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Yoon D, Doyle Z, Lee P, Hargreaves B, Stevens K. Clinical evaluation of isotropic MAVRIC-SL for symptomatic hip arthroplasties at 3 T MRI. Magn Reson Imaging 2024; 111:256-264. [PMID: 38621551 PMCID: PMC11186338 DOI: 10.1016/j.mri.2024.04.017] [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: 03/07/2024] [Revised: 04/07/2024] [Accepted: 04/12/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND 3D multi-spectral imaging (MSI) of metal implants necessitates relatively long scan times. OBJECTIVE We implemented a fast isotropic 3D MSI technique at 3 T and compared its image quality and clinical utility to non-isotropic MSI in the evaluation of hip implants. METHODS Two musculoskeletal radiologists scored images from coronal proton density-weighted conventional MAVRIC-SL and an isotropic MAVRIC-SL sequence accelerated with robust-component-analysis on a 3-point scale (3: diagnostic, 2: moderately diagnostic, 1: non-diagnostic) for overall image quality, metal artifact, and visualization around femoral and acetabular components. Grades were compared using a signed Wilcoxon test. Images were evaluated for effusion, synovitis, osteolysis, loosening, pseudotumor, fracture, and gluteal tendon abnormalities. Reformatted axial and sagittal images for both sequences were subsequently generated and compared for image quality with the Wilcoxon test. Whether these reformats increased diagnostic confidence or revealed additional pathology, including findings unrelated to arthroplasty that may contribute to hip pain, was also compared using the McNemar test. Inter-rater agreement was measured by Cohen's kappa. RESULTS 39 symptomatic patients with a total of 59 hip prostheses were imaged (mean age, 70 years ±9, 14 males, 25 females). Comparison scores between coronal images showed no significant difference in image quality, metal artifact, or visualization of the femur and acetabulum. Except for loosening, reviewers identified more positive cases of pathology on the original coronally-acquired isotropic sequence. In comparison of reformatted axial and sagittal images, the isotropic sequence scored significantly (p < 0.01) higher for overall image quality (3.0 vs 2.0) and produced significantly (p < 0.01) more cases of increased diagnostic confidence (42.4% vs 7.6%) or additional diagnoses (50.8% vs 22.9%). Inter-rater agreement was substantial (k = 0.798) for image quality. Mean scan times were 4.2 mins (isotropic) and 7.1 mins (non-isotropic). CONCLUSION Compared to the non-isotropic sequence, isotropic 3D MSI was acquired in less time while maintaining diagnostically acceptable image quality. It identified more pathology, including postoperative complications and potential pain-generating pathology unrelated to arthroplasty. This fast isotropic 3D MSI sequence demonstrates promise for improving diagnostic evaluation of symptomatic hip prostheses at 3 T while simultaneously reducing scan time.
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Affiliation(s)
- Daehyun Yoon
- Department of Radiology, Stanford University, Lucas MRS Center, 1201 Welch Road, Stanford, CA 94305, USA.
| | - Zoe Doyle
- Department of Radiology, Stanford University, Lucas MRS Center, 1201 Welch Road, Stanford, CA 94305, USA; Department of Radiology, VA Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304, USA.
| | - Philip Lee
- Department of Electrical Engineering, Stanford University, 350 Jane Stanford Way, Stanford, CA 94305, USA.
| | - Brian Hargreaves
- Department of Radiology, Stanford University, Lucas MRS Center, 1201 Welch Road, Stanford, CA 94305, USA; Department of Electrical Engineering, Stanford University, 350 Jane Stanford Way, Stanford, CA 94305, USA; Department of Bioengineering, Stanford University, 443 Via Ortega, Rm 119, Stanford, CA 94305, USA.
| | - Kathryn Stevens
- Department of Radiology, Stanford University, Lucas MRS Center, 1201 Welch Road, Stanford, CA 94305, USA; Department of Orthopaedic Surgery, Stanford University, 430 Broadway Street, MC: 6342, Pavilion C, 4th Floor, Redwood City, CA 94063, USA.
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Ghotra SS, Cottier Y, Bruguier C, Dominguez A, Monnin P, Sá Dos Reis C. A pilot study to identify suitable MRI protocols for preoperative planning of total hip arthroplasty. Eur J Radiol 2024; 178:111620. [PMID: 39029238 DOI: 10.1016/j.ejrad.2024.111620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 06/15/2024] [Accepted: 07/11/2024] [Indexed: 07/21/2024]
Abstract
PURPOSE The purpose of this study is to identify suitable MRI sequences and evaluate the feasibility and performance of MRI for total hip arthroplasty (THA) preoperative planning. METHOD A multicentric pilot study was conducted to evaluate DP TSE and T1 GRE 3D sequences. High-resolution pelvis, hip, knee and ankle images were acquired. Protocols were optimised to enhance image quality (IQ) and reduce acquisition time to fit clinical practice. The final protocol was validated with 19 healthy volunteers with variable BMIs at 1.5 and 3 Tesla. Visual assessment was performed by five radiographers and radiologists using the ViewDEX software. Visual Grading Analysis (VGA), Intraclass Correlation Coefficient (ICC), Prevalence-adjusted and bias-adjusted kappa (PABAK) and Visual Grading Characteristics (VGC) were performed to analyse data. RESULTS VGA scores indicated that the optimised 3D DP TSE and 3D T1 GRE sequences at 3 T, as well as 3D DP TSE sequence at 1.5 T offer adequate IQ and allow a correct visualisation of the anatomy. Overall ICC analysis was moderate to good reliability at 0.749 (95 % CI 0.69-0.79) and increased from good to excellent at 0.846 (95 % CI 0.72-0.91) for DP at 3 T. PABAK shows fair agreement at 0.25 (95 % CI 0.227-0.273). VGC analysis showed that 3D DP TSE sequences performed statistically better than 3D T1 GRE at 1.5 and 3 T (p-value ≤ 0.05). Furthermore, 3 T sequences showed a statistically better performance compared to 1.5 T (p-value ≤ 0.05). CONCLUSIONS According to the results, 3D DP and T1 MRI sequences can be considered for preoperative planning for THA. Further research is required to emphasize the clinical validation of the results.
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Affiliation(s)
- Switinder Singh Ghotra
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne 1011, Switzerland; Department of Radiology, Hospital of Yverdon-les-Bains (eHnv), 1400 Yverdon-les-Bains, Switzerland.
| | - Yann Cottier
- Centre d'Imagerie Diagnostique de Lausanne, Lausanne 1011, Switzerland
| | - Christine Bruguier
- Department of Diagnostic & Interventional Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne 1011, Switzerland; University Center of Legal Medicine Lausanne - Geneva, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne 1011, Switzerland.
| | - Alejandro Dominguez
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne 1011, Switzerland; University Center of Legal Medicine Lausanne - Geneva, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne 1011, Switzerland.
| | - Pascal Monnin
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne 1011, Switzerland.
| | - Cláudia Sá Dos Reis
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne 1011, Switzerland.
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do Amaral E Castro A, Peixoto JB, Miyahara LK, Akuri MC, Moriwaki TL, Sato VN, Rissato UP, Pinto JA, Taneja AK, Aihara AY. Clubfoot: Congenital Talipes Equinovarus. Radiographics 2024; 44:e230178. [PMID: 38935547 DOI: 10.1148/rg.230178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Abstract
Congenital talipes equinovarus (CTEV), also known as clubfoot, is a common musculoskeletal entity that affects one to two per 1000 live births worldwide. Imaging modalities including radiography, US, and MRI have emerged as valuable tools for the diagnosis, treatment, and monitoring of CTEV. The deformity is characterized by midfoot cavus, forefoot adductus, and hindfoot varus and equinus. The Ponseti method of manipulation and serial casting is the standard treatment of CTEV. Radiography shows the anatomy, position, and relationships of the different bones of the foot. US allows accurate assessment of cartilaginous and bony structures, in addition to its inherent advantages such as absence of ionizing radiation exposure. One of the indications for US is to monitor the response to Ponseti method treatment. MRI enables visualization of bones, cartilage, and soft tissues and allows multiplanar evaluation of deformities, providing a comprehensive imaging analysis of CTEV. An integrated approach that combines clinical examination and imaging findings is essential for effective management of CTEV. The authors provide a comprehensive overview of CTEV with a review of imaging modalities to help evaluate CTEV, focusing on radiography, US, and MRI. Using this article as a guide, radiologists involved in the assessment and treatment of CTEV can contribute to the management of the condition. ©RSNA, 2024 Supplemental material is available for this article.
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Affiliation(s)
- Adham do Amaral E Castro
- From the Division of Musculoskeletal Radiology, Department of Diagnostic Imaging (A.d.A.e.C., J.B.P., L.K.M., M.C.A., T.L.M., V.N.S., A.Y.A.), and Discipline of Pediatric Orthopedics, Department of Orthopedics and Traumatology (U.P.R., J.A.P.), Napoleão de Barros St, 800-Vila Clementino, Universidade Federal de São Paulo-Escola Paulista de Medicina, São Paulo, SP, Brazil 04024-002; Hospital Israelita Albert Einstein, São Paulo, Brazil (A.d.A.e.C.); Department of Diagnostic Imaging, DASA/Laboratório Delboni Auriemo, São Paulo, SP, Brazil (T.L.M., V.N.S., A.Y.A.); Department of Radiology, Hospital do Coração (HCor) and Teleimagem, São Paulo, SP, Brazil (V.N.S.); and Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX (A.K.T.)
| | - Júlia B Peixoto
- From the Division of Musculoskeletal Radiology, Department of Diagnostic Imaging (A.d.A.e.C., J.B.P., L.K.M., M.C.A., T.L.M., V.N.S., A.Y.A.), and Discipline of Pediatric Orthopedics, Department of Orthopedics and Traumatology (U.P.R., J.A.P.), Napoleão de Barros St, 800-Vila Clementino, Universidade Federal de São Paulo-Escola Paulista de Medicina, São Paulo, SP, Brazil 04024-002; Hospital Israelita Albert Einstein, São Paulo, Brazil (A.d.A.e.C.); Department of Diagnostic Imaging, DASA/Laboratório Delboni Auriemo, São Paulo, SP, Brazil (T.L.M., V.N.S., A.Y.A.); Department of Radiology, Hospital do Coração (HCor) and Teleimagem, São Paulo, SP, Brazil (V.N.S.); and Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX (A.K.T.)
| | - Lucas K Miyahara
- From the Division of Musculoskeletal Radiology, Department of Diagnostic Imaging (A.d.A.e.C., J.B.P., L.K.M., M.C.A., T.L.M., V.N.S., A.Y.A.), and Discipline of Pediatric Orthopedics, Department of Orthopedics and Traumatology (U.P.R., J.A.P.), Napoleão de Barros St, 800-Vila Clementino, Universidade Federal de São Paulo-Escola Paulista de Medicina, São Paulo, SP, Brazil 04024-002; Hospital Israelita Albert Einstein, São Paulo, Brazil (A.d.A.e.C.); Department of Diagnostic Imaging, DASA/Laboratório Delboni Auriemo, São Paulo, SP, Brazil (T.L.M., V.N.S., A.Y.A.); Department of Radiology, Hospital do Coração (HCor) and Teleimagem, São Paulo, SP, Brazil (V.N.S.); and Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX (A.K.T.)
| | - Marina C Akuri
- From the Division of Musculoskeletal Radiology, Department of Diagnostic Imaging (A.d.A.e.C., J.B.P., L.K.M., M.C.A., T.L.M., V.N.S., A.Y.A.), and Discipline of Pediatric Orthopedics, Department of Orthopedics and Traumatology (U.P.R., J.A.P.), Napoleão de Barros St, 800-Vila Clementino, Universidade Federal de São Paulo-Escola Paulista de Medicina, São Paulo, SP, Brazil 04024-002; Hospital Israelita Albert Einstein, São Paulo, Brazil (A.d.A.e.C.); Department of Diagnostic Imaging, DASA/Laboratório Delboni Auriemo, São Paulo, SP, Brazil (T.L.M., V.N.S., A.Y.A.); Department of Radiology, Hospital do Coração (HCor) and Teleimagem, São Paulo, SP, Brazil (V.N.S.); and Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX (A.K.T.)
| | - Tatiane L Moriwaki
- From the Division of Musculoskeletal Radiology, Department of Diagnostic Imaging (A.d.A.e.C., J.B.P., L.K.M., M.C.A., T.L.M., V.N.S., A.Y.A.), and Discipline of Pediatric Orthopedics, Department of Orthopedics and Traumatology (U.P.R., J.A.P.), Napoleão de Barros St, 800-Vila Clementino, Universidade Federal de São Paulo-Escola Paulista de Medicina, São Paulo, SP, Brazil 04024-002; Hospital Israelita Albert Einstein, São Paulo, Brazil (A.d.A.e.C.); Department of Diagnostic Imaging, DASA/Laboratório Delboni Auriemo, São Paulo, SP, Brazil (T.L.M., V.N.S., A.Y.A.); Department of Radiology, Hospital do Coração (HCor) and Teleimagem, São Paulo, SP, Brazil (V.N.S.); and Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX (A.K.T.)
| | - Vitor N Sato
- From the Division of Musculoskeletal Radiology, Department of Diagnostic Imaging (A.d.A.e.C., J.B.P., L.K.M., M.C.A., T.L.M., V.N.S., A.Y.A.), and Discipline of Pediatric Orthopedics, Department of Orthopedics and Traumatology (U.P.R., J.A.P.), Napoleão de Barros St, 800-Vila Clementino, Universidade Federal de São Paulo-Escola Paulista de Medicina, São Paulo, SP, Brazil 04024-002; Hospital Israelita Albert Einstein, São Paulo, Brazil (A.d.A.e.C.); Department of Diagnostic Imaging, DASA/Laboratório Delboni Auriemo, São Paulo, SP, Brazil (T.L.M., V.N.S., A.Y.A.); Department of Radiology, Hospital do Coração (HCor) and Teleimagem, São Paulo, SP, Brazil (V.N.S.); and Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX (A.K.T.)
| | - Ulysses P Rissato
- From the Division of Musculoskeletal Radiology, Department of Diagnostic Imaging (A.d.A.e.C., J.B.P., L.K.M., M.C.A., T.L.M., V.N.S., A.Y.A.), and Discipline of Pediatric Orthopedics, Department of Orthopedics and Traumatology (U.P.R., J.A.P.), Napoleão de Barros St, 800-Vila Clementino, Universidade Federal de São Paulo-Escola Paulista de Medicina, São Paulo, SP, Brazil 04024-002; Hospital Israelita Albert Einstein, São Paulo, Brazil (A.d.A.e.C.); Department of Diagnostic Imaging, DASA/Laboratório Delboni Auriemo, São Paulo, SP, Brazil (T.L.M., V.N.S., A.Y.A.); Department of Radiology, Hospital do Coração (HCor) and Teleimagem, São Paulo, SP, Brazil (V.N.S.); and Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX (A.K.T.)
| | - José A Pinto
- From the Division of Musculoskeletal Radiology, Department of Diagnostic Imaging (A.d.A.e.C., J.B.P., L.K.M., M.C.A., T.L.M., V.N.S., A.Y.A.), and Discipline of Pediatric Orthopedics, Department of Orthopedics and Traumatology (U.P.R., J.A.P.), Napoleão de Barros St, 800-Vila Clementino, Universidade Federal de São Paulo-Escola Paulista de Medicina, São Paulo, SP, Brazil 04024-002; Hospital Israelita Albert Einstein, São Paulo, Brazil (A.d.A.e.C.); Department of Diagnostic Imaging, DASA/Laboratório Delboni Auriemo, São Paulo, SP, Brazil (T.L.M., V.N.S., A.Y.A.); Department of Radiology, Hospital do Coração (HCor) and Teleimagem, São Paulo, SP, Brazil (V.N.S.); and Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX (A.K.T.)
| | - Atul K Taneja
- From the Division of Musculoskeletal Radiology, Department of Diagnostic Imaging (A.d.A.e.C., J.B.P., L.K.M., M.C.A., T.L.M., V.N.S., A.Y.A.), and Discipline of Pediatric Orthopedics, Department of Orthopedics and Traumatology (U.P.R., J.A.P.), Napoleão de Barros St, 800-Vila Clementino, Universidade Federal de São Paulo-Escola Paulista de Medicina, São Paulo, SP, Brazil 04024-002; Hospital Israelita Albert Einstein, São Paulo, Brazil (A.d.A.e.C.); Department of Diagnostic Imaging, DASA/Laboratório Delboni Auriemo, São Paulo, SP, Brazil (T.L.M., V.N.S., A.Y.A.); Department of Radiology, Hospital do Coração (HCor) and Teleimagem, São Paulo, SP, Brazil (V.N.S.); and Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX (A.K.T.)
| | - André Y Aihara
- From the Division of Musculoskeletal Radiology, Department of Diagnostic Imaging (A.d.A.e.C., J.B.P., L.K.M., M.C.A., T.L.M., V.N.S., A.Y.A.), and Discipline of Pediatric Orthopedics, Department of Orthopedics and Traumatology (U.P.R., J.A.P.), Napoleão de Barros St, 800-Vila Clementino, Universidade Federal de São Paulo-Escola Paulista de Medicina, São Paulo, SP, Brazil 04024-002; Hospital Israelita Albert Einstein, São Paulo, Brazil (A.d.A.e.C.); Department of Diagnostic Imaging, DASA/Laboratório Delboni Auriemo, São Paulo, SP, Brazil (T.L.M., V.N.S., A.Y.A.); Department of Radiology, Hospital do Coração (HCor) and Teleimagem, São Paulo, SP, Brazil (V.N.S.); and Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX (A.K.T.)
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Hergár L, Kovács N, Agócs G, Weninger V, Skaliczki G, Lutz E, Hegyi P, Kovács BK, Hetthéssy JR. No evidence for the superiority of 3 T MRI over 1.5 T MRI for diagnosing wrist ligamentous lesions: a systematic review and meta-analysis. Arthroscopy 2024:S0749-8063(24)00335-9. [PMID: 38735416 DOI: 10.1016/j.arthro.2024.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 05/14/2024]
Abstract
PURPOSES Our aim was to determine the diagnostic accuracy of native MRI regarding different ligamentous lesions of the wrist and to analyze the influence of technical characteristics, such as field strength, application of fat saturation, 3D sequences, and wrist coils. METHODS The systematic search was performed using MEDLINE, Embase, and CENTRAL databases. Studies that were published before the 12th of February 2024 were included. All studies comparing the diagnostic accuracy of native wrist MRI to that of wrist arthroscopy for suspected ligamentous lesions were included. Results were analyzed by anatomic localization and technical aspects of the MRI. To assess the quality of included studies, we used the revised QUADAS-2 tool. RESULTS The systematic search revealed 5,181 articles. Thirty-seven studies, reporting 3893 ligamentous lesions, were eligible for inclusion. The studies displayed heterogeneity in terms of technical conditions, such as field strength, the use of wrist coils, the application of 3D sequences and fat saturation. Research methods also varied. Overall sensitivity and specificity were 0.78 (0.66 - 0.86) and 0.81 (0.70 - 0.89) for 1.5T MRI, while sensitivity was 0.73 (0.68 - 0.78) and specificity was 0.90 (0.59 - 0.98) for 3T MRI. There was no significant difference between the two subgroups (p=0,3807 and p=0,4248). Sensitivity was 0.82 (0.75 - 0.87) for triangular fibrocartilage complex (TFCC) lesions, 0.63 (0.50 - 0.74) for scapholunate ligament (SL) tears, and 0.41 (0.25 - 0.60) for lunotriquetral ligament (LT) lesions. Specificity for TFCC lesions was 0.82 (0.73 - 0.89), for SL tears 0.86 (0.73 - 0.93), and for LT lesions 0.93 (0.81 - 0.98). CONCLUSION The sensitivity and specificity of MRI is influenced by the anatomic location of the lesion and technical conditions. In terms of diagnostic accuracy, no significant difference was found between 1.5T and 3T MRI. LEVEL OF EVIDENCE III. Systematic review of Level II. - III. STUDIES
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Affiliation(s)
- Luca Hergár
- Department of Orthopaedics, Semmelweis University, Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
| | - Norbert Kovács
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary; Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary.
| | - Gergely Agócs
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Semmelweis University Department of Biophysics and Radiation Biology.
| | - Viktor Weninger
- Department of Orthopaedics, Semmelweis University, Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
| | - Gábor Skaliczki
- Department of Orthopaedics, Semmelweis University, Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
| | - Elmar Lutz
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary; Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
| | | | - Judit Réka Hetthéssy
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Hand Clinic, Budapest, Hungary; Research Management Workgroup, Semmelweis University.
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Yi J, Hahn S, Lee HJ, Lee Y, Bang JY, Kim Y, Lee J. Thin-slice elbow MRI with deep learning reconstruction: Superior diagnostic performance of elbow ligament pathologies. Eur J Radiol 2024; 175:111471. [PMID: 38636411 DOI: 10.1016/j.ejrad.2024.111471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/31/2024] [Accepted: 04/15/2024] [Indexed: 04/20/2024]
Abstract
PURPOSE With the slice thickness routinely used in elbow MRI, small or subtle lesions may be overlooked or misinterpreted as insignificant. To compare 1 mm slice thickness MRI (1 mm MRI) with deep learning reconstruction (DLR) to 3 mm slice thickness MRI (3 mm MRI) without/with DLR, and 1 mm MRI without DLR regarding image quality and diagnostic performance for elbow tendons and ligaments. METHODS This retrospective study included 53 patients between February 2021 and January 2022, who underwent 3 T elbow MRI, including T2-weighted fat-saturated coronal 3 mm and 1 mm MRI without/with DLR. Two radiologists independently assessed four MRI scans for image quality and artefacts, and identified the pathologies of the five elbow tendons and ligaments. In 19 patients underwent elbow surgery after elbow MRI, diagnostic performance was evaluated using surgical records as a reference standard. RESULTS For both readers, 3 mm MRI with DLR had significant higher image quality scores than 3 mm MRI without DLR and 1 mm MRI with DLR (all P < 0.01). For common extensor tendon and elbow ligament pathologies, 1 mm MRI with DLR showed the highest number of pathologies for both readers. The 1 mm MRI with DLR had the highest kappa values for all tendons and ligaments. For reader 1, 1 mm MRI with DLR showed superior diagnostic performance than 3 mm MRI without/with DLR. For reader 2, 1 mm MRI with DLR showed the highest diagnostic performance; however, there was no significant difference. CONCLUSIONS One mm MRI with DLR showed the highest diagnostic performance for evaluating elbow tendon and ligament pathologies, with similar subjective image qualities and artefacts.
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Affiliation(s)
- Jisook Yi
- Department of Radiology, Inje University College of Medicine, Haeundae Paik Hospital, 875 Haeundae-ro, Haeundae-gu, Busan 48108, Republic of Korea
| | - Seok Hahn
- Department of Radiology, Inje University College of Medicine, Haeundae Paik Hospital, 875 Haeundae-ro, Haeundae-gu, Busan 48108, Republic of Korea.
| | - Ho-Joon Lee
- Department of Radiology, Inje University College of Medicine, Haeundae Paik Hospital, 875 Haeundae-ro, Haeundae-gu, Busan 48108, Republic of Korea
| | - Yedaun Lee
- Department of Radiology, Inje University College of Medicine, Haeundae Paik Hospital, 875 Haeundae-ro, Haeundae-gu, Busan 48108, Republic of Korea
| | - Jin-Young Bang
- Department of Orthopaedic Surgery, Inje University College of Medicine, Haeundae Paik Hospital, 875 Haeundae-ro, Haeundae-gu, Busan 48108, Republic of Korea
| | - Youngbok Kim
- Department of Orthopaedic Surgery, Inje University College of Medicine, Haeundae Paik Hospital, 875 Haeundae-ro, Haeundae-gu, Busan 48108, Republic of Korea
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Aggarwal VA, Thakur U, Silva FD, Ray G, Weinschenk C, Gandy M, Xi Y, Chhabra A. Flexed elbow, abducted shoulder, forearm supinated (FABS) reconstruction from three-dimensional elbow MRI: diagnostic performance assessment in biceps head anatomy and pathology. Clin Radiol 2024; 79:e567-e573. [PMID: 38341341 DOI: 10.1016/j.crad.2023.12.018] [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: 08/18/2023] [Revised: 12/19/2023] [Accepted: 12/24/2023] [Indexed: 02/12/2024]
Abstract
AIM To determine inter-reader analysis and diagnostic performance on digitally reconstructed virtual flexed, abducted, supinated (FABS) imaging from three-dimensional (3D) isotropic elbow magnetic resonance imaging (MRI). MATERIALS AND METHODS Six musculoskeletal radiologists independently evaluated elbow MRI images with virtual FABS reconstructions, blinded to clinical findings and final diagnoses. Each radiologist recorded a binary result as to whether the tendon was intact and if both heads were visible, along with a categorical value to the type of tear and extent of retraction in centimetres where applicable. Kappa and interclass correlation (ICC) were reported with 95% confidence intervals. Areas under the receiver operating curve (AUC) were reported. RESULTS FABS reconstructions were obtained successfully in all 48 cases. With respect to tendon intactness, visibility of both heads, and type of tear, the Kappa values were 0.66 (0.53-0.78), 0.24 (0.12-0.37), and 0.55 (0.43-0.66), respectively. For the extent of retraction, the ICC was 0.85 (0.79-0.91) when including the tendons with and without retraction and 0.78 (0.61-0.91) when only including tendons with retraction. For tear versus no tear, AUC values were 0.82 (0.74-0.89) to 0.96 (0.91-1.01). CONCLUSION Digital reconstruction of FABS positioning is feasible and allows good assessment of individual tendon head tears and retraction with high diagnostic performance.
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Affiliation(s)
- V A Aggarwal
- Radiology, UT Southwestern Medical Center, Dallas, TX, USA.
| | - U Thakur
- Radiology, UT Southwestern Medical Center, Dallas, TX, USA
| | - F D Silva
- Radiology, UT Southwestern Medical Center, Dallas, TX, USA
| | - G Ray
- Radiology, UT Southwestern Medical Center, Dallas, TX, USA
| | - C Weinschenk
- Radiology, UT Southwestern Medical Center, Dallas, TX, USA
| | - M Gandy
- Radiology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Y Xi
- Radiology, UT Southwestern Medical Center, Dallas, TX, USA
| | - A Chhabra
- Radiology, UT Southwestern Medical Center, Dallas, TX, USA; Orthopedic Surgery, UT Southwestern Medical Center, Dallas, TX, USA
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Engelke K, Chaudry O, Gast L, Eldib MAB, Wang L, Laredo JD, Schett G, Nagel AM. Magnetic resonance imaging techniques for the quantitative analysis of skeletal muscle: State of the art. J Orthop Translat 2023; 42:57-72. [PMID: 37654433 PMCID: PMC10465967 DOI: 10.1016/j.jot.2023.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 07/04/2023] [Accepted: 07/19/2023] [Indexed: 09/02/2023] Open
Abstract
Background Magnetic resonance imaging (MRI) is the dominant 3D imaging modality to quantify muscle properties in skeletal muscle disorders, in inherited and acquired muscle diseases, and in sarcopenia, in cachexia and frailty. Methods This review covers T1 weighted and Dixon sequences, introduces T2 mapping, diffusion tensor imaging (DTI) and non-proton MRI. Technical concepts, strengths, limitations and translational aspects of these techniques are discussed in detail. Examples of clinical applications are outlined. For comparison 31P-and 13C-MR Spectroscopy are also addressed. Results MRI technology provides a rich toolset to assess muscle deterioration. In addition to classical measures such as muscle atrophy using T1 weighted imaging and fat infiltration using Dixon sequences, parameters characterizing inflammation from T2 maps, tissue sodium using non-proton MRI techniques or concentration or fiber architecture using diffusion tensor imaging may be useful for an even earlier diagnosis of the impairment of muscle quality. Conclusion Quantitative MRI provides new options for muscle research and clinical applications. Current limitations that also impair its more widespread use in clinical trials are lack of standardization, ambiguity of image segmentation and analysis approaches, a multitude of outcome parameters without a clear strategy which ones to use and the lack of normal data.
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Affiliation(s)
- Klaus Engelke
- Department of Medicine III, Friedrich-Alexander University of Erlangen-Nürnberg, University Hospital Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
- Institute of Medical Physics (IMP), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Henkestr. 91, 91052, Erlangen, Germany
- Clario Inc, Germany
| | - Oliver Chaudry
- Department of Medicine III, Friedrich-Alexander University of Erlangen-Nürnberg, University Hospital Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Lena Gast
- Institute of Radiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, Maximiliansplatz 3, 91054, Erlangen, Germany
| | | | - Ling Wang
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
| | - Jean-Denis Laredo
- Service d’Imagerie Médicale, Institut Mutualiste Montsouris & B3OA, UMR CNRS 7052, Inserm U1271 Université de Paris-Cité, Paris, France
| | - Georg Schett
- Department of Medicine III, Friedrich-Alexander University of Erlangen-Nürnberg, University Hospital Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Armin M. Nagel
- Institute of Radiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, Maximiliansplatz 3, 91054, Erlangen, Germany
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
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Diagnostic Utility of Double-Echo Steady-State (DESS) MRI for Fracture and Bone Marrow Edema Detection in Adolescent Lumbar Spondylolysis. Diagnostics (Basel) 2023; 13:diagnostics13030461. [PMID: 36766566 PMCID: PMC9914111 DOI: 10.3390/diagnostics13030461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/24/2023] [Accepted: 01/24/2023] [Indexed: 01/28/2023] Open
Abstract
To evaluate the ability of double-echo steady-state (DESS) MRI to detect pars interarticularis fracture and bone marrow edema (BME) in spondylolysis, 500 lumber pars interarticularis from 50 consecutive patients (38 males and 12 females, mean age 14.2 ± 3.28 years) with spondylolysis who underwent both MRI and CT within 1 week were evaluated. All participants were young athletes who complained of lower back pain. Fractures were classified into four grades and CT was used as a reference; BME was evaluated in a binary manner and STIR was used as a reference. The diagnostic performance of fractures on DESS and T1WI, and BME on DESS was assessed by two radiologists independently. For fracture detection, DESS showed high diagnostic performance at a sensitivity of 94%, specificity of 99.5%, and accuracy of 98.8%, whereas T1WI showed lower sensitivity (70.1%). Fracture grading performed by DESS showed excellent agreement with CT grading (Kappa = 0.9). For BME, the sensitivity, specificity, and accuracy of DESS were 96.5%, 100%, and 99.6%, respectively. The inter-rater agreement of DESS for fracture and BME was 0.8 and 0.85, respectively. However, the inter-rater agreement for fracture on T1WI was 0.52. DESS had high diagnostic performance for fracture and BME in pars interarticularis. In conclusion, DESS had potential to detect all critical imaging findings in spondylolysis and may replace the role of CT.
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Kulseng CPS, Nainamalai V, Grøvik E, Geitung JT, Årøen A, Gjesdal KI. Automatic segmentation of human knee anatomy by a convolutional neural network applying a 3D MRI protocol. BMC Musculoskelet Disord 2023; 24:41. [PMID: 36650496 PMCID: PMC9847207 DOI: 10.1186/s12891-023-06153-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 01/10/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND To study deep learning segmentation of knee anatomy with 13 anatomical classes by using a magnetic resonance (MR) protocol of four three-dimensional (3D) pulse sequences, and evaluate possible clinical usefulness. METHODS The sample selection involved 40 healthy right knee volumes from adult participants. Further, a recently injured single left knee with previous known ACL reconstruction was included as a test subject. The MR protocol consisted of the following 3D pulse sequences: T1 TSE, PD TSE, PD FS TSE, and Angio GE. The DenseVNet neural network was considered for these experiments. Five input combinations of sequences (i) T1, (ii) T1 and FS, (iii) PD and FS, (iv) T1, PD, and FS and (v) T1, PD, FS and Angio were trained using the deep learning algorithm. The Dice similarity coefficient (DSC), Jaccard index and Hausdorff were used to compare the performance of the networks. RESULTS Combining all sequences collectively performed significantly better than other alternatives. The following DSCs (±standard deviation) were obtained for the test dataset: Bone medulla 0.997 (±0.002), PCL 0.973 (±0.015), ACL 0.964 (±0.022), muscle 0.998 (±0.001), cartilage 0.966 (±0.018), bone cortex 0.980 (±0.010), arteries 0.943 (±0.038), collateral ligaments 0.919 (± 0.069), tendons 0.982 (±0.005), meniscus 0.955 (±0.032), adipose tissue 0.998 (±0.001), veins 0.980 (±0.010) and nerves 0.921 (±0.071). The deep learning network correctly identified the anterior cruciate ligament (ACL) tear of the left knee, thus indicating a future aid to orthopaedics. CONCLUSIONS The convolutional neural network proves highly capable of correctly labeling all anatomical structures of the knee joint when applied to 3D MR sequences. We have demonstrated that this deep learning model is capable of automatized segmentation that may give 3D models and discover pathology. Both useful for a preoperative evaluation.
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Affiliation(s)
| | - Varatharajan Nainamalai
- grid.5947.f0000 0001 1516 2393Norwegian University of Science and Technology, Larsgaardvegen 2, Ålesund, 6025 Norway
| | - Endre Grøvik
- grid.5947.f0000 0001 1516 2393Norwegian University of Science and Technology, Høgskoleringen 5, Trondheim, 7491 Norway ,Møre og Romsdal Hospital Trust, Postboks 1600, Ålesund, 6025 Norway
| | - Jonn-Terje Geitung
- Sunnmøre MR-klinikk, Langelandsvegen 15, Ålesund, 6010 Norway ,grid.5510.10000 0004 1936 8921Faculty of Medicine, University of Oslo, Klaus Torgårds vei 3, Oslo, 0372 Norway ,grid.411279.80000 0000 9637 455XDepartment of Radiology, Akershus University Hospital, Postboks 1000, Lørenskog, 1478 Norway
| | - Asbjørn Årøen
- grid.411279.80000 0000 9637 455XDepartment of Orthopedic Surgery, Institute of Clinical Medicine, Akershus University Hospital, Problemveien 7, Oslo, 0315 Norway ,grid.412285.80000 0000 8567 2092Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Postboks 4014 Ullevål Stadion, Oslo, 0806 Norway
| | - Kjell-Inge Gjesdal
- Sunnmøre MR-klinikk, Langelandsvegen 15, Ålesund, 6010 Norway ,grid.5947.f0000 0001 1516 2393Norwegian University of Science and Technology, Larsgaardvegen 2, Ålesund, 6025 Norway ,grid.411279.80000 0000 9637 455XDepartment of Radiology, Akershus University Hospital, Postboks 1000, Lørenskog, 1478 Norway
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10
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Rosso F, Rossi R, Faletti R, Cantivalli A, Blonna D, Bonasia DE. Transepicondylar distance measured on MRI can predict the length of the graft required for different anterior cruciate ligament reconstruction (ACLR) techniques useful for revision surgery. J Orthop Traumatol 2022; 23:50. [PMID: 36242704 PMCID: PMC9569264 DOI: 10.1186/s10195-022-00670-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 09/24/2022] [Indexed: 12/04/2022] Open
Abstract
Background The aim of this study is to find a correlation between linear measurements and the graft length required for different anterior cruciate ligament (ACL) revision techniques, to extract formulas to predict required graft length during the preoperative planning. Methods At time 0 and 30 days later, two observers measured eight linear distances on standard 2D knee magnetic resonance imaging (MRI), and nine curved distances on 3D MRI sequences, corresponding to different techniques for ACL revision, anatomic anterolateral ligament (ALL) reconstruction, and lateral extrarticular tenodesis (LET). Intra- and interobserver reliability was tested for 2D and 3D measurements. The correlation between 2D and 3D measurements was tested. The 2D measurements with highest repeatability and reproducibility, and with strongest correlation with 3D measurements were used to extract formulas to calculate the graft length from 2D values. Results Fifty MRIs acquired with both 2D and 3D sequences were used. The intra- and interobserver reliability of linear 2D measurement was high, with the transepicondylar distance (TD) showing the highest reproducibility and repeatability. The intra- and interobserver reliability of 3D measurements was lower than 2D, but acceptable for all measurements except for ALL reconstruction. The TD showed the strongest correlation with 3D measurements. The formulas extracted to calculate the graft length from the TD proved to be accurate. Conclusion Accurate formulas were created to calculate the graft length needed for different ACL revision techniques and ALL reconstruction/LET techniques from TD. These formulas can be used during preoperative planning of ACL revision cases.
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Affiliation(s)
- Federica Rosso
- Department of Orthopaedics and Traumatology, AO Ordine Mauriziano Hospital, University of Torino, Largo Turati 62, 10128, Turin, Italy
| | - Roberto Rossi
- Department of Orthopaedics and Traumatology, AO Ordine Mauriziano Hospital, University of Torino, Largo Turati 62, 10128, Turin, Italy. .,Università Degli Studi Di Torino, Via Po 8, 10100, Turin, Italy.
| | - Riccardo Faletti
- Department of Radiology, AOU "Città Della Salute e Della Scienza" Hospital, University of Torino, Via Genova 3, 10126, Turin, Italy
| | - Antonino Cantivalli
- Department of Orthopaedics and Traumatology, AO Ordine Mauriziano Hospital, University of Torino, Largo Turati 62, 10128, Turin, Italy
| | - Davide Blonna
- Department of Orthopaedics and Traumatology, AO Ordine Mauriziano Hospital, University of Torino, Largo Turati 62, 10128, Turin, Italy
| | - Davide Edoardo Bonasia
- Department of Orthopaedics and Traumatology, AO Ordine Mauriziano Hospital, University of Torino, Largo Turati 62, 10128, Turin, Italy
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3D CAIPIRINHA SPACE versus standard 2D TSE for routine knee MRI: a large-scale interchangeability study. Eur Radiol 2022; 32:6456-6467. [PMID: 35353196 DOI: 10.1007/s00330-022-08715-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 02/03/2022] [Accepted: 03/05/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To perform a large-scale interchangeability study comparing 3D controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA) sampling perfection with application optimized contrast using different flip angle evolutions (SPACE) TSE with standard 2D TSE for knee MRI. METHODS In this prospective study, 250 patients underwent 3 T knee MRI, including a multicontrast 3D CAIPIRINHA SPACE TSE (9:26 min) and a standard 2D TSE protocol (12:14 min). Thirty-three (13%) patients had previous anterior cruciate ligament and/or meniscus surgery. Two radiologists assessed MRIs for image quality and identified pathologies of menisci, ligaments, and cartilage by using a 4-point Likert scale according to the level of diagnostic confidence. Interchangeability of the protocols was tested under the same-reader scenario using a bootstrap percentile confidence interval. Interreader reliability and intermethod concordance were also evaluated. RESULTS Despite higher image quality and diagnostic confidence for standard 2D TSE compared to 3D CAIPIRINHA SPACE TSE, the protocols were found interchangeable for diagnosing knee abnormalities, except for patellar (6.8% difference; 95% CI: 4.0, 9.6) and trochlear (3.6% difference; 95% CI: 0.8, 6.6) cartilage defects. The interreader reliability was substantial to almost perfect for 2D and 3D MRI (range κ, 0.785-1 and κ, 0.725-0.964, respectively). Intermethod concordance was almost perfect for all diagnoses (range κ, 0.817-0.986). CONCLUSION Multicontrast 3D CAIPIRINHA SPACE TSE and standard 2D TSE protocols perform interchangeably for diagnosing knee abnormalities, except for patellofemoral cartilage defects. Despite the radiologist's preference for 2D TSE imaging, a pursuit towards time-saving 3D TSE knee MRI is justified for routine practice. KEY POINTS • Multicontrast 3D CAIPIRINHA SPACE and standard 2D TSE protocols perform interchangeably for diagnosing knee abnormalities, except for patellofemoral cartilage defects. • Radiologists are more confident in diagnosing knee abnormalities on 2D TSE than on 3D CAIPIRINHA SPACE TSE MRI. • Despite the radiologist's preference for 2D TSE, a pursuit towards accelerated 3D TSE knee MRI is justified for routine practice.
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12
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Sui H, Li J, Liu L, Lv Z, Zhang Y, Dai Y, Mo Z. Accelerating Knee MRI: 3D Modulated Flip-Angle Technique in Refocused Imaging with an Extended Echo Train and Compressed Sensing. J Pain Res 2022; 15:577-590. [PMID: 35241934 PMCID: PMC8887673 DOI: 10.2147/jpr.s345210] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 01/28/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose The three-dimensional (3D) sequence of magnetic resonance imaging (MRI) plays a critical role in the imaging of musculoskeletal joints; however, its long acquisition time limits its clinical application. In such conditions, compressed sensing (CS) is introduced to accelerate MRI in clinical practice. We aimed to investigate the feasibility of an isotropic 3D variable-flip-angle fast spin echo (FSE) sequence with CS technique (CS-MATRIX) compared to conventional 2D sequences in knee imaging. Methods Images from different sequences of both the accelerated CS-MATRIX and the corresponding conventional acquisitions were prospectively analyzed and compared. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the structures within the knees were measured for quantitative analysis. The subjective image quality and diagnostic agreement were compared between CS-MATRIX and conventional 2D sequences. Quantitative and subjective image quality scores were statistically analyzed with the paired t-test and Wilcoxon signed-rank test, respectively. Diagnostic agreements of knee substructure were assessed using Cohen’s weighted kappa statistic. Results For quantitative analysis, images from the CS-MATRIX sequence showed a significantly higher SNR than T2-fs 2D sequences for visualizing cartilage, menisci, and ligaments, as well as a higher SNR than proton density (pd) 2D sequences for visualizing menisci and ligaments. There was no significant difference between CS-MATRIX and 2D T2-fs sequences in subjective image quality assessment. The diagnostic agreement was rated as moderate to very good between CS-MATRIX and 2D sequences. Conclusion This study demonstrates the feasibility and clinical potential of the CS-MATRIX sequence technique for detecting knee lesions The CS-MATRIX sequence allows for faster knee imaging than conventional 2D sequences, yielding similar image quality to 2D sequences.
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Affiliation(s)
- He Sui
- China-Japan Union Hospital of Jilin University, Changchun, People’s Republic of China
| | - Jin Li
- Jilin Province People’s Hospital, Changchun, People’s Republic of China
- The Department of Trauma Surgery, Shanghai Oriental Hospital, Shanghai, People's Republic of China
| | - Lin Liu
- China-Japan Union Hospital of Jilin University, Changchun, People’s Republic of China
| | - Zhongwen Lv
- China-Japan Union Hospital of Jilin University, Changchun, People’s Republic of China
| | - Yunfei Zhang
- Central Research Institute, United Imaging Healthcare, Shanghai, 201800, People’s Republic of China
| | - Yongming Dai
- Central Research Institute, United Imaging Healthcare, Shanghai, 201800, People’s Republic of China
| | - Zhanhao Mo
- China-Japan Union Hospital of Jilin University, Changchun, People’s Republic of China
- Correspondence: Zhanhao Mo, China-Japan Union Hospital of Jilin University, No. 126 Xiantai Street, Erdao District, Changchun, People’s Republic of China, Email
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13
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Trolinger-Meadows KD, Biedrzycki AH, He H, Werpy N. Three-Dimensional Segmentation and in silico Comparison of Equine Deep Digital Flexor Tendon Pathology in Horses Undergoing Repeated MRI Examination. Front Vet Sci 2021; 8:706046. [PMID: 34746274 PMCID: PMC8566955 DOI: 10.3389/fvets.2021.706046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 09/21/2021] [Indexed: 11/13/2022] Open
Abstract
The use of magnetic resonance imaging (MRI) has led to increased clinical and research applications using 3D segmentation and reconstructed volumetric data in musculoskeletal imaging. Lesions of the deep digital flexor tendon (DDFT) are a common pathology in horses undergoing MRI. Three-dimensional MRI reconstruction performed for volumetric tendon analysis in horses has not previously been documented. The aim of this proof-of-concept study was to evaluate the 3D segmentation of horses undergoing repeated MRI at several time points and to perform an analysis of the segmented DDFTs across time. MRI DICOM files were acquired from six horses undergoing repeated MRI examination of the foot for DDFT injury. Once segmented, volumetric tendon surface tessellation language (STL) files were created. Thickness and volumetric data were acquired for each tendon in addition to a tendon comparison across timepoints within each horse. Pearson correlation coefficients were calculated for comparison of MRI reports to computer analysis. There was a significant and positive correlation between MRI and medial record reports of clinical improvement or deterioration and computer analysis (r = 0.56, p = 0.01). The lower end range limit for tendon thickness varied between 0.16 and 1.74 mm. The upper end range limit for DDFT thickness varied between 4.6 and 23.6 mm. During tendon part comparison, changes in DDFT were reported between −3.0 and + 14.3 mm. Changes in DDFT size were non-uniform and demonstrated fluctuations throughout the tendon. The study was successful in establishing the volumetric appearance and thickness of the DDFT as it courses in the foot and tracking this over time. We encountered difficulties in accurate segmentation of the distal insertion of the DDFT as it blends with the distal phalanx. The data demonstrated that the DDFT can be segmented and volumetric studies based on size and shape can be performed using an in silico approach.
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Affiliation(s)
- Kimberly D Trolinger-Meadows
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, United States
| | - Adam H Biedrzycki
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, United States
| | - Hongjia He
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, United States
| | - Natasha Werpy
- Equine Diagnostic Imaging, Inc., Archer, FL, United States
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Altahawi F, Pierce J, Aslan M, Li X, Winalski CS, Subhas N. 3D MRI of the Knee. Semin Musculoskelet Radiol 2021; 25:455-467. [PMID: 34547811 DOI: 10.1055/s-0041-1730400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Three-dimensional (3D) magnetic resonance imaging (MRI) of the knee is widely used in musculoskeletal (MSK) imaging. Currently, 3D sequences are most commonly used for morphological imaging. Isotropic 3D MRI provides higher out-of-plane resolution than standard two-dimensional (2D) MRI, leading to reduced partial volume averaging artifacts and allowing for multiplanar reconstructions in any plane with any thickness from a single high-resolution isotropic acquisition. Specifically, isotropic 3D fast spin-echo imaging, with options for tissue weighting similar to those used in multiplanar 2D FSE imaging, is of particular interest to MSK radiologists. New applications for 3D spatially encoded sequences are also increasingly available for clinical use. These applications offer advantages over standard 2D techniques for metal artifact reduction, quantitative cartilage imaging, nerve imaging, and bone shape analysis. Emerging fast imaging techniques can be used to overcome the long acquisition times that have limited the adoption of 3D imaging in clinical protocols.
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Affiliation(s)
- Faysal Altahawi
- Section of Musculoskeletal Imaging, Imaging Institute, Cleveland Clinic, Cleveland, Ohio
| | - Jason Pierce
- Diagnostic Radiology Residency, Imaging Institute, Cleveland Clinic, Cleveland, Ohio
| | - Mercan Aslan
- Section of Musculoskeletal Imaging, Imaging Institute, Cleveland Clinic, Cleveland, Ohio
| | - Xiaojuan Li
- Section of Musculoskeletal Imaging, Imaging Institute, Cleveland Clinic, Cleveland, Ohio.,Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Carl S Winalski
- Section of Musculoskeletal Imaging, Imaging Institute, Cleveland Clinic, Cleveland, Ohio.,Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Naveen Subhas
- Section of Musculoskeletal Imaging, Imaging Institute, Cleveland Clinic, Cleveland, Ohio
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15
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Del Grande F, Hinterholzer N, Nanz D. 3D MRI: Technical Considerations and Practical Integration. Semin Musculoskelet Radiol 2021; 25:381-387. [PMID: 34547803 DOI: 10.1055/s-0041-1731059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
One of the main advantages of three-dimensional (3D) magnetic resonance imaging (MRI) is the possibility of isotropic voxels and reconstructed planar cuts through the volumetric data set in any orientation with multiplanar reformation software through real-time evaluation. For example, reformats by the radiologist during reporting allows exploitation of the full potential of isotropic 3D volumetric acquisition or through standardized retrospective reformats of thicker predefined slices of an isotropic volumetric data set by technologists. The main challenges for integrating 3D fast spin echo (FSE) and turbo spin-echo (TSE) MRI in clinical practice are a long acquisition time and some artifacts, whereas for integrating 3D gradient-recalled echo protocols, the main challenges are lower signal-to-noise ratios (SNRs) and the inability to produce intermediate, and T2-weighted contrast. The implementation of bidirectional parallel imaging acquisition and random undersampling acceleration strategies of 3D TSE pulse sequences substantially shortens the examination time with only minor SNR reductions. This article provides an overview of general technical considerations of 3D FSE and TSE sequences in musculoskeletal MRI. It also describes how these sequences achieve efficient data acquisition and reviews the main advantages and challenges for their introduction to clinical practice.
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Affiliation(s)
- Filippo Del Grande
- Clinica di Radiologia EOC, Istituto di Imaging della Svizzera Italiana (IIMSI), Lugano, Svizzera
| | - Natalie Hinterholzer
- SCMI, Swiss Center for Musculoskeletal Imaging, Balgrist Campus AG, Zürich, Switzerland
| | - Daniel Nanz
- SCMI, Swiss Center for Musculoskeletal Imaging, Balgrist Campus AG, Zürich, Switzerland.,University of Zürich, Zürich, Switzerland
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16
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Abstract
Three-dimensional (3D) magnetic resonance imaging of the spine is now clinically feasible due to technological advancements. Its advantages over two-dimensional imaging include higher in-plane spatial resolution and the ability for reformation in any plane that enables time savings in image acquisition and aids more accurate interpretation. Multispectral 3D techniques for imaging around metal are sometimes useful for evaluating anatomy adjacent to spinal fixation hardware. 3D gradient-recalled echo sequences, including ultrashort or zero time to echo sequences, can provide osseous detail similar to conventional computed tomography.
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Affiliation(s)
- Meghan Sahr
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York
| | - Ek Tsoon Tan
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York
| | - Darryl B Sneag
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York
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17
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Abstract
Magnetic resonance imaging provides a comprehensive evaluation of the shoulder including the rotator cuff muscles and tendons, glenoid labrum, long head biceps tendon, and glenohumeral and acromioclavicular joint articulations. Most institutions use two-dimensional sequences acquired in all three imaging planes to accurately evaluate the many important structures of the shoulder. Recently, the addition of three-dimensional (3D) acquisitions with 3D reconstructions has become clinically feasible and helped improve our understanding of several important pathologic conditions, allowing us to provide added value for referring clinicians. This article briefly describes techniques used in 3D imaging of the shoulder and discusses applications of these techniques including measuring glenoid bone loss in anterior glenohumeral instability. We also review the literature on routine 3D imaging for the evaluation of common shoulder abnormalities as 3D imaging will likely become more common as imaging software continues to improve.
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Affiliation(s)
- Steven P Daniels
- Department of Radiology, New York University Grossman School of Medicine, New York University, New York, New York
| | - Soterios Gyftopoulos
- Department of Radiology, New York University Grossman School of Medicine, New York University, New York, New York
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18
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Abstract
Computed tomography (CT) is most commonly used to produce three-dimensional (3D) models for evaluating bone and joint morphology in clinical practice. However, 3D models created from magnetic resonance imaging (MRI) data can be equally effective for comprehensive and accurate assessment of osseous and soft tissue structure morphology and pathology. The quality of 3D MRI models has steadily increased over time, with growing potential to replace 3D CT models in various musculoskeletal (MSK) applications. In practice, a single MRI examination for two-dimensional and 3D assessments can increase the value of MRI and simplify the pre- and postoperative imaging work-up. Multiple studies have shown excellent performance of 3D MRI models in shoulder injuries, in the hip in the setting of femoroacetabular impingement, and in the knee for the creation of bone surface models. Therefore, the utility of 3D MRI postprocessed models is expected to continue to rise and broaden in applications. Computer-based and artificial intelligence-assisted postprocessing techniques have tremendous potential to improve the efficiency of 3D model creation, opening many research avenues to validate the applicability of 3D MRI and establish 3D-specific quantitative assessment criteria. We provide a practice-focused overview of 3D MRI acquisition strategies, postprocessing techniques for 3D model creation, MSK applications of 3D MRI models, and an illustration of cases from our daily clinical practice.
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Affiliation(s)
- Mohammad Samim
- Department of Radiology, NYU Langone Medical Center, New York, New York
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19
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Sharifi A, Siebert MJ, Chhabra A. How to Measure Glenoid Bone Stock and Version and Why It Is Important: A Practical Guide. Radiographics 2021; 40:1671-1683. [PMID: 33001780 DOI: 10.1148/rg.2020200008] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Shoulder osteoarthritis (OA) is a common and debilitating condition and a source of high morbidity and medical expenditures across the world among individuals older than 60 years. Shoulder OA results in the gradual destruction of articular cartilage of the humeral head and glenoid component, causing inflammation, pain, and a restricted range of motion. Most patients are diagnosed with shoulder OA after experiencing shoulder pain and stiffness, and the diagnosis is often made after medical and physical histories are obtained and physical and imaging examinations are performed. Use of various surgical techniques such as total anatomic or reverse shoulder arthroplasty and hemiarthroplasty has increased in recent years, resulting in reduced morbidity and improved functional status of patients. However, the rate of surgical complications such as premature loosening of components is significant, reducing the effectiveness of such procedures. Data in the literature indicate that high-grade fatty infiltration of the rotator cuff muscle before surgery is associated with postoperative glenoid component loosening. High-grade rotator cuff fatty infiltration and atrophy have been found to be associated with more severe Walch classification-based glenoid morphology subtypes, increased joint line medialization, glenoid bone loss, and increased pathologic glenoid version. The authors describe how advanced imaging techniques are used for preoperative evaluation of the shoulder and discuss how to measure glenoid version and bone stock and classify glenoid morphology types on the basis of Walch classification, as these parameters are commonly used in surgical planning. Methods involving the use of Friedman and paleoglenoid lines for respective measurements are illustrated by using three-dimensional CT and MRI case examples. ©RSNA, 2020.
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Affiliation(s)
- Arghavan Sharifi
- From the School of Medicine (A.S., M.J.S.) and Department of Radiology and Orthopedic Surgery (A.C.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-8585
| | - Matthew J Siebert
- From the School of Medicine (A.S., M.J.S.) and Department of Radiology and Orthopedic Surgery (A.C.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-8585
| | - Avneesh Chhabra
- From the School of Medicine (A.S., M.J.S.) and Department of Radiology and Orthopedic Surgery (A.C.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-8585
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Van Dyck P, Smekens C, Vanhevel F, De Smet E, Roelant E, Sijbers J, Jeurissen B. Super-Resolution Magnetic Resonance Imaging of the Knee Using 2-Dimensional Turbo Spin Echo Imaging. Invest Radiol 2021; 55:481-493. [PMID: 32404629 DOI: 10.1097/rli.0000000000000676] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVES The purpose of this study was to assess the technical feasibility of 3-dimensional (3D) super-resolution reconstruction (SRR) of 2D turbo spin echo (TSE) knee magnetic resonance imaging (MRI) and to compare its image quality with conventional 3D TSE sampling perfection with application optimized contrast using different flip angle evolutions (SPACE) MRI. MATERIALS AND METHODS Super-resolution reconstruction 2D TSE MRI and 3D TSE SPACE images were acquired from a phantom and from the knee of 22 subjects (8 healthy volunteers and 14 patients) using a clinical 3-T scanner. For SRR, 7 anisotropic 2D TSE stacks (voxel size, 0.5 × 0.5 × 2.0 mm; scan time per stack, 1 minute 55 seconds; total scan time, 13 minutes 25 seconds) were acquired with the slice stack rotated around the phase-encoding axis. Super-resolution reconstruction was performed at an isotropic high-resolution grid with a voxel size of 0.5 × 0.5 × 0.5 mm. Direct isotropic 3D image acquisition was performed with the conventional SPACE sequence (voxel size, 0.5 × 0.5 × 0.5 mm; scan time, 12 minutes 42 seconds). For quantitative evaluation, perceptual blur metrics and edge response functions were obtained in the phantom image, and signal-to-noise and contrast-to-noise ratios were measured in the images from the healthy volunteers. Images were qualitatively evaluated by 2 independent radiologists in terms of overall image quality, edge blurring, anatomic visibility, and diagnostic confidence to assess normal and abnormal knee structures. Nonparametric statistical analysis was performed, and significance was defined for P values less than 0.05. RESULTS In the phantom, perceptual blur metrics and edge response functions demonstrated a clear improvement in spatial resolution for SRR compared with conventional 3D SPACE. In healthy subjects, signal-to-noise and contrast-to-noise ratios in clinically relevant structures were not significantly different between SRR and 3D SPACE. Super-resolution reconstruction provided better overall image quality and less edge blurring than conventional 3D SPACE, yet the perceived image contrast was better for 3D SPACE. Super-resolution reconstruction received significantly better visibility scores for the menisci, whereas the visibility of cartilage was significantly higher for 3D SPACE. Ligaments had high visibility on both SRR and 3D SPACE images. The diagnostic confidence for assessing menisci was significantly higher for SRR than for conventional 3D SPACE, whereas there were no significant differences between SRR and 3D SPACE for cartilage and ligaments. The interreader agreement for assessing menisci was substantial with 3D SPACE and almost perfect with SRR, and the agreement for assessing cartilage was almost perfect with 3D SPACE and moderate with SRR. CONCLUSIONS We demonstrate the technical feasibility of SRR for high-resolution isotropic knee MRI. Our SRR results show superior image quality in terms of edge blurring, but lower image contrast and fluid brightness when compared with conventional 3D SPACE acquisitions. Further contrast optimization and shortening of the acquisition time with state-of-the-art acceleration techniques are necessary for future clinical validation of SRR knee MRI.
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Affiliation(s)
- Pieter Van Dyck
- From the Department of Radiology, Antwerp University Hospital and University of Antwerp, Edegem
| | | | - Floris Vanhevel
- From the Department of Radiology, Antwerp University Hospital and University of Antwerp, Edegem
| | - Eline De Smet
- From the Department of Radiology, Antwerp University Hospital and University of Antwerp, Edegem
| | - Ella Roelant
- Clinical Trial Center (CTC), CRC Antwerp, Antwerp University Hospital and University of Antwerp, Edegem
| | - Jan Sijbers
- imec-Vision Lab, Department of Physics, University of Antwerp, Wilrijk, Belgium
| | - Ben Jeurissen
- imec-Vision Lab, Department of Physics, University of Antwerp, Wilrijk, Belgium
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MRI evaluation of solid soft tissue masses of the fingers with pathology correlation. Eur J Radiol 2020; 135:109465. [PMID: 33341071 DOI: 10.1016/j.ejrad.2020.109465] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 11/11/2020] [Accepted: 12/01/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Space occupying lesions of the fingers are commonly encountered in clinical and radiology practice. The objective of this study was to determine the characteristics of these lesions on MRI and to correlate with surgical pathology results. MATERIAL AND METHODS This IRB-approved HIPAA-compliant study retrospectively evaluated the clinical, imaging and pathology findings of 100 consecutive patients referred for evaluation of solid soft tissue masses of the fingers. Only solid lesions with MR imaging prior to surgery were included in this study. MR images and when available corresponding radiographs were evaluated by two radiologist in regard to signal characteristics, relation to surrounding structures and enhancement. All masses were classified into different groups based on pathology results. RESULTS Tenosynovial giant cell tumor (TSGCT) and fibroma of the tendon sheath were the most common solid tumors (36 %) and malignant tumors represent only 5% of the cohort. 70 % of masses with low T2 signal were TSGCT and fibroma of tendon sheath; 100 % of masses with peripheral high T2 signal and central low T2 signal/thrombus were vascular lesions, representing 41 % of the total vascular lesions in the cohort. Additionally, 100 % of serpiginous/tubular shaped masses were vascular lesions and 67 % of masses with infiltrative borders were malignant masses. Enhancement was important in identifying solid lesions but there was no statistical difference between groups related to enhancement pattern. There was a good agreement for all analyses between both readers. CONCLUSION Typical MR findings can help to narrow the differential diagnosis in the evaluation of finger masses and provide crucial information to guide further management.
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Banjar M, Nor FEM, Singh P, Horiuchi S, Quek ST, Yoshioka H. Comparison of visibility of ulnar sided triangular fibrocartilage complex (TFCC) ligaments between isotropic three-dimensional and two-dimensional high-resolution FSE MR images. Eur J Radiol 2020; 134:109418. [PMID: 33302025 DOI: 10.1016/j.ejrad.2020.109418] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 10/29/2020] [Accepted: 11/15/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Assessment of the ulnar attachment of the triangular fibrocartilage complex (TFCC) in a neutral forearm position remains challenging. Our study aims to evaluate the visibility of ulnar sided TFCC on 3 T MRI and compare isotropic 3D FSE sequences utilizing multiplanar reformation (MPR) with standard high-resolution 2D FSE sequences. METHODS Ninety-nine MRI wrist studies in patients with wrist pain were retrospectively analyzed. Patients were scanned with a neutral forearm position and reviewed with isotropic 3D coronal FSE proton density-weighted images (PDWI) and 2D coronal FSE PDWI. MPR was used for 3D assessment. Visibility of the dorsal radioulnar ligament (DRUL), triangular ligament (TL), and volar radioulnar ligament (VRUL) was assessed by three raters utilizing a five-point grading scale. Grades were compared between 2D and 3D sequences. Intrarater and interrater reliability for the delineation of anatomic structures was measured by Spearman's rank correlation coefficient, Cohen's kappa, and percentage of exact agreement/agreement within a range of ±1 score point. RESULTS Visibility grades in 3D were statistically significantly higher than those in 2D in all ligaments by all raters (p < 0.01). In Spearman's rank correlation coefficient and Cohen's kappa analysis, interrater correlations and agreements are variable but tended to be higher on 3D than on 2D. Both 2D and 3D sequences showed high intrarater exact agreement in all ligaments (80-91 % on 2D and 88-95 % on 3D). All exact interrater agreements on 3D were acceptable for TL (83-93 %) and acceptable to close to acceptable for VRUL (72-96 %). CONCLUSION The utilization of isotopic 3D imaging combined with MPR function significantly improves visibility of ulnar attachment of the TFCC.
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Affiliation(s)
- Mai Banjar
- Department of Diagnostic Imaging, National University Hospital, Singapore; Medical Imaging Department, King Abdullah Medical Complex Jeddah, Saudi Arabia.
| | | | - Pavel Singh
- Department of Diagnostic Imaging, National University Hospital, Singapore
| | - Saya Horiuchi
- Department of Radiology, St Luke's International Hospital, Tokyo, Japan
| | - Swee Tian Quek
- Department of Diagnostic Imaging, National University Hospital, Singapore
| | - Hiroshi Yoshioka
- Department of Radiological Sciences, University of California, Irvine, CA, USA
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Luna R, Fritz J, Del Grande F, Ahlawat S, Fayad LM. Determination of skeletal tumor extent: is an isotropic T1-weighted 3D sequence adequate? Eur Radiol 2020; 31:3138-3146. [PMID: 33179165 DOI: 10.1007/s00330-020-07394-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 10/08/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To test the hypothesis that an accelerated, T1-weighted 3D CAIPIRINHA SPACE sequence with isotropic voxel size offers a similar performance to conventional T1-weighted 2D TSE (turbo spin echo) for the evaluation of bone tumor extent and characteristics. METHODS Thirty-four patients who underwent 3-T MRI with 3DT1 (CAIPIRINHA SPACE TSE) and 2DT1 (TSE) were included. Sequence acquisition time was reported. Two radiologists independently evaluated each technique for tumor location, size/length, tumor-to-joint distance, signal intensity, margin/extraosseous extension, and signal-to-noise (SNR) and contrast-to-noise (CNR) ratios. RESULTS Tumors were located in long (20/36, 55.5%) and pelvic (16/36, 44.4%) bones. 3DT1 sequence required an average acquisition time of 235 s (± 42 s, range 156-372), while two plane 2DT1 sequences combined (coronal and axial) had an average acquisition time of 381 s (± 73 s, range 312-523). There was no difference in the measurements of tumor length and tumor-to-joint distance (p = 0.95) between 3DT1 and 2DT1 images. Tumors were hypointense (17/36, 47.2% vs 17/36, 47.2%), isointense (12/36, 33.3% vs 12/36, 33.3%), or hyperintense (7/36, 19.4% vs 7/36, 19.4%) on 3DT1 vs 2DT1, respectively. Assessment of tumor margins and extraosseous extension was similar, and there was no difference in tumor SNR or CNR (p > 0.05). CONCLUSIONS An accelerated 3D CAIPIRINHA SPACE T1 sequence provides comparable assessments of intramedullary bone tumor extent and similar tumor characteristics to conventional 2DT1 MRI. For the assessment of bone tumors, the isotropic volume acquisition and multiplanar reformation capability of the 3DT1 datasets can obviate the need for 2DT1 acquisitions in multiple planes. KEY POINTS • 3DT1 offers an equivalent performance to 2DT1 for the assessment of bone tumor characteristics, with faster and higher resolution capability, obviating the need for acquiring 2DT1 in multiple planes. • There was no difference in the measurements of tumor length and tumor-to-joint distance obtained on 3DT1 and 2DT1 images. • There was no difference in signal-to-noise ratio (SNR) or contrast-to-noise ratio (CNR) measures between 3DT1 and 2DT1.
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Affiliation(s)
- Rodrigo Luna
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA
| | - Jan Fritz
- Grossman School of Medicine, NYU Langone Health, 550 First Avenue, New York, NY, 10016, USA
| | - Filippo Del Grande
- Servizio si Radiologia del Sottoceneri, Ospedale Regionale di Lugano, Lugano, Ticino, Switzerland
| | - Shivani Ahlawat
- Division of Musculoskeletal Imaging, The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA
| | - Laura M Fayad
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA.
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Lee S, Lee GY, Kim S, Park YB, Lee HJ. Clinical utility of fat-suppressed 3-dimensional controlled aliasing in parallel imaging results in higher acceleration sampling perfection with application optimized contrast using different flip angle evolutions MRI of the knee in adults. Br J Radiol 2020; 93:20190725. [PMID: 32516546 DOI: 10.1259/bjr.20190725] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To compare htree-dimensional CAIPIRINHA SPACE and two-dimensional turbo spin echo (2D TSE) MRI in the diagnosis of knee pathology in symptomatic adult patients. METHODS From February to September in 2018, 120 patients who underwent a knee MRI using both 3D CAIPIRINHA SPACE and 2D TSE MRI were enrolled. The signal-to-noise ratios (SNRs) and contrast-to-noise ratio (CNR) of the 2D and 3D MRI were compared using a paired t-test. Two radiologists independently evaluated both 2D and 3D MRI images using scoring systems for the menisci, ligaments, and cartilage. Intermethod, inter- and intrareader agreements were determined using an intraclass correlation coefficient (ICC). The diagnostic performance of both methods was measured in 44 patients with arthroscopy. RESULTS The mean scan time of 3D CAIPIRINHA SPACE MRI (4' 43") was shorter than that of 2D TSE MRI (17' 27"). The mean SNR and CNR of 3D CAIPIRINHA SPACE was higher than those of 2D TSE MRI (mean difference, 3.97 of SNR and 1.58 of CNR; p < 0.001 and p = .038, respectively). Intermethod (ICC, 0.84-1.0) and inter-reader (ICC, 0.75-0.97), and intra-reader agreements (ICC, 0.87-1.0) were good or excellent. The diagnostic accuracy of 3D CAIPIRINHA SPACE sequence was equal for ligament (95.5%) and better for meniscal and cartilage evaluation (84.1% each), compared to 2D TSE MRI (79.5% each). CONCLUSION The fat-suppressed 3D CAIPIRINHA SPACE MRI maybe useful in clinical practice for the evaluation of the knee in place of the 2D conventional MRI protocol. ADVANCES IN KNOWLEDGE 1. The 3D CAIPIRINHA SPACE MRI of the knee joint may be acceptable to be used in clinical practice showing comparable imaging quality compared to conventional 2D TSE MRI.2. Compared with arthroscopic findings as the gold-standard, the diagnostic performance of 3D CAIPIRINHA SPACE MRI was equal or better for knee joint evaluation than that of 2D TSE MRI, as well as with shorter scan time.
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Affiliation(s)
- Seungho Lee
- Department of the Radiology, Chung-Ang University Hospital, Seoul, Korea
| | - Guen Young Lee
- Department of the Radiology, Chung-Ang University Hospital, Seoul, Korea
| | - Sujin Kim
- Department of the Radiology, Chung-Ang University Hospital, Seoul, Korea
| | - Yong-Beom Park
- Department of the orthopedic Surgery, Chung-Ang University Hospital, Seoul, Korea
| | - Han-Jun Lee
- Department of the orthopedic Surgery, Chung-Ang University Hospital, Seoul, Korea
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Iovane A, Palma A, Messina G, Cappello F, Thomas E, Fiore R. The posterior talocalcaneal ligament: an MRI evaluation. Surg Radiol Anat 2020; 42:1167-1174. [DOI: 10.1007/s00276-020-02506-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 05/25/2020] [Indexed: 10/24/2022]
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Bae Y, Perta K, Obert K, Kalmar E. Contracted Extravelar Segments of the Levator Veli Palatini Muscle: A Magnetic Resonance Imaging Morphometric Study. Cleft Palate Craniofac J 2020; 58:118-125. [PMID: 32551942 DOI: 10.1177/1055665620933472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To provide detailed descriptions of contraction-induced morphometric changes in the extravelar segments of the levator veli palatini (LVP) muscle using 3-dimensional (3-D) magnetic resonance imaging (MRI). DESIGN Three-dimensional MRI data were acquired at rest and during "silent /i/" from 4 singers. During silent /i/, participants voluntarily sustained velar elevation while breathing orally for the entire scan time. Focusing on the extravelar segments, LVP length, angle of the muscle origin, and cross-sectional area (CSA), measurements were obtained and compared between tasks. RESULTS Three of the 4 participants exhibited the expected patterns of change following concentric contraction of the LVP muscle. Consistent changes from the resting to the contracted state included reductions in LVP length by 13.5% and angle of the muscle origin by 9.8%, as well as increases in CSAs by 22.1%, on average. CONCLUSIONS This study presented high-resolution data of the LVP muscle behavior with the first in vivo 3-D measurements of the contracted LVP muscle, which can be useful for the validation of computational models that aim at describing biomechanical properties of the LVP muscle in future research. The active behavior of the extravelar LVP muscle also provides some insight on optimal LVP muscle geometry to consider during cleft palate repair.
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Affiliation(s)
- Youkyung Bae
- Department of Speech and Hearing Science, 215745The Ohio State University, Columbus, OH, USA
| | - Karen Perta
- Department of Speech and Hearing Science, 215745The Ohio State University, Columbus, OH, USA
| | - Kerrie Obert
- Department of Otolaryngology, 215745The Ohio State University, Columbus, OH, USA
| | - Eileen Kalmar
- Department of Biomedical Education and Anatomy, 12305The Ohio State University, Columbus, OH, USA
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Ha DH. MR Neurography: Current Several Issues for Novice Radiologists. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2020; 81:81-100. [PMID: 36238129 PMCID: PMC9432089 DOI: 10.3348/jksr.2020.81.1.81] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 12/24/2019] [Accepted: 01/08/2020] [Indexed: 11/15/2022]
Abstract
말초신경병증의 진단을 위해 MR neurography의 사용이 점차 증가하고 있다. 고대조도와 고해상도로 말초신경을 직접 영상화한 MR 영상을 MR neurography라고 하고, 지방억제 T2 강조영상과 확산강조영상이 흔히 사용되는 시퀀스이다. 작은 직경, 복잡한 해부학적 구조를 가진 말초신경을 합리적 시간 안에 영상화하기 위해서 최신의 isotropic 3차원 기법, 다양한 고속영상기법, post-processing 영상 기법 등이 사용된다. 이런 발전들로 인해 MR neurography가 유용하게 사용되지만 항상 적절한 MR neurography 영상을 얻을 수 있는 것은 아니다. 적절한 MR neurography 영상을 얻기 위해 영상의학과 의사가 고려해야 할 다음의 몇가지 쟁점들이 있다. 이에는 적절한 표준 프로토콜의 선책, 지방억제 기법의 선택, 해상도와 field of view와 slice thickness 간의 상호 관계의 이해, 적절한 post-processing 영상 기법의 적용, 2차원 영상획득 기법과 3차원 영상획득 기법의 장단점, 근위부 말초신경과 말단부 말초신경의 T2 대조도의 차이, 말초신경에 인접한 정맥이 MR neurography에 미치는 영향, 확산강조영상에서 기하학적 왜곡의 발생과 적절한 b value의 선택 등이다. 이런 쟁점들을 잘 이해하는 것이 경험이 적은 영상의학과 의사가 적절한 MR neurography 영상을 얻고, 말초신경병증을 정확히 평가하는 데 많은 도움이 될 것이다.
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Affiliation(s)
- Dong-ho Ha
- Department of Radiology, Dong-A University, Busan, Korea
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van Vucht N, Santiago R, Lottmann B, Pressney I, Harder D, Sheikh A, Saifuddin A. The Dixon technique for MRI of the bone marrow. Skeletal Radiol 2019; 48:1861-1874. [PMID: 31309243 DOI: 10.1007/s00256-019-03271-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 06/25/2019] [Accepted: 06/27/2019] [Indexed: 02/02/2023]
Abstract
Dixon sequences are established as a reliable MRI technique that can be used for problem-solving in the assessment of bone marrow lesions. Unlike other fat suppression methods, Dixon techniques rely on the difference in resonance frequency between fat and water and in a single acquisition, fat only, water only, in-phase and out-of-phase images are acquired. This gives Dixon techniques the unique ability to quantify the amount of fat within a bone lesion, allowing discrimination between marrow-infiltrating and non-marrow-infiltrating lesions such as focal nodular marrow hyperplasia. Dixon can be used with gradient echo and spin echo techniques, both two-dimensional and three-dimensional imaging. Another advantage is its rapid acquisition time, especially when using traditional two-point Dixon gradient echo sequences. Overall, Dixon is a robust fat suppression method that can also be used with intravenous contrast agents. After reviewing the available literature, we would like to advocate the implementation of additional Dixon sequences as a problem-solving tool during the assessment of bone marrow pathology.
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Affiliation(s)
- Niels van Vucht
- Department of Medical Imaging, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, UK.
| | - Rodney Santiago
- Department of Medical Imaging, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, UK
| | - Bianca Lottmann
- Department of Medical Imaging, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, UK
| | - Ian Pressney
- Department of Medical Imaging, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, UK
| | - Dorothee Harder
- Clinic of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Adnan Sheikh
- Department of Medical Imaging, The Ottawa Hospital, Civic Campus, 1053 Carling Avenue, Ottawa, Ontario, K1Y 4E9, Canada
| | - Asif Saifuddin
- Department of Medical Imaging, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, HA7 4LP, UK
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Duran AH, Duran MN, Masood I, Maciolek LM, Hussain H. The Additional Diagnostic Value of the Three-dimensional Volume Rendering Imaging in Routine Radiology Practice. Cureus 2019; 11:e5579. [PMID: 31695998 PMCID: PMC6820665 DOI: 10.7759/cureus.5579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Three-dimensional volume rendering (3DVR) is useful in a wide variety of medical-imaging applications. The increasingly advanced capabilities of CT and MRI to acquire volumetric data sets with isotropic voxels have resulted in the increased use of the 3DVR techniques for clinical applications. The two most commonly used techniques are the maximum intensity projection (MIP) and, more recently, 3DVR. Several kinds of medical imaging data could be reconstructed for 3D display, including CT, MRI, and ultrasonography (US). In particular, the 3D CT imaging has been developed, improved, and widely used of late. Understanding the mechanisms of 3DVR is essential for the accurate evaluation of the resulting images. Although further research is required to detect the efficiency of 3DVR in radiological applications, with wider availability and improved diagnostic performance, 3DVR is likely to enjoy widespread acceptance in the radiology practice going forward.
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Affiliation(s)
| | | | - Irfan Masood
- Radiology, University of Texas Medical Branch, Galveston, USA
| | | | - Huda Hussain
- Radiology, University of Texas Medical Branch, Galveston, USA
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Suzuki N, Kuribayashi A, Sakamoto K, Sakamoto J, Nakamura S, Watanabe H, Harada H, Kurabayashi T. Diagnostic abilities of 3T MRI for assessing mandibular invasion of squamous cell carcinoma in the oral cavity: comparison with 64-row multidetector CT. Dentomaxillofac Radiol 2019; 48:20180311. [PMID: 30633558 DOI: 10.1259/dmfr.20180311] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To evaluate the diagnostic accuracies of 3T MRI in evaluating mandibular invasion of squamous cell carcinoma (SCC) in the oral cavity and to compare those with that of multidetector CT (MDCT). METHODS 41 cases with oral SCC examined by both 3T MRI and MDCT prior to surgery were included in this study. Intravenous contrast medium was administered in all examinations. Images were evaluated for the presence or absence of mandibular invasion and mandibular canal involvement by the tumour. For MRI, both two-dimensional (2D) fast spin echo (FSE) and three-dimensional (3D) volumetric interpolated breath-hold examination (VIBE) images were used for the evaluation. For MDCT, dental CT cross-sectional images were rused. The results were correlated with histopathological findings, and sensitivity and specificity of each imaging technique were calculated.DMFR prrof. RESULTS Histopathologically, 32 of 41 cases had mandibular invasion and 10 cases had mandibular canal involvement. For mandibular invasion, all three imaging techniques showed sensitivities of 100%. However, the specificities of 2D FSE (56%) and 3D VIBE (78%) were lower than that of MDCT (89%), although the differences were not significant. For mandibular canal involvement, whereas the sensitivities of all three imaging techniques were 100%, the specificities of 2D FSE, 3D VIBE and MDCT were 54, 62 and 85%, respectively. The specificity of 2D FSE was significantlylower than that of MDCT (P < 0.017). CONCLUSIONS In the evaluation of mandibular invasion, 3T MRI was not as accurate as MDCT. In particular, 2D FSE sequences showed significantly lower specificity than MDCT in evaluating the extent of mandibular invasion. The use of 3D VIBE sequence slightly improved the low specificity of 2D FSE sequences.
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Affiliation(s)
- Noriko Suzuki
- 1 Department of Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University , Tokyo , Japan
| | - Ami Kuribayashi
- 1 Department of Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University , Tokyo , Japan
| | - Kei Sakamoto
- 2 Department of Oral Pathology, Graduate School, Tokyo Medical and Dental University , Tokyo , Japan
| | - Junichiro Sakamoto
- 1 Department of Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University , Tokyo , Japan
| | - Shin Nakamura
- 1 Department of Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University , Tokyo , Japan
| | - Hiroshi Watanabe
- 1 Department of Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University , Tokyo , Japan
| | - Hiroyuki Harada
- 3 Department of Oral and Maxillofacial Surgery, Graduate School, Tokyo Medical and Dental University , Tokyo , Japan
| | - Tohru Kurabayashi
- 1 Department of Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University , Tokyo , Japan
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Sueoka T, Tanitame K, Honda Y, Shoji T, Yamasaki T, Adachi N, Kazuo A. Utility of radial reformation of three-dimensional fat-suppressed multi-echo gradient-recalled-echo images for the evaluation of acetabular labral injuries and femoroacetabular impingement. Skeletal Radiol 2019; 48:267-273. [PMID: 30006827 DOI: 10.1007/s00256-018-3026-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 06/24/2018] [Accepted: 07/05/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To assess the utility of the radial reformation of three-dimensional fat-suppressed multi-echo gradient-recalled-echo (3D FS me-GRE) for evaluating acetabular labral injuries and femoroacetabular impingement (FAI). MATERIALS AND METHODS A total of 25 patients with suspected acetabular labral injuries were examined using 3D FS me-GRE and radial 2D T2*-weighted imaging (T2*WI) on a 3-T magnetic resonance imaging (MRI) scanner. The range of acetabular labral injuries was evaluated by radial reformation through the center of the acetabulum perpendicular to the plane across the entire acetabular rim (type 1 radial reformation) of 3D FS me-GRE and radial 2D T2*WI. To evaluate the FAI morphology, we performed radial reformation perpendicular to the central axis of the femoral head and neck (type 2 radial reformation) of 3D FS me-GRE. RESULTS Acetabular labral injuries were identified in 23 patients, and no acetabular labral injury was seen in two patients on type 1 radial reformation of 3D FS me-GRE and radial 2D T2*WI. The diagnostic concordance rate for the range of acetabular labral injuries between the two imaging methods was 76.0%, and there was excellent agreement for the injured angles (r = 0.977, p < 0.001). FAI morphology could be evaluated in all patients (no FAI, n = 8; cam, n = 10; pincer, n = 4; combined cam and pincer, n = 3) using type 2 radial reformation of 3D FS me-GRE. CONCLUSIONS Type 1 and type 2 radial reformations of 3D FS me-GRE imaging were useful for evaluating acetabular labral injuries and determining whether patients with acetabular labral injuries have FAI, respectively.
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Affiliation(s)
- Takahiro Sueoka
- Department of Diagnostic Radiology, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Keizo Tanitame
- Department of Radiology, Chugoku Rosai Hospital, Hiro-Tagaya 1-5-1, Kure, 737-0193, Japan.
| | - Yukiko Honda
- Department of Diagnostic Radiology, Graduate School and Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takeshi Shoji
- Department of Orthopaedic Surgery, Division of Medicine, Biomedical Sciences Major, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Takuma Yamasaki
- Department of Orthopaedic Surgery, Division of Medicine, Biomedical Sciences Major, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Nobuo Adachi
- Department of Orthopaedic Surgery, Division of Medicine, Biomedical Sciences Major, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Awai Kazuo
- Department of Diagnostic Radiology, Graduate School and Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Altahawi F, Subhas N. 3D MRI in Musculoskeletal Imaging: Current and Future Applications. CURRENT RADIOLOGY REPORTS 2018. [DOI: 10.1007/s40134-018-0287-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Lee SH, Yun SJ, Jin W, Park SY, Park JS, Ryu KN. Comparison between 3D isotropic and 2D conventional MR arthrography for diagnosing rotator cuff tear and labral lesions: A meta-analysis. J Magn Reson Imaging 2018; 48:1034-1045. [DOI: 10.1002/jmri.26024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 02/20/2018] [Indexed: 02/01/2023] Open
Affiliation(s)
- Sun Hwa Lee
- Department of Emergency Medicine; Sanggye Paik Hospital, Inje University College of Medicine; Seoul Republic of Korea
| | - Seong Jong Yun
- Department of Radiology; Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine; Seoul Republic of Korea
| | - Wook Jin
- Department of Radiology; Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine; Seoul Republic of Korea
| | - So Young Park
- Department of Radiology; Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine; Seoul Republic of Korea
| | - Ji Seon Park
- Department of Radiology; Kyung Hee University Hospital; Seoul Republic of Korea
| | - Kyung Nam Ryu
- Department of Radiology; Kyung Hee University Hospital; Seoul Republic of Korea
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Koh E, Walton ER, Watson P. VIBE MRI: an alternative to CT in the imaging of sports-related osseous pathology? Br J Radiol 2018; 91:20170815. [PMID: 29474097 DOI: 10.1259/bjr.20170815] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
MRI is an excellent diagnostic tool in the imaging of sports-related musculoskeletal pathology; however, standard slice thickness acquisitions can lack the spatial resolution to accurately define and characterise osseous abnormalities. Standard MRI sequences may be supplemented with CT to reduce diagnostic uncertainty. We provide a clinical perspective, in the form of pictorial review, on the potential applications of 3D MRI sequences, specifically using volumetric interpolated breath-hold examination in the characterisation of various musculoskeletal osseous pathologies. The potential to negate the requirement for CT in a young radiation sensitive cohort is a clinically significant concept and suggests the requirement for further studies comparing the performance of volumetric MRI to CT.
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Affiliation(s)
- Eamon Koh
- 1 MRI, Envision Medical Imaging , Wembley, Perth, WA , Australia
| | - Edward Rj Walton
- 2 Radiology, Fiona Stanley and Fremantle Hospitals , Murdoch and Fremantle, WA , Australia
| | - Phil Watson
- 3 MRI, Envision Medical Imaging , Wembley, Perth, WA , Australia
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Advanced MRI Techniques of the Shoulder Joint: Current Applications in Clinical Practice. AJR Am J Roentgenol 2017; 209:544-551. [PMID: 28829170 DOI: 10.2214/ajr.17.17945] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE We are fortunate to live in a time when real advances in medicine are happening at an increasingly rapid pace. This is especially true in the field of radiology, and keeping abreast of these advances is one of the main challenges of clinical practice. Traditionally, cutting edge techniques in our field have been researched and validated at major academic medical centers before slowly making their way into the armamentarium of routine clinical practice. However, the improved ability to communicate and disseminate information in our modern age has facilitated more rapid implementation of new techniques to allow us to better serve our patients. CONCLUSION As such, this article aims to review the current standards for MRI of the shoulder used in routine practice. Furthermore, we will discuss some of the most recent advances in shoulder MRI, with particular emphasis on the applicability of an additional axial 3D T1-weighted FLASH sequence with Dixon-based water-fat separation in routine clinical practice that can be useful in characterizing several commonly encountered pathologic processes of the shoulder joint.
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Barbera F, Lorenzetti F, Marsili R, Ragoni M, Lisa A, Zampa V, Pantaloni M. MRI anatomical preoperative evaluation of distally based peroneus brevis muscle flap in reconstructive surgery of the lower limb. J Plast Reconstr Aesthet Surg 2017; 70:1563-1570. [PMID: 28720406 DOI: 10.1016/j.bjps.2017.06.018] [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] [Received: 11/30/2016] [Revised: 06/11/2017] [Accepted: 06/18/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND The distally based peroneus brevis muscle flap has proved to be a simple solution for small- to moderate-sized wounds of the lower limb. The length of the muscle belly suitable for coverage is a crucial parameter. In this study, we evaluated the capability of 3D MRI of the lower limb to measure it preoperatively. METHODS Between 2008 and 2017, 32 patients with lower limb defects underwent preoperative MRI to measure the peroneus brevis muscle length. All patients underwent reconstruction, and the muscle was measured again intraoperatively during surgical dissection. Surgical measurements were then compared to the MRI ones. RESULTS MRI measures of the peroneus brevis muscle belly ranged from 9 to 21 cm (μ = 14.44 ± 3.43 cm), and intraoperative measures ranged from 9 to 20 cm (μ = 14.2 ± 2.3 cm). Thirty of 32 intraoperative measures corresponded to the MRI ones (variation = ± 1 cm, r = 0.92, p = 0.002). One patient showed an intraoperative muscle length 3 cm shorter than the MRI measure, and another patient had intraoperative muscle length 3 cm longer than the MRI one. All flaps survived, and no secondary local flap coverage was required, with no flap-related complication, limited donor site morbidity, and acceptable patient discomfort. CONCLUSIONS The reverse peroneus brevis muscle flap is a versatile alternative to free flap reconstruction in small- to moderate-sized defects of the lower limb. Preoperative 3D MRI is accurate to evaluate the anatomy of the muscle when performed by an expert radiologist. In our experience, it should become part of preoperative workup before performing a peroneus brevis flap procedure.
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Affiliation(s)
- Federico Barbera
- Plastic and Reconstructive Surgery Unit, University of Pisa, Santa Chiara Hospital, Pisa, Italy; Scuola Superiore Sant'Anna di Studi Universitari e Perfezionamento, Pisa, Italy.
| | - Fulvio Lorenzetti
- Plastic and Reconstructive Surgery Unit, University of Pisa, Santa Chiara Hospital, Pisa, Italy
| | - Ricccardo Marsili
- Plastic and Reconstructive Surgery Unit, University of Pisa, Santa Chiara Hospital, Pisa, Italy
| | - Matteo Ragoni
- Plastic and Reconstructive Surgery Unit, University of Pisa, Santa Chiara Hospital, Pisa, Italy
| | - Andrea Lisa
- Humanitas Research Hospital, University of Milan, Italy
| | - Virna Zampa
- Diagnostic Radiology Department, University of Pisa, Italy
| | - Marcello Pantaloni
- Plastic and Reconstructive Surgery Unit, University of Pisa, Santa Chiara Hospital, Pisa, Italy
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Welch ML, Jaffray DA. The correction of time and temperature effects in MR-based 3D Fricke xylenol orange dosimetry. Phys Med Biol 2017; 62:3221-3236. [PMID: 28164865 DOI: 10.1088/1361-6560/aa5e63] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Previously developed MR-based three-dimensional (3D) Fricke-xylenol orange (FXG) dosimeters can provide end-to-end quality assurance and validation protocols for pre-clinical radiation platforms. FXG dosimeters quantify ionizing irradiation induced oxidation of Fe2+ ions using pre- and post-irradiation MR imaging methods that detect changes in spin-lattice relaxation rates (R 1 = [Formula: see text]) caused by irradiation induced oxidation of Fe2+. Chemical changes in MR-based FXG dosimeters that occur over time and with changes in temperature can decrease dosimetric accuracy if they are not properly characterized and corrected. This paper describes the characterization, development and utilization of an empirical model-based correction algorithm for time and temperature effects in the context of a pre-clinical irradiator and a 7 T pre-clinical MR imaging system. Time and temperature dependent changes of R 1 values were characterized using variable TR spin-echo imaging. R 1-time and R 1-temperature dependencies were fit using non-linear least squares fitting methods. Models were validated using leave-one-out cross-validation and resampling. Subsequently, a correction algorithm was developed that employed the previously fit empirical models to predict and reduce baseline R 1 shifts that occurred in the presence of time and temperature changes. The correction algorithm was tested on R 1-dose response curves and 3D dose distributions delivered using a small animal irradiator at 225 kVp. The correction algorithm reduced baseline R 1 shifts from -2.8 × 10-2 s-1 to 1.5 × 10-3 s-1. In terms of absolute dosimetric performance as assessed with traceable standards, the correction algorithm reduced dose discrepancies from approximately 3% to approximately 0.5% (2.90 ± 2.08% to 0.20 ± 0.07%, and 2.68 ± 1.84% to 0.46 ± 0.37% for the 10 × 10 and 8 × 12 mm2 fields, respectively). Chemical changes in MR-based FXG dosimeters produce time and temperature dependent R 1 values for the time intervals and temperature changes found in a typical small animal imaging and irradiation laboratory setting. These changes cause baseline R 1 shifts that negatively affect dosimeter accuracy. Characterization, modeling and correction of these effects improved in-field reported dose accuracy to less than 1% when compared to standardized ion chamber measurements.
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Affiliation(s)
- Mattea L Welch
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
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Clinical utility of optimized three-dimensional T1-, T2-, and T2*-weighted sequences in spinal magnetic resonance imaging. Jpn J Radiol 2017; 35:135-144. [PMID: 28233194 DOI: 10.1007/s11604-017-0621-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 02/10/2017] [Indexed: 10/20/2022]
Abstract
This article reviews the clinical utility of 3D magnetic resonance imaging (MRI) sequences optimized for the evaluation of various intraspinal lesions. First, intraspinal tumors with hypervascular components and arteriovenous malformations (AVM) are clearly shown on contrast-enhanced (CE)-3D T1-weighted gradient-echo (GE) sequences with high spatial resolution. Second, dynamic CE-3D time-resolved magnetic resonance angiography (MRA) shows delineated feeding arteries of intraspinal AVM or arteriovenous fistula (AVF), greatly aiding subsequent digital subtraction angiography (DSA). Third, 3D multiecho T2*-weighted GE sequences are used to visualize intraspinal structures and spinal cord lesions and are sensitive to the magnetic susceptibility of intraspinal hemorrhages. Three-dimensional balanced steady-state free precession (SSFP) and multishot 3D balanced non-SSFP sequences produce contiguous thin images with high signal-to-noise ratio (SNR) in short scanning times. Intraspinal cystic lesions and small nerve-root tumors in subarachnoid space can be viewed using 3D balanced SSFP. Spinal cord myelomalacia and cord compression can be evaluated on fat-suppressed multishot 3D balanced non-SSFP. Finally, a 3D T2-weighted fast spin-echo (FSE) sequence with variable flip angle (FA) refocusing pulse improves through-plane spatial resolution over conventional 2D T2-weighted FSE sequences while matching image contrast.
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Sung J, Jee WH, Jung JY, Jang J, Kim JS, Kim YH, Ha KY. Diagnosis of Nerve Root Compromise of the Lumbar Spine: Evaluation of the Performance of Three-dimensional Isotropic T2-weighted Turbo Spin-Echo SPACE Sequence at 3T. Korean J Radiol 2017; 18:249-259. [PMID: 28096733 PMCID: PMC5240479 DOI: 10.3348/kjr.2017.18.1.249] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 08/12/2016] [Indexed: 11/29/2022] Open
Abstract
Objective To explore the performance of three-dimensional (3D) isotropic T2-weighted turbo spin-echo (TSE) sampling perfection with application optimized contrasts using different flip angle evolution (SPACE) sequence on a 3T system, for the evaluation of nerve root compromise by disc herniation or stenosis from central to extraforaminal location of the lumbar spine, when used alone or in combination with conventional two-dimensional (2D) TSE sequence. Materials and Methods Thirty-seven patients who had undergone 3T spine MRI including 2D and 3D sequences, and had subsequent spine surgery for nerve root compromise at a total of 39 nerve levels, were analyzed. A total of 78 nerve roots (48 symptomatic and 30 asymptomatic sites) were graded (0 to 3) using different MRI sets of 2D, 3D (axial plus sagittal), 3D (all planes), and combination of 2D and 3D sequences, with respect to the nerve root compromise caused by posterior disc herniations, lateral recess stenoses, neural foraminal stenoses, or extraforaminal disc herniations; grading was done independently by two readers. Diagnostic performance was compared between different imaging sets using the receiver operating characteristics (ROC) curve analysis. Results There were no statistically significant differences (p = 0.203 to > 0.999) in the ROC curve area between the imaging sets for both readers 1 and 2, except for combined 2D and 3D (0.843) vs. 2D (0.802) for reader 1 (p = 0.035), and combined 2D and 3D (0.820) vs. 3D including all planes (0.765) for reader 2 (p = 0.049). Conclusion The performance of 3D isotropic T2-weighted TSE sequence of the lumbar spine, whether axial plus sagittal images, or all planes of images, was not significantly different from that of 2D TSE sequences, for the evaluation of nerve root compromise of the lumbar spine. Combining 2D and 3D might possibly improve the diagnostic accuracy compared with either one.
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Affiliation(s)
- Jinkyeong Sung
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Won-Hee Jee
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Joon-Yong Jung
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Jinhee Jang
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Jin-Sung Kim
- Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Young-Hoon Kim
- Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Kee-Yong Ha
- Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
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Altahawi FF, Blount KJ, Morley NP, Raithel E, Omar IM. Comparing an accelerated 3D fast spin-echo sequence (CS-SPACE) for knee 3-T magnetic resonance imaging with traditional 3D fast spin-echo (SPACE) and routine 2D sequences. Skeletal Radiol 2017; 46:7-15. [PMID: 27744578 DOI: 10.1007/s00256-016-2490-8] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 08/19/2016] [Accepted: 09/14/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE To compare a faster, new, high-resolution accelerated 3D-fast-spin-echo (3D-FSE) acquisition sequence (CS-SPACE) to traditional 2D and high-resolution 3D sequences for knee 3-T magnetic resonance imaging (MRI). MATERIALS AND METHODS Twenty patients received knee MRIs that included routine 2D (T1, PD ± FS, T2-FS; 0.5 × 0.5 × 3 mm3; ∼10 min), traditional 3D FSE (SPACE-PD-FS; 0.5 × 0.5 × 0.5 mm3; ∼7.5 min), and accelerated 3D-FSE prototype (CS-SPACE-PD-FS; 0.5 × 0.5 × 0.5 mm3; ∼5 min) acquisitions on a 3-T MRI system (Siemens MAGNETOM Skyra). Three musculoskeletal radiologists (MSKRs) prospectively and independently reviewed the studies with graded surveys comparing image and diagnostic quality. Tissue-specific signal-to-noise ratios (SNR) and contrast-to-noise ratios (CNR) were also compared. RESULTS MSKR-perceived diagnostic quality of cartilage was significantly higher for CS-SPACE than for SPACE and 2D sequences (p < 0.001). Assessment of diagnostic quality of menisci and synovial fluid was higher for CS-SPACE than for SPACE (p < 0.001). CS-SPACE was not significantly different from SPACE but had lower assessments than 2D sequences for evaluation of bones, ligaments, muscles, and fat (p ≤ 0.004). 3D sequences had higher spatial resolution, but lower overall assessed contrast (p < 0.001). Overall image quality from CS-SPACE was assessed as higher than SPACE (p = 0.007), but lower than 2D sequences (p < 0.001). Compared to SPACE, CS-SPACE had higher fluid SNR and CNR against all other tissues (all p < 0.001). CONCLUSIONS The CS-SPACE prototype allows for faster isotropic acquisitions of knee MRIs over currently used protocols. High fluid-to-cartilage CNR and higher spatial resolution over routine 2D sequences may present a valuable role for CS-SPACE in the evaluation of cartilage and menisci.
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Affiliation(s)
- Faysal F Altahawi
- Department of Radiology, Northwestern University Feinberg School of Medicine, 676 N Saint Clair St Suite 800, Chicago, IL, 60611, USA.
| | - Kevin J Blount
- Department of Radiology, Northwestern University Feinberg School of Medicine, 676 N Saint Clair St Suite 800, Chicago, IL, 60611, USA
| | | | | | - Imran M Omar
- Department of Radiology, Northwestern University Feinberg School of Medicine, 676 N Saint Clair St Suite 800, Chicago, IL, 60611, USA
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Chae HD, Yoo HJ, Hong SH, Choi JY, Kang HS. Assessment of pisotriquetral misalignment with magnetic resonance imaging: Is it associated with trauma? Eur Radiol 2016; 27:3033-3041. [PMID: 27921157 DOI: 10.1007/s00330-016-4624-8] [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: 05/01/2016] [Revised: 09/21/2016] [Accepted: 09/26/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Our objective was to determine whether there is an association between pisotriquetral (PT) malalignment and acute distal radius fracture by using magnetic resonance imaging (MRI). METHODS We evaluated 138 patients who underwent 3-T MRI of the wrists. Group A comprised 85 patients with acute distal radius fracture, and group B comprised 53 patients without trauma. PT interval and angle and pisiform excursion were measured on oblique axial and sagittal multiplanar reformats. The presence of abnormalities in the flexor carpi ulnaris tendon (FCU), pisometacarpal ligament (PML), and pisohamate ligament (PHL) were evaluated. RESULTS PT interval was wider in group A on both the axial and sagittal planes (P < 0.001). Axial PT angle opened more radially in group A (P < 0.001), and the absolute value of the sagittal PT angle in group A was wider than that in group B (P = 0.006). Abnormalities in FCU, PML, and PHL were more frequently observed in group A (P < 0.001). On multiple linear regression, distal radius fracture remained significant after adjusting for the patient's age and PT osteoarthritis. CONCLUSIONS Acute distal radius fracture can affect normal alignment of the PT joint, resulting in associated injuries to the primary PT joint stabilizers. KEY POINTS • Acute distal radius fracture is associated with malalignment of PT joints. • Acute distal radius fracture is associated with abnormalities of PT stabilizers. • PT joint alignment can be evaluated with MRI with 3D sequences. • Wrist MRI is useful for evaluating primary PT stabilizer injuries.
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Affiliation(s)
- Hee-Dong Chae
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, 101, Daehak-Ro, Jongno-Gu, Seoul, 110-744, Korea
| | - Hye Jin Yoo
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, 101, Daehak-Ro, Jongno-Gu, Seoul, 110-744, Korea.
| | - Sung Hwan Hong
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, 101, Daehak-Ro, Jongno-Gu, Seoul, 110-744, Korea
| | - Ja-Young Choi
- Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, 101, Daehak-Ro, Jongno-Gu, Seoul, 110-744, Korea
| | - Heung Sik Kang
- Department of Radiology, Seoul National University Bundang Hospital, 300 Gumidong, Bundang-Gu, Seongnam-City, Gyeongi-Do, 463-707, Korea
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Abdulhadi MA, Perno JR, Melhem ER, Nucifora PGP. Characteristics of spondylotic myelopathy on 3D driven-equilibrium fast spin echo and 2D fast spin echo magnetic resonance imaging: a retrospective cross-sectional study. PLoS One 2014; 9:e100964. [PMID: 25025170 PMCID: PMC4099062 DOI: 10.1371/journal.pone.0100964] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 06/01/2014] [Indexed: 12/13/2022] Open
Abstract
In patients with spinal stenosis, magnetic resonance imaging of the cervical spine can be improved by using 3D driven-equilibrium fast spin echo sequences to provide a high-resolution assessment of osseous and ligamentous structures. However, it is not yet clear whether 3D driven-equilibrium fast spin echo sequences adequately evaluate the spinal cord itself. As a result, they are generally supplemented by additional 2D fast spin echo sequences, adding time to the examination and potential discomfort to the patient. Here we investigate the hypothesis that in patients with spinal stenosis and spondylotic myelopathy, 3D driven-equilibrium fast spin echo sequences can characterize cord lesions equally well as 2D fast spin echo sequences. We performed a retrospective analysis of 30 adult patients with spondylotic myelopathy who had been examined with both 3D driven-equilibrium fast spin echo sequences and 2D fast spin echo sequences at the same scanning session. The two sequences were inspected separately for each patient, and visible cord lesions were manually traced. We found no significant differences between 3D driven-equilibrium fast spin echo and 2D fast spin echo sequences in the mean number, mean area, or mean transverse dimensions of spondylotic cord lesions. Nevertheless, the mean contrast-to-noise ratio of cord lesions was decreased on 3D driven-equilibrium fast spin echo sequences compared to 2D fast spin echo sequences. These findings suggest that 3D driven-equilibrium fast spin echo sequences do not need supplemental 2D fast spin echo sequences for the diagnosis of spondylotic myelopathy, but they may be less well suited for quantitative signal measurements in the spinal cord.
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Affiliation(s)
- Mike A. Abdulhadi
- Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota, United States of America
| | - Joseph R. Perno
- Philadelphia VA Medical Center, Philadelphia, Pennsylvania, United States of America
| | - Elias R. Melhem
- University of Maryland, Baltimore, Maryland, United States of America
| | - Paolo G. P. Nucifora
- Philadelphia VA Medical Center, Philadelphia, Pennsylvania, United States of America
- University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- * E-mail:
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Zak L, Albrecht C, Wondrasch B, Widhalm H, Vekszler G, Trattnig S, Marlovits S, Aldrian S. Results 2 Years After Matrix-Associated Autologous Chondrocyte Transplantation Using the Novocart 3D Scaffold: An Analysis of Clinical and Radiological Data. Am J Sports Med 2014; 42:1618-27. [PMID: 24817007 DOI: 10.1177/0363546514532337] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND A range of scaffolds is available from various manufacturers for cartilage repair through matrix-associated autologous chondrocyte transplantation (MACT), with good medium- to long-term results. PURPOSE To evaluate clinical and magnetic resonance imaging (MRI) outcomes 2 years after MACT on the knee joint using the Novocart 3D scaffold based on a bilayered collagen type I sponge. STUDY DESIGN Case series; Level of evidence, 4. METHODS Of 28 initial patients, 23 were clinically and radiologically evaluated 24 months after transplantation. Indications for MACT were chondral or osteochondral lesions on the knee joint with a defect size >2 cm2, no instability, and no malalignment (axis deviation <5°). Then, MRI was performed on a 3-T scanner to assess the magnetic resonance observation of cartilage repair tissue (MOCART) and 3-dimensional (3D) MOCART scores. A variety of subjective scores (International Knee Documentation Committee [IKDC], Knee injury and Osteoarthritis Outcome Score [KOOS], Noyes sports activity rating scale, Tegner activity scale, and visual analog scale [VAS] for pain) were used for clinical evaluation. RESULTS Two years after MACT, the MRI evaluation showed a mean MOCART score of 73.2 ± 12.4 and a 3D MOCART score of 73.4 ± 9.7. Clinical results showed mean values of 69.8 ± 15.2 for the IKDC; 51.6 ± 21.2, 86.5 ± 13.9, 54.5 ± 23.6, 65.0 ± 8.0, and 91.5 ± 10.6 for the KOOS subscales (Quality of Life, Pain, Sports and Recreation, Symptoms, and Activities of Daily Living, respectively); 77.5 ± 12.7 for the Noyes scale; 4.4 ± 1.6 for the Tegner activity scale; and 1.8 ± 1.7 for the VAS, with statistically significant improvement in all scores other than KOOS-Symptoms. CONCLUSION Undergoing MACT using the Novocart 3D scaffold is an applicable method to treat large focal chondral and osteochondral defects, with good short-term clinical and radiological results.
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Affiliation(s)
- Lukas Zak
- Department of Traumatology, Medical University of Vienna, Vienna, Austria
| | - Christian Albrecht
- Department of Traumatology, Medical University of Vienna, Vienna, Austria
| | - Barbara Wondrasch
- Department of Health and Social Sciences, St Pölten University of Applied Sciences, St Pölten, Austria Norwegian Research Center for Active Rehabilitation, Department of Sport Medicine, Norwegian School for Sport Sciences, Oslo, Norway
| | - Harald Widhalm
- Department of Traumatology, Medical University of Vienna, Vienna, Austria
| | - György Vekszler
- Department of Traumatology, Medical University of Vienna, Vienna, Austria
| | - Siegfried Trattnig
- Investigation performed at the Medical University of Vienna, Vienna, Austria
| | - Stefan Marlovits
- Department of Traumatology, Medical University of Vienna, Vienna, Austria
| | - Silke Aldrian
- Department of Traumatology, Medical University of Vienna, Vienna, Austria
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Abstract
MRI has been established as an essential tool for accurate diagnosis in patients with musculoskeletal trauma. Its major advantages include excellent soft tissue contrast, high spatial resolution and lack of ionizing radiation. Although plain radiographs remain the basic tool for diagnosis and treatment planning in bone fractures assisted by CT in pelvic, spine and large joints injuries, there are specific circumstances that require MRI. For instance, tendinous, ligamentous, intraarticular structures such as the cartilage and menisci, and intramedullary injury are seen mostly with MRI. Volumetric 3D techniques are now commercially available and provide higher spatial resolution which improves anatomic detail, allows multiplanar reformations and reduces the acquisition time. Newer applications on quantitative rather than morphologic imaging, such as relaxometry and diffusion tensor imaging, may be of paramount importance in treatment planning in the near future. Software improvements reduce metal induced artefacts, allowing thus imaging of the postoperative patient with metallic implants. A tendency towards a structured reporting pattern and standardised medical communication needs to be further explored for the benefit of orthopaedic surgeons, radiologists and patients.
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Multibanded Anterior Talofibular Ligaments in Normal Ankles and Sprained Ankles Using 3D Isotropic Proton Density–Weighted Fast Spin-Echo MRI Sequence. AJR Am J Roentgenol 2014; 202:W87-94. [DOI: 10.2214/ajr.13.10727] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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