver correlation coefficients were 0.97 and 0.87 for trapezium translation and 0.84 and 0.67 for CTD. CONCLUSION This study is the first to demonstrate the performance of dynamic MRI to quantify STJ motion and CTD. Dynamic MRI with a short acquisition time may be used as a tool to supplement static MRI in evaluation of the midcarpal compartment.
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Affiliation(s)
| | | | - Calvin Shaw
- Department of Radiology, University of California - Davis, Sacramento, CA 95817
| | - Christopher O. Bayne
- Department of Orthopaedic Surgery, University of California - Davis, Sacramento, CA 95817
| | - Robert M. Szabo
- Department of Orthopaedic Surgery, University of California - Davis, Sacramento, CA 95817
| | | | - Robert D. Boutin
- Department of Radiology, University of California - Davis, Sacramento, CA 95817
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19
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Shaw CB, Foster BH, Borgese M, Boutin RD, Bateni C, Boonsri P, Bayne CO, Szabo RM, Nayak KS, Chaudhari AJ. Real-time three-dimensional MRI for the assessment of dynamic carpal instability. PLoS One 2019; 14:e0222704. [PMID: 31536561 PMCID: PMC6752861 DOI: 10.1371/journal.pone.0222704] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 09/03/2019] [Indexed: 12/11/2022] Open
Abstract
Background Carpal instability is defined as a condition where wrist motion and/or loading creates mechanical dysfunction, resulting in weakness, pain and decreased function. When conventional methods do not identify the instability patterns, yet clinical signs of instability exist, the diagnosis of dynamic instability is often suggested to describe carpal derangement manifested only during the wrist’s active motion or stress. We addressed the question: can advanced MRI techniques provide quantitative means to evaluate dynamic carpal instability and supplement standard static MRI acquisition? Our objectives were to (i) develop a real-time, three-dimensional MRI method to image the carpal joints during their active, uninterrupted motion; and (ii) demonstrate feasibility of the method for assessing metrics relevant to dynamic carpal instability, thus overcoming limitations of standard MRI. Methods Twenty wrists (bilateral wrists of ten healthy participants) were scanned during radial-ulnar deviation and clenched-fist maneuvers. Images resulting from two real-time MRI pulse sequences, four sparse data-acquisition schemes, and three constrained image reconstruction techniques were compared. Image quality was assessed via blinded scoring by three radiologists and quantitative imaging metrics. Results Real-time MRI data-acquisition employing sparse radial sampling with a gradient-recalled-echo acquisition and constrained iterative reconstruction appeared to provide a practical tradeoff between imaging speed (temporal resolution up to 135 ms per slice) and image quality. The method effectively reduced streaking artifacts arising from data undersampling and enabled the derivation of quantitative measures pertinent to evaluating dynamic carpal instability. Conclusion This study demonstrates that real-time, three-dimensional MRI of the moving wrist is feasible and may be useful for the evaluation of dynamic carpal instability.
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Affiliation(s)
- Calvin B. Shaw
- Department of Radiology, University of California Davis, Sacramento, California, United States of America
| | - Brent H. Foster
- Department of Biomedical Engineering, University of California Davis, Davis, California, United States of America
| | - Marissa Borgese
- Department of Radiology, University of California Davis, Sacramento, California, United States of America
| | - Robert D. Boutin
- Department of Radiology, University of California Davis, Sacramento, California, United States of America
| | - Cyrus Bateni
- Department of Radiology, University of California Davis, Sacramento, California, United States of America
| | - Pattira Boonsri
- Department of Radiology, University of California Davis, Sacramento, California, United States of America
| | - Christopher O. Bayne
- Department of Orthopaedic Surgery, University of California Davis, Sacramento, California, United States of America
| | - Robert M. Szabo
- Department of Orthopaedic Surgery, University of California Davis, Sacramento, California, United States of America
| | - Krishna S. Nayak
- Ming Hsieh Department of Electrical Engineering, University of Southern California, Los Angeles, California, United States of America
| | - Abhijit J. Chaudhari
- Department of Radiology, University of California Davis, Sacramento, California, United States of America
- * E-mail:
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20
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Knowles BR, Friedrich F, Fischer C, Paech D, Ladd ME. Beyond T2 and 3T: New MRI techniques for clinicians. Clin Transl Radiat Oncol 2019; 18:87-97. [PMID: 31341982 PMCID: PMC6630188 DOI: 10.1016/j.ctro.2019.04.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 04/11/2019] [Accepted: 04/11/2019] [Indexed: 12/12/2022] Open
Abstract
Technological advances in Magnetic Resonance Imaging (MRI) in terms of field strength and hybrid MR systems have led to improvements in tumor imaging in terms of anatomy and functionality. This review paper discusses the applications of such advances in the field of radiation oncology with regards to treatment planning, therapy guidance and monitoring tumor response and predicting outcome.
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Affiliation(s)
- Benjamin R. Knowles
- Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Florian Friedrich
- Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Physics and Astronomy, University of Heidelberg, Heidelberg, Germany
| | - Carola Fischer
- Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Physics and Astronomy, University of Heidelberg, Heidelberg, Germany
| | - Daniel Paech
- Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Mark E. Ladd
- Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Physics and Astronomy, University of Heidelberg, Heidelberg, Germany
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21
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ECU tendon subluxation: A nonspecific MRI finding occurring in all wrist positions irrespective of ulnar-sided symptoms? Eur J Radiol 2019; 116:192-197. [DOI: 10.1016/j.ejrad.2019.05.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 02/25/2019] [Accepted: 05/09/2019] [Indexed: 11/17/2022]
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Foster BH, Shaw CB, Boutin RD, Joshi AA, Bayne CO, Szabo RM, Chaudhari AJ. A principal component analysis-based framework for statistical modeling of bone displacement during wrist maneuvers. J Biomech 2019; 85:173-181. [PMID: 30738587 DOI: 10.1016/j.jbiomech.2019.01.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 01/13/2019] [Accepted: 01/16/2019] [Indexed: 01/06/2023]
Abstract
We present a method for the statistical modeling of the displacements of wrist bones during the performance of coordinated maneuvers, such as radial-ulnar deviation (RUD). In our approach, we decompose bone displacement via a set of basis functions, identified via principal component analysis (PCA). We utilized MRI wrist scans acquired at multiple static positions for deriving these basis functions. We then utilized these basis functions to compare the displacements undergone by the bones of the left versus right wrist in the same individual, and between bones of the wrists of men and women, during the performance of the coordinated RUD maneuver. Our results show that the complex displacements of the wrist bones during RUD can be modeled with high reliability with just 5 basis functions, that captured over 91% of variation across individuals. The basis functions were able to predict intermediate wrist bone poses with an overall high accuracy (mean error of 0.26 mm). Our proposed approach found statistically significant differences between bone displacement trajectories in women versus men, however, did not find significant differences in those of the left versus right wrist in the same individual. Our proposed method has the potential to enable detailed analysis of wrist kinematics for each sex, and provide a robust framework for characterizing the normal and pathologic displacement of the wrist bones, such as in the context of wrist instability.
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Affiliation(s)
- Brent H Foster
- Department of Biomedical Engineering, University of California Davis, Davis, CA 95616, USA
| | - Calvin B Shaw
- Department of Radiology, University of California Davis School of Medicine, Sacramento, CA 95817, USA
| | - Robert D Boutin
- Department of Radiology, University of California Davis School of Medicine, Sacramento, CA 95817, USA
| | - Anand A Joshi
- Signal and Image Processing Institute, University of Southern California, Los Angeles, CA 90089, USA
| | - Christopher O Bayne
- Department of Orthopedic Surgery, University of California Davis School of Medicine, Sacramento, CA 95817, USA
| | - Robert M Szabo
- Department of Orthopedic Surgery, University of California Davis School of Medicine, Sacramento, CA 95817, USA
| | - Abhijit J Chaudhari
- Department of Radiology, University of California Davis School of Medicine, Sacramento, CA 95817, USA.
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Peter K, Luzian H, Markus G, Ansgar R, Andrea K, Arora R. Mid-term outcome (11-90 months) of the extensor retinaculum flap procedure for extensor carpi ulnaris tendon instability. Arch Orthop Trauma Surg 2019; 139:1323-1328. [PMID: 31222435 PMCID: PMC6687678 DOI: 10.1007/s00402-019-03227-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The aim of our study was the assessment of the mid-term outcome of patients treated with a pediculated extensor retinaculum flap for extensor carpi ulnaris (ECU) tendon subluxation including postoperative tendon stability control. MATERIALS AND METHODS Twelve patients treated with an extensor retinaculum flap for symptomatic ECU tendon instability were retrospectively evaluated. Follow-up examinations included functional and radiologic assessment. The range of motion, grip strength, DASH score, PRWE score, Krimmer score and subjective satisfaction were recorded. A rotation-movie MRI was conducted before and after surgery to visualize tendon displacement. RESULTS Wrist extension was 65.8° (SD 10.0°), flexion 64.2° (SD 12.2°), radial deviation 15.8° (SD 6.0°), ulnar deviation 32.1° (SD 7.2°), pronation 82.5° (SD 9.4°) and supination 85.0° (SD 9.0°). Mean grip strength was 30.5 kg (SD 8.9 kg). Six patients presented an excellent, four a good, one a fair and one a poor result on the Krimmer score. The DASH and PRWE scores showed a mean of 24.2 (SD 25.1) and 32.2 (SD 29.4) points. MRI showed a dislocation (n = 7) or subluxation (n = 5) of the ECU tendon preoperatively. Five patients showed an unchanged displacement pattern postoperatively. CONCLUSION The pediculated extensor retinaculum flap as a treatment for a symptomatic ECU instability shows good to excellent results and a high subjective satisfaction independent of postoperative ECU tendon displacement.
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Affiliation(s)
- Kaiser Peter
- Department of Trauma Surgery, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Haug Luzian
- Department of Trauma Surgery, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
- Department for Plastic, Reconstructive and Hand Surgery, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Gabl Markus
- Department of Trauma Surgery, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Rudisch Ansgar
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Klauser Andrea
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Rohit Arora
- Department of Trauma Surgery, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.
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Koehler SM, Beck CM, Nasser P, Gluck M, Hausman MR. The effect of screw trajectory for the reduction and association of the scaphoid and lunate (RASL) procedure: a biomechanical analysis. J Hand Surg Eur Vol 2018; 43:635-641. [PMID: 28886667 DOI: 10.1177/1753193417729257] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The purpose of this study was to determine if screw placement in the reduction and association of the scaphoid and the lunate (RASL) procedure affected the ability of the scapholunate joint to withstand force. After completely disrupting of the scapholunate ligament in 29 fresh-frozen cadaveric wrists, we placed the RASL screw either distal or proximal to the lateral aspect of the dorsal ridge of the scaphoid and into the dorsal or volar aspect of the lunate. Specimens were subjected to repeated cycles of transcarpal axial force, mimicking clenched-fist loading, until failure. Screw placement distal to the lateral aspect of the dorsal scaphoid ridge was significantly associated with failure when examined manually, radiographically (1.8 vs. 0.5 mm) and using real-time motion capture (diastasis: 1.6 vs. 0.4 mm; Euler angle: 4.5 ° vs. 0.8 °). The lateral aspect of the dorsal ridge is a reliable radiographic landmark on the scaphoid and provides surgeons with a convenient starting point to achieve the most biomechanically stable RASL construct, and, therefore, enhances the potential for an optimal clinical outcome.
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Affiliation(s)
- Steven M Koehler
- Department of Orthopaedic Surgery, Mount Sinai Hospital, Mount Sinai Health System, New York, New York, USA
| | - Christina M Beck
- Department of Orthopaedic Surgery, Mount Sinai Hospital, Mount Sinai Health System, New York, New York, USA
| | - Philip Nasser
- Department of Orthopaedic Surgery, Mount Sinai Hospital, Mount Sinai Health System, New York, New York, USA
| | - Matthew Gluck
- Department of Orthopaedic Surgery, Mount Sinai Hospital, Mount Sinai Health System, New York, New York, USA
| | - Michael R Hausman
- Department of Orthopaedic Surgery, Mount Sinai Hospital, Mount Sinai Health System, New York, New York, USA
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25
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Kaiser P, Kellermann F, Arora R, Henninger B, Rudisch A. Diagnosing extensor carpi ulnaris tendon dislocation with dynamic rotation MRI of the wrist. Clin Imaging 2018; 51:323-326. [PMID: 29958158 DOI: 10.1016/j.clinimag.2018.06.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 06/05/2018] [Accepted: 06/20/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of this study was to retrospectively correlate the kinematic dynamic rotation MRI (DR-MRI) of the wrist for assessment of extensor carpi ulnaris (ECU) tendon subluxation and dislocation. MATERIAL AND METHODS The presence of an ECU tendon subluxation or dislocation on the DR-MRI report was correlated to findings of the surgical report. RESULTS DR-MRI findings showed an ECU subluxation in 12 cases and an ECU dislocation in 13 cases. Surgery showed an ECU subluxation in 13 cases and an ECU dislocation in 12 cases (ĸ = 0.92). CONCLUSION DR-MRI is a feasible method to visualize ECU tendon subluxation and dislocation.
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Affiliation(s)
- Peter Kaiser
- Department of Trauma Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Rohit Arora
- Department of Trauma Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Benjamin Henninger
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Ansgar Rudisch
- Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria.
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26
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Borotikar B, Lempereur M, Lelievre M, Burdin V, Ben Salem D, Brochard S. Dynamic MRI to quantify musculoskeletal motion: A systematic review of concurrent validity and reliability, and perspectives for evaluation of musculoskeletal disorders. PLoS One 2017; 12:e0189587. [PMID: 29232401 PMCID: PMC5726646 DOI: 10.1371/journal.pone.0189587] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 11/29/2017] [Indexed: 11/30/2022] Open
Abstract
Purpose To report evidence for the concurrent validity and reliability of dynamic MRI techniques to evaluate in vivo joint and muscle mechanics, and to propose recommendations for their use in the assessment of normal and impaired musculoskeletal function. Materials and methods The search was conducted on articles published in Web of science, PubMed, Scopus, Academic search Premier, and Cochrane Library between 1990 and August 2017. Studies that reported the concurrent validity and/or reliability of dynamic MRI techniques for in vivo evaluation of joint or muscle mechanics were included after assessment by two independent reviewers. Selected articles were assessed using an adapted quality assessment tool and a data extraction process. Results for concurrent validity and reliability were categorized as poor, moderate, or excellent. Results Twenty articles fulfilled the inclusion criteria with a mean quality assessment score of 66% (±10.4%). Concurrent validity and/or reliability of eight dynamic MRI techniques were reported, with the knee being the most evaluated joint (seven studies). Moderate to excellent concurrent validity and reliability were reported for seven out of eight dynamic MRI techniques. Cine phase contrast and real-time MRI appeared to be the most valid and reliable techniques to evaluate joint motion, and spin tag for muscle motion. Conclusion Dynamic MRI techniques are promising for the in vivo evaluation of musculoskeletal mechanics; however results should be evaluated with caution since validity and reliability have not been determined for all joints and muscles, nor for many pathological conditions.
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Affiliation(s)
- Bhushan Borotikar
- Laboratoire de Traitement de l’Information Médicale, INSERM U1101, Brest, France
- IMT Atlantique, Brest, France
- * E-mail:
| | - Mathieu Lempereur
- Laboratoire de Traitement de l’Information Médicale, INSERM U1101, Brest, France
- CHRU de Brest, Hôpital Morvan, Service de Médecine Physique et de Réadaptation, Brest, France
| | | | - Valérie Burdin
- Laboratoire de Traitement de l’Information Médicale, INSERM U1101, Brest, France
- IMT Atlantique, Brest, France
| | - Douraied Ben Salem
- Laboratoire de Traitement de l’Information Médicale, INSERM U1101, Brest, France
- Université de Bretagne Occidentale, Brest, France
- CHRU de Brest, Neuroradiologie, Imagerie Médico-Légale, Brest, France
| | - Sylvain Brochard
- Laboratoire de Traitement de l’Information Médicale, INSERM U1101, Brest, France
- CHRU de Brest, Hôpital Morvan, Service de Médecine Physique et de Réadaptation, Brest, France
- Université de Bretagne Occidentale, Brest, France
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27
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Bayer T, Adler W, Janka R, Uder M, Roemer F. Magnetic resonance cinematography of the fingers: a 3.0 Tesla feasibility study with comparison of incremental and continuous dynamic protocols. Skeletal Radiol 2017; 46:1721-1728. [PMID: 28821929 DOI: 10.1007/s00256-017-2742-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 06/16/2017] [Accepted: 07/24/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To study the feasibility of magnetic resonance cinematography of the fingers (MRCF) with comparison of image quality of different protocols for depicting the finger anatomy during motion. MATERIALS AND METHODS MRCF was performed during a full flexion and extension movement in 14 healthy volunteers using a finger-gating device. Three real-time sequences (frame rates 17-59 images/min) and one proton density (PD) sequence (3 images/min) were acquired during incremental and continuous motion. Analyses were performed independently by three readers. Qualitative image analysis included Likert-scale grading from 0 (useless) to 5 (excellent) and specific visual analog scale (VAS) grading from 0 (insufficient) to 100 (excellent). Signal-to-noise calculation was performed. Overall percentage agreement and mean absolute disagreement were calculated. RESULTS Within the real-time sequences a high frame-rate true fast imaging with steady-state free precession (TRUFI) yielded the best image quality with Likert and overall VAS scores of 3.0 ± 0.2 and 60.4 ± 25.3, respectively. The best sequence regarding image quality was an incremental PD with mean values of 4.8 ± 0.2 and 91.2 ± 9.4, respectively. Overall percentage agreement and mean absolute disagreement were 47.9 and 0.7, respectively. No statistically significant SNR differences were found between continuous and incremental motion for the real-time protocols. CONCLUSION MRCF is feasible with appropriate image quality during continuous motion using a finger-gating device. Almost perfect image quality is achievable with incremental PD imaging, which represents a compromise for MRCF with the drawback of prolonged scanning time.
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Affiliation(s)
- Thomas Bayer
- Department of Radiology, University of Erlangen-Nuremberg, Maximiliansplatz 1, 91054, Erlangen, Germany.
| | - Werner Adler
- IMBE, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Rolf Janka
- Department of Radiology, University of Erlangen-Nuremberg, Maximiliansplatz 1, 91054, Erlangen, Germany
| | - Michael Uder
- Department of Radiology, University of Erlangen-Nuremberg, Maximiliansplatz 1, 91054, Erlangen, Germany
| | - Frank Roemer
- Department of Radiology, University of Erlangen-Nuremberg, Maximiliansplatz 1, 91054, Erlangen, Germany
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A Case Report of Traumatic Partial Extensor Carpi Ulnaris Subluxation in an Elite Hockey Player With Review of the Literature. Clin J Sport Med 2017; 27:e60-e62. [PMID: 27347858 DOI: 10.1097/jsm.0000000000000357] [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] [Indexed: 02/02/2023]
Abstract
In this article, we present a unique case of traumatic partial recurrent extensor carpi ulnaris (ECU) subluxation in an elite hockey player. To the best of our knowledge, this is the only report of partial ECU subluxation due to a split in the ECU tendon presented in the literature. This case illustrates the importance of proper diagnosis and treatment of such a lesion. We also emphasize that dynamic ultrasound is an excellent and cost-effective imaging modality that can help with the diagnosis of partial ECU subluxation. Finally, surgical treatment for failed conservative management showed excellent results in an elite athlete.
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29
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Cheriex KCAL, Sulkers GSI, Terra MP, Schep NWL, van Aard BJPL, Strackee SD. Scapholunate dissociation; diagnostics made easy. Eur J Radiol 2017. [PMID: 28624019 DOI: 10.1016/j.ejrad.2017.04.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Scapholunate dissociation (SLD) is a form of carpal instability, caused by rupture of the scapholunate ligament (SLL) the secondary stabiliser of the scapholunate (SL) compartment. SLD can cause osteoarthritis of the wrist. Recently a study was published that shows cineradiography to be an excellent radiological imaging technique for diagnosing SLD at a tertiary centre for hand and wrist surgery [1]. As the quality of these results can be influenced by the expertise of the operator and observer of the cineradiographic studies, the aim of this study was to determine if these results were reproducible at a secondary centre for hand and wrist surgery with less expertise in wrist cineradiography. All cineradiographic studies carried out during a 10-year period were obtained. All patients who underwent the gold standard procedure (arthroscopy/arthrotomy) after cineradiography were included, a total of 50 patients. The diagnostic accuracy of detecting SLD by both cineradiography and conventional radiography was calculated. Cineradiography had a high diagnostic accuracy, while the accuracy for conventional radiography was average. When all wrists with an SL distance ≥3mm were excluded (static SLD), diagnostic accuracy for conventional radiography dropped even lower, while accuracy for cineradiography remained high. These results are comparable with published accuracy rates and show that cineradiography has a high diagnostic value for detecting SLD and do not seem to be influenced by the operator or observer of the cineradiographic studies.
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Affiliation(s)
- K C A L Cheriex
- Department of Plastic, Reconstructive and Hand Surgery, Onze Lieve Vrouw Gasthuis Oost, Oosterpark 9, 1091 AC, Amsterdam, The Netherlands.
| | - G S I Sulkers
- Department of Plastic, Reconstructive and Hand Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - M P Terra
- Department of Radiology, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - N W L Schep
- Trauma Unit, Department of surgery, Maasstad Hospital, Maasstadweg 21, 3079 DZ Rotterdam, The Netherlands.
| | - B J P L van Aard
- Department of Plastic, Reconstructive and Hand Surgery, Onze Lieve Vrouw Gasthuis Oost, Oosterpark 9, 1091 AC, Amsterdam, The Netherlands.
| | - S D Strackee
- Department of Plastic, Reconstructive and Hand Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
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30
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Garwood ER, Souza RB, Zhang A, Zhang AL, Ma CB, Link TM, Motamedi D. Axial traction magnetic resonance imaging (MRI) of the glenohumeral joint in healthy volunteers: initial experience. Clin Imaging 2017; 42:178-182. [PMID: 28095361 DOI: 10.1016/j.clinimag.2016.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 11/12/2016] [Accepted: 12/26/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Evaluate technical feasibility and potential applications of glenohumeral (GH) joint axial traction magnetic resonance imaging (MRI) in healthy volunteers. MATERIALS AND METHODS Eleven shoulders were imaged in neutral and with 4kg axial traction at 3T. Quantitative measurements were assessed. RESULTS Axial traction was well tolerated. There was statistically significant widening of the superior GH joint space (p=0.002) and acromial angle (p=0.017) with traction. Inter-rater agreement was high. CONCLUSION GH joint axial traction MRI is technically feasible and well tolerated in volunteers. Traction of the capsule, widening of the superior GH joint space and acromial angle were observed.
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Affiliation(s)
- Elisabeth R Garwood
- New York University, Department of Radiology, Division of Musculoskeletal Radiology, United States.
| | - Richard B Souza
- University of California, San Francisco, Department of Radiology and Biomedical Imaging, United States; University of California, San Francisco, Department of Physical Therapy and Rehabilitation Science, United States
| | - Amy Zhang
- University of California, San Francisco, Department of Epidemiology and Biostatistics, United States
| | - Alan L Zhang
- University of California, San Francisco, Department of Orthopaedic Surgery, United States
| | - C Benjamin Ma
- University of California, San Francisco, Department of Orthopaedic Surgery, United States
| | - Thomas M Link
- University of California, San Francisco, Department of Radiology and Biomedical Imaging, United States
| | - Daria Motamedi
- University of California, San Francisco, Department of Radiology and Biomedical Imaging, United States
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31
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Mazzoli V, Nederveen AJ, Oudeman J, Sprengers A, Nicolay K, Strijkers GJ, Verdonschot N. Water and fat separation in real-time MRI of joint movement with phase-sensitive bSSFP. Magn Reson Med 2016; 78:58-68. [DOI: 10.1002/mrm.26341] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 06/20/2016] [Accepted: 06/20/2016] [Indexed: 01/04/2023]
Affiliation(s)
- Valentina Mazzoli
- Biomedical NMR, Department of Biomedical Engineering; Eindhoven University of Technology; Eindhoven The Netherlands
- Department of Radiology; Academic Medical Center; Amsterdam The Netherlands
- Orthopaedic Research Lab; Radboud University Medical Center; Nijmegen The Netherlands
| | - Aart J. Nederveen
- Department of Radiology; Academic Medical Center; Amsterdam The Netherlands
| | - Jos Oudeman
- Department of Radiology; Academic Medical Center; Amsterdam The Netherlands
| | - Andre Sprengers
- Orthopaedic Research Lab; Radboud University Medical Center; Nijmegen The Netherlands
- Laboratory of Biomechanical Engineering; University of Twente; Enschede The Netherlands
| | - Klaas Nicolay
- Biomedical NMR, Department of Biomedical Engineering; Eindhoven University of Technology; Eindhoven The Netherlands
| | - Gustav J. Strijkers
- Biomedical NMR, Department of Biomedical Engineering; Eindhoven University of Technology; Eindhoven The Netherlands
- Biomedical Engineering and Physics; Academic Medical Center; Amsterdam The Netherlands
| | - Nico Verdonschot
- Orthopaedic Research Lab; Radboud University Medical Center; Nijmegen The Netherlands
- Laboratory of Biomechanical Engineering; University of Twente; Enschede The Netherlands
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32
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Ramamurthy NK, Chojnowski AJ, Toms AP. Imaging in carpal instability. J Hand Surg Eur Vol 2016; 41:22-34. [PMID: 26586689 DOI: 10.1177/1753193415610515] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 09/01/2015] [Indexed: 02/03/2023]
Abstract
Carpal instability is a complex and heterogeneous clinical condition. Management requires accurate identification of structural injury with an understanding of the resultant movement (kinematic) and load transfer (kinetic) failure. Static imaging techniques, such as plain film radiography, stress views, ultrasound, magnetic resonance, MR arthrography and computerized tomography arthrography, may accurately depict major wrist ligamentous injury. Dynamic ultrasound and videofluoroscopy may demonstrate dynamic instability and kinematic dysfunction. There is a growing evidence base for the diagnostic accuracy of these techniques in detecting intrinsic ligament tears, but there are limitations. Evidence of their efficacy and relevance in detection of non-dissociative carpal instability and extrinsic ligament tears is weak. Further research into the accuracy of existing imaging modalities is still required. Novel techniques, including four-dimensional computerized tomography and magnetic resonance, can evaluate both cross-sectional and functional carpal anatomy. This is a narrative review of level-III studies evaluating the role of imaging in carpal instability.
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Affiliation(s)
- N K Ramamurthy
- Department of Radiology, Norfolk & Norwich University Hospital NHS Foundation Trust, Norwich, UK
| | - A J Chojnowski
- Department of Orthopaedic Surgery, Norfolk & Norwich University Hospital NHS Foundation Trust, Norwich, UK
| | - A P Toms
- Department of Radiology, Norfolk & Norwich University Hospital NHS Foundation Trust, Norwich, UK
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Abstract
Wrist and elbow MR imaging technology is advancing at a dramatic rate. Wrist and elbow MR imaging is performed at medium and higher field strengths with more specialized surface coils and more variable pulse sequences and postprocessing techniques. High field imaging and improved coils lead to an increased signal-to-noise ratio and increased variety of soft tissue contrast options. Three-dimensional imaging is improving in terms of usability and artifacts. Some of these advances have challenges in wrist and elbow imaging, such as postoperative patient imaging, cartilage mapping, and molecular imaging. This review considers technical advances in hardware and software and their clinical applications.
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35
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Breighner R, Holmes DR, Leng S, An KN, McCollough C, Zhao K. Relative accuracy of spin-image-based registration of partial capitate bones in 4DCT of the wrist. COMPUTER METHODS IN BIOMECHANICS AND BIOMEDICAL ENGINEERING. IMAGING & VISUALIZATION 2014; 4:360-367. [PMID: 27722036 PMCID: PMC5048743 DOI: 10.1080/21681163.2014.947384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In image-based biomechanical analyses, registration transformations are the data of interest. In dynamic 4DCT imaging the capitate is often partially imaged. While alignment of incomplete objects poses a significant registration challenge, the established spin-image surface-matching algorithm can be utilized to align two surfaces representing disparate but overlapping portions of an object. For this reason the spin-image algorithm was chosen for the registration of partial bone geometry in 4DCT of the wrist. Registrations were performed on eleven 4DCT datasets using complete and partial capitate meshes generated by cropping complete meshes. Relative accuracy was assessed as the difference between partial- and complete-geometry registrations. Accurate registration of partial capitates geometry was achieved with 55% of the proximal capitate geometry on average, and in some cases as little as 35%. Requisite geometry depends on feature salience and imaging resolution, however the spin-image algorithm should be considered a valuable tool for biomechanists and image analysts.
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Affiliation(s)
- Ryan Breighner
- Biomechanics Laboratory, Division of Orthopedic Research, Mayo Clinic, 200 First St. SW, Rochester, MN, USA, 55905
| | - David R Holmes
- Biomedical Imaging Resource, Mayo Clinic College of Medicine, Mayo Clinic, 200 First St. SW, Rochester, MN, USA, 55905
| | - Shuai Leng
- Department of Radiology, Mayo Clinic, 200 First St. SW, Rochester, MN, USA, 55905
| | - Kai-Nan An
- Biomechanics Laboratory, Division of Orthopedic Research, Mayo Clinic, 200 First St. SW, Rochester, MN, USA, 55905
| | - Cynthia McCollough
- Department of Radiology, Mayo Clinic, 200 First St. SW, Rochester, MN, USA, 55905
| | - Kristin Zhao
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, 200 First St. SW, Rochester, MN, USA, 55905
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Chaudhari AJ, Leahy RM, Wise BL, Lane NE, Badawi RD, Joshi AA. Global point signature for shape analysis of carpal bones. Phys Med Biol 2014; 59:961-73. [PMID: 24503490 DOI: 10.1088/0031-9155/59/4/961] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We present a method based on spectral theory for the shape analysis of carpal bones of the human wrist. We represent the cortical surface of the carpal bone in a coordinate system based on the eigensystem of the two-dimensional Helmholtz equation. We employ a metric--global point signature (GPS)--that exploits the scale and isometric invariance of eigenfunctions to quantify overall bone shape. We use a fast finite-element-method to compute the GPS metric. We capitalize upon the properties of GPS representation--such as stability, a standard Euclidean (ℓ(2)) metric definition, and invariance to scaling, translation and rotation--to perform shape analysis of the carpal bones of ten women and ten men from a publicly-available database. We demonstrate the utility of the proposed GPS representation to provide a means for comparing shapes of the carpal bones across populations.
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Affiliation(s)
- Abhijit J Chaudhari
- Department of Radiology, University of California-Davis School of Medicine, Sacramento, CA 95817, USA
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