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Taneja AK, Chhabra A. 2-Dimensional and 3-Dimensional MR Imaging-Aid to Knee Preservation Surgery: Focus on Meniscus and Articular Cartilage. Semin Ultrasound CT MR 2023. [DOI: 10.1053/j.sult.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Ajmera P, Kharat A, Botchu R, Gupta H, Kulkarni V. Real-world analysis of artificial intelligence in musculoskeletal trauma. J Clin Orthop Trauma 2021; 22:101573. [PMID: 34527511 PMCID: PMC8427222 DOI: 10.1016/j.jcot.2021.101573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/20/2021] [Accepted: 08/20/2021] [Indexed: 11/30/2022] Open
Abstract
Musculoskeletal trauma accounts for a large percentage of emergency room visits and is amongst the top causes of unscheduled patient visits to the emergency room. Musculoskeletal trauma results in expenditure of billions of dollars and protracted losses of quality-adjusted life years. New and innovative methods are needed to minimise the impact by ensuring quick and accurate assessment. However, each of the currently utilised radiological procedures, such as radiography, ultrasonography, computed tomography, and magnetic resonance imaging, has resulted in implosion of medical imaging data. Deep learning, a recent advancement in artificial intelligence, has demonstrated the potential to analyse medical images with sensitivity and specificity at par with experts. In this review article, we intend to summarise and showcase the various developments which have occurred in the dynamic field of artificial intelligence and machine learning and how their applicability to different aspects of imaging in trauma can be explored to improvise our existing reporting systems and improvise on patient outcomes.
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Affiliation(s)
- Pranav Ajmera
- Department of Radiology, Dr D.Y. Patil Medical College, Hospital and Research Center, DPU, Pune, India
| | - Amit Kharat
- Department of Radiology, Dr D.Y. Patil Medical College, Hospital and Research Center, DPU, Pune, India
| | - Rajesh Botchu
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, UK
| | - Harun Gupta
- Department of Musculoskeletal Radiology, Leeds Teaching Hospitals, Leeds, UK
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Mandell JC, Rhodes JA, Shah N, Gaviola GC, Gomoll AH, Smith SE. Routine clinical knee MR reports: comparison of diagnostic performance at 1.5 T and 3.0 T for assessment of the articular cartilage. Skeletal Radiol 2017; 46:1487-1498. [PMID: 28717928 DOI: 10.1007/s00256-017-2714-6] [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: 04/13/2017] [Revised: 05/28/2017] [Accepted: 07/03/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Accurate assessment of knee articular cartilage is clinically important. Although 3.0 Tesla (T) MRI is reported to offer improved diagnostic performance, literature regarding the clinical impact of MRI field strength is lacking. The purpose of this study is to compare the diagnostic performance of clinical MRI reports for assessment of cartilage at 1.5 and 3.0 T in comparison to arthroscopy. MATERIALS AND METHODS This IRB-approved retrospective study consisted of 300 consecutive knees in 297 patients who had routine clinical MRI and arthroscopy. Descriptions of cartilage from MRI reports of 165 knees at 1.5 T and 135 at 3.0 T were compared with arthroscopy. The sensitivity, specificity, percent of articular surfaces graded concordantly, and percent of articular surfaces graded within one grade of the arthroscopic grading were calculated for each articular surface at 1.5 and 3.0 T. Agreement between MRI and arthroscopy was calculated with the weighted-kappa statistic. Significance testing was performed utilizing the z-test after bootstrapping to obtain the standard error. RESULTS AND CONCLUSIONS The sensitivity, specificity, percent of articular surfaces graded concordantly, and percent of articular surfaces graded within one grade were 61.4%, 82.7%, 62.2%, and 77.5% at 1.5 T and 61.8%, 80.6%, 59.5%, and 75.6% at 3.0 T, respectively. The weighted kappa statistic was 0.56 at 1.5 T and 0.55 at 3.0 T. There was no statistically significant difference in any of these parameters between 1.5 and 3.0 T. Factors potentially contributing to the lack of diagnostic advantage of 3.0 T MRI are discussed.
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Affiliation(s)
- Jacob C Mandell
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA.
| | - Jeffrey A Rhodes
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA
| | - Nehal Shah
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA
| | - Glenn C Gaviola
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA
| | - Andreas H Gomoll
- Cartilage Repair Center, Department of Orthopedic Surgery, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA
| | - Stacy E Smith
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA
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A narrative overview of the current status of MRI of the hip and its relevance for osteoarthritis research - what we know, what has changed and where are we going? Osteoarthritis Cartilage 2017; 25:1-13. [PMID: 27621214 DOI: 10.1016/j.joca.2016.08.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Revised: 08/24/2016] [Accepted: 08/28/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To review and discuss the role of magnetic resonance imaging (MRI) in the context of hip osteoarthritis (OA) research. DESIGN The content of this narrative review, based on an extensive PubMed database research including English literature only, describes the advances in MRI of the hip joint and its potential usefulness in hip OA research, reviews the relevance of different MRI features in regard to symptomatic and structural progression in hip OA, and gives an outlook regarding future use of MRI in hip OA research endeavors. RESULTS Recent technical advances have helped to overcome many of the past difficulties related to MRI assessment of hip OA. MRI-based morphologic scoring systems allow for detailed assessment of several hip joint tissues and, in combination with the recent advances in MRI, may increase reproducibility and sensitivity to change. Compositional MRI techniques may add to our understanding of disease onset and progression. Knowledge about imaging pitfalls and anatomical variants is crucial to avoid misinterpretation. In comparison to research on knee OA, the associations between MRI features and the incidence and progression of disease as well as with clinical symptoms have been little explored. Anatomic alterations of the hip joint as seen in femoro-acetabular impingement (FAI) seem to play a role in the onset and progression of structural damage. CONCLUSIONS With the technical advances occurring in recent years, MRI may play a major role in investigating the natural history of hip OA and provide an improved method for assessment of the efficacy of new therapeutic approaches.
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7 Tesla quantitative hip MRI: a comparison between TESS and CPMG for T2 mapping. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2016; 29:503-12. [DOI: 10.1007/s10334-016-0557-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 03/21/2016] [Accepted: 03/31/2016] [Indexed: 12/20/2022]
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Morphological imaging and T2 and T2* mapping of hip cartilage at 7 Tesla MRI under the influence of intravenous gadolinium. Eur Radiol 2016; 26:3923-3931. [DOI: 10.1007/s00330-016-4247-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 01/21/2016] [Accepted: 01/25/2016] [Indexed: 12/16/2022]
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Dordevic M, Hirschmann MT, Rechsteiner J, Falkowski A, Testa E, Hirschmann A. Do Chondral Lesions of the Knee Correlate with Bone Tracer Uptake by Using SPECT/CT? Radiology 2016; 278:223-31. [DOI: 10.1148/radiol.2015141714] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Lazik A, Theysohn JM, Geis C, Johst S, Ladd ME, Quick HH, Kraff O. 7 Tesla quantitative hip MRI: T1, T2 and T2* mapping of hip cartilage in healthy volunteers. Eur Radiol 2015; 26:1245-53. [DOI: 10.1007/s00330-015-3964-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 07/28/2015] [Accepted: 08/03/2015] [Indexed: 12/26/2022]
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Ammann B, Mauch F, Schmitz B, Kraus M. [Weightings and sequences in magnetic resonance imaging in orthopedic surgery]. Unfallchirurg 2015; 117:197-8, 200-5. [PMID: 24622903 DOI: 10.1007/s00113-013-2399-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Magnetic resonance imaging (MRI) plays a very important role in the diagnosis of musculoskeletal conditions; its importance in orthopedic trauma continues to grow. To ensure optimal imaging and to be able to answer all clinically relevant questions, some prerequisites must be taken into account. Of uttermost importance is a functioning communication between surgeons and radiologists. To adapt the best sequences, the radiologist needs to know all suspected injuries and the mechanism of trauma. Second, the surgeon must have basic knowledge regarding this technology to optimally use all its possibilities. The aim of this article is to familiarize the reader with basic MRI in traumatology focusing on weightings and sequences.
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Affiliation(s)
- B Ammann
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland,
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Seo DK, Na S, Park JH, Choi KW, Lee HB, Han DK. Effectiveness of a silicone device for foot MRI in order to obtain homogeneous fat suppression images. Acta Radiol 2015; 56:471-6. [PMID: 24782573 DOI: 10.1177/0284185114531572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Incomplete fat suppression induced by magnetic field inhomogeneity is difficult to compensate for with hardware magnetic-field shimming. PURPOSE To evaluate the effectiveness of a silicone device used to obtain homogeneous fat suppression during 3T magnetic resonance imaging (MRI) scans of the foot. MATERIAL AND METHODS Thirty-eight healthy volunteers were enrolled and examined twice, before (group A) and after (group B) the application of a silicone device. Fat-saturated, T2-weighted, fast spin-echo images were acquired using the same scanning protocol at both examinations. Signal- and contrast-to-noise ratios (SNR and CNR) were calculated and compared in the four regions of interest (ROIs). ROI 1 and 2 were selected from toe-side bone and soft tissue, while ROI 3 and 4 were selected from proximal bone and soft tissue. Qualitative analysis using a four-point scale was performed for three categories. The categories are as follows: the overall image quality, homogeneity of the first phalange and metatarsal bone, respectively. RESULTS The SNR and CNR in ROI 1 and 2 were significantly higher in group A than in group B (SNR; P < 0.001, CNR; P < 0.001), and there were no significant difference in ROI 3 and 4. The qualitative score of the overall fat suppression in group B was significantly higher than that in group A (P < 0.001). Homogeneity of the first phalange in group B was also significantly higher than that in group A (P < 0.001). On the other hand, the homogeneity of the metatarsal bone was not significantly different in the two groups. CONCLUSION The use of a silicone device provides homogeneous fat suppression in 3T MRI of the foot and can significantly improve image quality.
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Affiliation(s)
- Dae Keon Seo
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sara Na
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jung-Hoon Park
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kwan Woo Choi
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ho Beom Lee
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Dong-Kyoon Han
- Department of Radiological Science, College of Health Sciences, Eulji University, Gyeonggi-do, Republic of Korea
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Chandra SS, Surowiec R, Ho C, Xia Y, Engstrom C, Crozier S, Fripp J. Automated analysis of hip joint cartilage combining MR T2 and three‐dimensional fast‐spin‐echo images. Magn Reson Med 2015; 75:403-13. [DOI: 10.1002/mrm.25598] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Revised: 12/07/2014] [Accepted: 12/09/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Shekhar S. Chandra
- School of Information Technology and Electrical EngineeringUniversity of Queensland Australia
| | | | - Charles Ho
- Steadman Philippon Research Institute (SPRI)Colorado USA
| | - Ying Xia
- School of Information Technology and Electrical EngineeringUniversity of Queensland Australia
- Australian e‐Health Research CentreCSIRO Computational Informatics Australia
| | - Craig Engstrom
- School of Human Movement Studies, University of Queensland Australia
| | - Stuart Crozier
- School of Information Technology and Electrical EngineeringUniversity of Queensland Australia
| | - Jurgen Fripp
- Australian e‐Health Research CentreCSIRO Computational Informatics Australia
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Xia Y, Chandra SS, Engstrom C, Strudwick MW, Crozier S, Fripp J. Automatic hip cartilage segmentation from 3D MR images using arc-weighted graph searching. Phys Med Biol 2014; 59:7245-66. [DOI: 10.1088/0031-9155/59/23/7245] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Hip MRI: how useful is intraarticular contrast material for evaluating surgically proven lesions of the labrum and articular cartilage? AJR Am J Roentgenol 2014; 202:160-9. [PMID: 24370140 DOI: 10.2214/ajr.12.10266] [Citation(s) in RCA: 111] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The objective of our study was to prospectively compare the diagnostic performance of MR arthrography and conventional MRI with surgical correlation in the same patient for detecting labrum and articular cartilage defects. SUBJECTS AND METHODS Twenty-eight patients (mean age, 31.8 years) underwent MR arthrography, conventional MRI, and subsequent hip surgery, which served as the reference standard. Labrum and cartilage defects were evaluated at MRI by two independent readers. A McNemar test and kappa statistics were used for statistical analysis. RESULTS At surgery, 31 labral tears were identified. MR arthrography had an advantage over conventional MRI for detecting labral tears at the anterosuperior quadrant (sensitivity of MR arthrography, 81% and 69% for readers 1 and 2, respectively; sensitivity of conventional MRI, 50% for both readers); this difference in performance between MR arthrography and conventional MRI was statistically significant for reader 1 (p = 0.02) but not for reader 2 (p = 0.2). Interobserver agreement for labral tears was higher for MR arthrography (κ = 0.81) than for conventional MRI (κ = 0.63). Surgery showed 31 acetabular cartilage defects and nine femoral cartilage defects. MR arthrography had an advantage over conventional MRI for detecting acetabular cartilage defects (sensitivity of MR arthrography, 71% and 92% for readers 1 and 2, respectively; sensitivity of conventional MRI, 58% and 83%), whereas there was no advantage to using MR arthrography for detecting femoral cartilage defects with statistically significant difference for the acetabular cartilage or femoral cartilage. Interobserver agreement was slightly higher for MR arthrography (κ = 0.50) than for conventional MRI (κ = 0.40) for assessing the acetabular cartilage and was almost identical for the femoral cartilage (κ = 0.62 and 0.63, respectively). CONCLUSION MR arthrography was superior to conventional MRI for detecting labral tears and acetabular cartilage defects and showed a higher interobserver agreement. For femoral cartilage lesions, both modalities yielded comparable results.
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A comparison of 3-T magnetic resonance imaging and computed tomography arthrography to identify structural cartilage defects of the fetlock joint in the horse. Vet J 2013; 199:115-22. [PMID: 24321368 DOI: 10.1016/j.tvjl.2013.10.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 10/14/2013] [Accepted: 10/18/2013] [Indexed: 11/23/2022]
Abstract
Articular cartilage defects are prevalent in metacarpo/metatarsophalangeal (MCP/MTP) joints of horses. The aim of this study was to determine and compare the sensitivity and specificity of 3-Tesla magnetic resonance imaging (3-T MRI) and computed tomography arthrography (CTA) to identify structural cartilage defects in the equine MCP/MTP joint. Forty distal cadaver limbs were imaged by CTA (after injection of contrast medium) and by 3-T MRI using specific sequences, namely, dual-echo in the steady-state (DESS), and sampling perfection with application-optimised contrast using different flip-angle evolutions (SPACE). Gross anatomy was used as the gold standard to evaluate sensitivity and specificity of both imaging techniques. CTA sensitivity and specificity were 0.82 and 0.96, respectively, and were significantly higher than those of MRI (0.41 and 0.93, respectively) in detecting overall cartilage defects (no defect vs. defect). The intra and inter-rater agreements were 0.96 and 0.92, respectively, and 0.82 and 0.88, respectively, for CT and MRI. The positive predictive value for MRI was low (0.57). CTA was considered a valuable tool for assessing cartilage defects in the MCP/MTP joint due to its short acquisition time, its specificity and sensitivity, and it was also more accurate than MRI. However, MRI permits assessment of soft tissues and subchondral bone and is a useful technique for joint evaluation, although clinicians should be aware of the limitations of this diagnostic technique, including reduced accuracy.
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Cartilage assessment of the metacarpophalangeal joints: cadaveric study with magnetic resonance arthrography and finger traction. Clin Imaging 2013; 37:718-22. [PMID: 23395553 DOI: 10.1016/j.clinimag.2012.12.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 12/12/2012] [Indexed: 11/22/2022]
Abstract
We investigated the efficacy of axial traction of the fingers combined with magnetic resonance (MR) arthrography in assessing the metacarpophalangeal (MCP) joint cartilage in cadavers. Cartilage was imaged and graded before/after MR arthrography, with/without traction, then correlated with cadaveric sectioning. The application of traction with MR arthrography is a promising technique for improved visualization of the articular cartilage of the MCP joints compared with similar imaging without traction and/or without arthrography, but its true benefit requires further study.
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Kok HK, Donnellan J, Ryan D, Torreggiani WC. Correlation between subcutaneous knee fat thickness and chondromalacia patellae on magnetic resonance imaging of the knee. Can Assoc Radiol J 2012; 64:182-6. [PMID: 22884229 DOI: 10.1016/j.carj.2012.04.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2012] [Revised: 03/28/2012] [Accepted: 04/08/2012] [Indexed: 10/28/2022] Open
Abstract
PURPOSE Chondromalacia patellae is a common cause of anterior knee pain in young patients and can be detected noninvasively with magnetic resonance imaging (MRI). The purpose of our study was to evaluate the correlation between subcutaneous fat thickness around the knee joint on axial MRIs as a surrogate marker of obesity, with the presence or absence of chondromalacia patellae. METHODS A retrospective review was conducted of knee MRIs in 170 patients who satisfied the inclusion criteria. Imaging was performed over a 12-month period on a 1.5T MRI system with a dedicated extremity coil. Two radiologists experienced in musculoskeletal imaging assessed each examination in consensus for the presence or absence of chondromalacia patellae and graded positive studies from 0 (absent) to 3 (full cartilage thickness defect). Measurement of subcutaneous knee fat thickness was obtained on the medial aspect of the knee. RESULTS MRI findings of chondromalacia patellae were present in 33 patients (19.4%), of which, there were 11 grade 1 lesions (33.3%), 9 grade 2 lesions (27.3%), and 13 grade 3 lesions (39.4%). The mean subcutaneous knee fat thickness was significantly higher in the chondromalacia patellae group for all grades compared with the normal group (P < .001), and there was a significant correlation between subcutaneous knee fat thickness and grades of chondromalacia patellae (R = 0.48 [95% confidence interval, 0.38-0.68]; P < .001). Female patients had thicker subcutaneous knee fat and more severe grades of chondromalacia patellae. CONCLUSION Subcutaneous knee fat thickness as a surrogate marker of obesity was positively associated with the presence and severity of chondromalacia patellae on MRI.
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Affiliation(s)
- Hong Kuan Kok
- Department of Radiology, Adelaide and Meath Hospital Incorporating the National Children's Hospital, Dublin, Ireland.
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Bittersohl B, Miese FR, Hosalkar HS, Herten M, Antoch G, Krauspe R, Zilkens C. T2* mapping of hip joint cartilage in various histological grades of degeneration. Osteoarthritis Cartilage 2012; 20:653-60. [PMID: 22469845 DOI: 10.1016/j.joca.2012.03.011] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Revised: 03/14/2012] [Accepted: 03/21/2012] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate T2* values in various histological severities of osteoarthritis (OA). METHOD Magnetic resonance imaging (MRI) and T2* mapping including a three-dimensional (3D) double-echo steady-state (DESS) sequence for morphological cartilage assessment and a 3D multiecho data image combination (MEDIC) sequence for T2* mapping were conducted in 21 human femoral head specimens with varying severities of OA. Subsequently, histological assessment was undertaken in all specimens to correlate the observations of T2* mapping with histological analyses. According to the Mankin score, four grades of histological changes were determined: grade 0 (Mankin scores of 0-4), grade I (scores of 5-8), grade II (scores of 9-10), and grade III (scores of 11-14). For reliability assessment, cartilage T2* measurements were repeated after 4 weeks in 10 randomly selected femoral head specimens. RESULTS T2* values decreased significantly with increasing cartilage degeneration (total P-values <0.001) ranging from 36.3 ± 4.3 ms in grade 0 regions to 22.8 ± 4.3 ms in regions with grade III changes. Pearson correlation analysis proved a fair correlation between T2* values and Mankin score (correlation coefficient = -0.362) that was statistically significant (P-value <0.001). Intra-class correlation (ICC) analysis demonstrated high intra-observer reproducibility for the T2* measurement (ICC: 0.949, P < 0.001). CONCLUSIONS Given the advantages of the T2* mapping technique with no need for contrast medium, high image resolution and ability to perform 3D biochemically sensitive imaging, T2* mapping may be a strong addition to the currently evolving era of cartilage biochemical imaging.
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Affiliation(s)
- B Bittersohl
- University Düsseldorf, Medical Faculty, Orthopedic Department, 40225 Dusseldorf, Germany.
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Abstract
Objective: To clarify the pathophysiology of knee arthropathy, articular sound in the knee joint was recorded using an accelerometer, vibroarthrography (VAG), during standing-up and sitting-down movements in patients with osteoarthropathy (OA) of the knees. Methods: VAG signals and angular changes of the knee joint during standing-up and sitting-down movements were recorded in patients with OA, including 17 knees with OA at Kellgren–Lawrence stage I and II, 16 knees with OA at III and IV stages, and 20 knees of age-matched control subjects. Results: The level of VAG signals was greater in knees with a higher stage of OA at 50–99 and 100–149 Hz among the groups (ANOVA with Tukey–Kramer multiple comparisons test, p < 0.01). The VAG signals did not correlate with WOMAC-pain or physical scores. Conclusions: We considered that the increase in VAG signals in these ranges of frequency corresponded with pathological changes of OA, but not self-reported clinical symptoms. This method of VAG can be used by clinicians during interventions to obtain pathological information regarding structural changes of the knee joint.
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Affiliation(s)
- Noriyuki Tanaka
- Department of Rehabilitation Sciences, Postgraduate School of Health Sciences, Nagoya University, 1-1-20, Daiko-minami, Higashi-ku, Nagoya 461-8673, Japan
- Division of Rehabilitation, Syutaikai Hospital, 8-1 Shirokita-cho, Yokkaichi, Mie 510-0823, Japan
| | - Minoru Hoshiyama
- Department of Rehabilitation Sciences, Postgraduate School of Health Sciences, Nagoya University, 1-1-20, Daiko-minami, Higashi-ku, Nagoya 461-8673, Japan
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Guntern D, Becce F, Richarme D, Palhais NS, Meuli R, Theumann N. Direct magnetic resonance arthrography of the wrist with axial traction: a feasibility study to assess joint cartilage. J Magn Reson Imaging 2011; 34:239-44. [PMID: 21618335 DOI: 10.1002/jmri.22615] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Accepted: 03/15/2011] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To assess the impact of axial traction during acquisition of direct magnetic resonance (MR) arthrography of the wrist with regard to joint space width and amount of contrast material between the opposing cartilage surfaces. MATERIALS AND METHODS Fifteen consecutive patients (12 male, mean age 38.1 years) were included in this Institutional Review Board-approved prospective study. Three-compartment wrist MR arthrographies were performed between October and December 2009 on a 3 T unit using a fat-suppressed T1-weighted isotropic high-resolution volumetric interpolated breathhold examination (VIBE) sequence in the coronal plane, with and without axial traction (3 kg). Two radiologists measured radiocarpal (radioscaphoid, radiolunate) and midcarpal (lunocapitate, hamatolunate) joint space widths, with and without traction, and assessed the amount of contrast material between the opposing cartilage surfaces using a three-point scale: 0 = absence, 1 = partial, 2 = complete. RESULTS With traction, joint space width increased significantly at the radioscaphoid (Δ = 0.78 mm, P < 0.01), radiolunate (Δ = 0.18 mm, P < 0.01), and lunocapitate (Δ = 0.45 mm, P < 0.01) spaces, and both observers detected significantly more contrast material between the cartilage surfaces. At the hamatolunate space, the differences in joint space width (Δ = 0.14 mm, P = 0.54) and amount of contrast material were not significant. CONCLUSION Direct wrist MR arthrography with axial traction of 3 kg increases joint space width at the radiocarpal and lunocapitate spaces, and prompts better coverage of the articular cartilage by the contrast material.
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Affiliation(s)
- Daniel Guntern
- Department of Diagnostic and Interventional Radiology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
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Benson R, Patakas A, McQueenie R, Ross K, McInnes I, Brewer J, Garside P. Arthritis in space and time - To boldly go! FEBS Lett 2011; 585:3640-8. [DOI: 10.1016/j.febslet.2011.04.069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Revised: 04/28/2011] [Accepted: 04/29/2011] [Indexed: 01/13/2023]
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van Buul GM, Kotek G, Wielopolski PA, Farrell E, Bos PK, Weinans H, Grohnert AU, Jahr H, Verhaar JAN, Krestin GP, van Osch GJVM, Bernsen MR. Clinically translatable cell tracking and quantification by MRI in cartilage repair using superparamagnetic iron oxides. PLoS One 2011; 6:e17001. [PMID: 21373640 PMCID: PMC3044153 DOI: 10.1371/journal.pone.0017001] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2010] [Accepted: 01/18/2011] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Articular cartilage has very limited intrinsic regenerative capacity, making cell-based therapy a tempting approach for cartilage repair. Cell tracking can be a major step towards unraveling and improving the repair process of these therapies. We studied superparamagnetic iron oxides (SPIO) for labeling human bone marrow-derived mesenchymal stem cells (hBMSCs) regarding effectivity, cell viability, long term metabolic cell activity, chondrogenic differentiation and hBMSC secretion profile. We additionally examined the capacity of synovial cells to endocytose SPIO from dead, labeled cells, together with the use of magnetic resonance imaging (MRI) for intra-articular visualization and quantification of SPIO labeled cells. METHODOLOGY/PRINICIPAL FINDINGS Efficacy and various safety aspects of SPIO cell labeling were determined using appropriate assays. Synovial SPIO re-uptake was investigated in vitro by co-labeling cells with SPIO and green fluorescent protein (GFP). MRI experiments were performed on a clinical 3.0T MRI scanner. Two cell-based cartilage repair techniques were mimicked for evaluating MRI traceability of labeled cells: intra-articular cell injection and cell implantation in cartilage defects. Cells were applied ex vivo or in vitro in an intra-articular environment and immediately scanned. SPIO labeling was effective and did not impair any of the studied safety aspects, including hBMSC secretion profile. SPIO from dead, labeled cells could be taken up by synovial cells. Both injected and implanted SPIO-labeled cells could accurately be visualized by MRI in a clinically relevant sized joint model using clinically applied cell doses. Finally, we quantified the amount of labeled cells seeded in cartilage defects using MR-based relaxometry. CONCLUSIONS SPIO labeling appears to be safe without influencing cell behavior. SPIO labeled cells can be visualized in an intra-articular environment and quantified when seeded in cartilage defects.
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Affiliation(s)
- Gerben M. van Buul
- Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
- Department of Orthopaedics, Erasmus MC, Rotterdam, The Netherlands
| | - Gyula Kotek
- Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
| | | | - Eric Farrell
- Department of Orthopaedics, Erasmus MC, Rotterdam, The Netherlands
- Department of Otorhinolaryngology, Erasmus MC, Rotterdam, The Netherlands
| | - P. Koen Bos
- Department of Orthopaedics, Erasmus MC, Rotterdam, The Netherlands
| | - Harrie Weinans
- Department of Orthopaedics, Erasmus MC, Rotterdam, The Netherlands
- Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands
| | - Anja U. Grohnert
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Holger Jahr
- Department of Orthopaedics, Erasmus MC, Rotterdam, The Netherlands
| | | | | | - Gerjo J. V. M. van Osch
- Department of Orthopaedics, Erasmus MC, Rotterdam, The Netherlands
- Department of Otorhinolaryngology, Erasmus MC, Rotterdam, The Netherlands
| | - Monique R. Bernsen
- Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
- * E-mail:
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