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Gassert FT, Kufner A, Gassert FG, Leonhardt Y, Kronthaler S, Schwaiger BJ, Boehm C, Makowski MR, Kirschke JS, Baum T, Karampinos DC, Gersing AS. MR-based proton density fat fraction (PDFF) of the vertebral bone marrow differentiates between patients with and without osteoporotic vertebral fractures. Osteoporos Int 2022; 33:487-496. [PMID: 34537863 PMCID: PMC8813693 DOI: 10.1007/s00198-021-06147-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 09/03/2021] [Indexed: 12/20/2022]
Abstract
UNLABELLED The bone marrow proton density fat fraction (PDFF) assessed with MRI enables the differentiation between osteoporotic/osteopenic patients with and without vertebral fractures. Therefore, PDFF may be a potentially useful biomarker for bone fragility assessment. INTRODUCTION To evaluate whether magnetic resonance imaging (MRI)-based proton density fat fraction (PDFF) of vertebral bone marrow can differentiate between osteoporotic/osteopenic patients with and without vertebral fractures. METHODS Of the 52 study patients, 32 presented with vertebral fractures of the lumbar spine (66.4 ± 14.4 years, 62.5% women; acute low-energy osteoporotic/osteopenic vertebral fractures, N = 25; acute high-energy traumatic vertebral fractures, N = 7). These patients were frequency matched for age and sex to patients without vertebral fractures (N = 20, 69.3 ± 10.1 years, 70.0% women). Trabecular bone mineral density (BMD) values were derived from quantitative computed tomography. Chemical shift encoding-based water-fat MRI of the lumbar spine was performed, and PDFF maps were calculated. Associations between fracture status and PDFF were assessed using multivariable linear regression models. RESULTS Over all patients, mean PDFF and trabecular BMD correlated significantly (r = - 0.51, P < 0.001). In the osteoporotic/osteopenic group, those patients with osteoporotic/osteopenic fractures had a significantly higher PDFF than those without osteoporotic fractures after adjusting for age, sex, weight, height, and trabecular BMD (adjusted mean difference [95% confidence interval], 20.8% [10.4%, 30.7%]; P < 0.001), although trabecular BMD values showed no significant difference between the subgroups (P = 0.63). For the differentiation of patients with and without vertebral fractures in the osteoporotic/osteopenic subgroup using mean PDFF, an area under the receiver operating characteristic (ROC) curve (AUC) of 0.88 (P = 0.006) was assessed. When evaluating all patients with vertebral fractures, those with high-energy traumatic fractures had a significantly lower PDFF than those with low-energy osteoporotic/osteopenic vertebral fractures (P < 0.001). CONCLUSION MR-based PDFF enables the differentiation between osteoporotic/osteopenic patients with and without vertebral fractures, suggesting the use of PDFF as a potential biomarker for bone fragility.
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Affiliation(s)
- F T Gassert
- Department of Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany.
| | - A Kufner
- Department of Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - F G Gassert
- Department of Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - Y Leonhardt
- Department of Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - S Kronthaler
- Department of Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - B J Schwaiger
- Department of Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany
- Department of Neuroradiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - C Boehm
- Department of Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - M R Makowski
- Department of Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - J S Kirschke
- Department of Neuroradiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - T Baum
- Department of Neuroradiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - D C Karampinos
- Department of Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - A S Gersing
- Department of Radiology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaningerstr. 22, 81675, Munich, Germany
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Gassert FT, Hammel J, Hofmann F, Pfeiffer D, Pfeiffer F, Makowski MR, Wörtler K, Gersing AS, Schwaiger BJ. Detection of Perifocal Bone Marrow Edema in Patients with Osteoid Osteoma Using Three-material Decomposition with Dual-layer Spectral CT. Semin Musculoskelet Radiol 2021. [DOI: 10.1055/s-0041-1731520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Bodden JH, Neumann J, Rasper M, Fingerle AA, Knebel C, Bollwein C, Schwaiger BJ, Gersing AS, Wörtler K. Diagnosis of Joint Invasion in Patients with Malignant Bone Tumors: Value and Reproducibility of Direct and Indirect Signs on MRI. Semin Musculoskelet Radiol 2021. [DOI: 10.1055/s-0041-1731543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Feuerriegel GC, Kopp F, Pfeiffer D, Leonhardt Y, Karampinos DC, Schwaiger BJ, Makowski MR, Wörtler K, Gersing AS. Evaluation of MR-derived Simulated CT-like Images and Simulated Radiographs Compared with Conventional Radiography in Patients with Suspected Shoulder Pathology. Semin Musculoskelet Radiol 2021. [DOI: 10.1055/s-0041-1731541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Heilmeier U, Mamoto K, Amano K, Eck B, Tanaka M, Bullen JA, Schwaiger BJ, Huebner JL, Stabler TV, Kraus VB, Ma CB, Link TM, Li X. Infrapatellar fat pad abnormalities are associated with a higher inflammatory synovial fluid cytokine profile in young adults following ACL tear. Osteoarthritis Cartilage 2020; 28:82-91. [PMID: 31526878 PMCID: PMC6935420 DOI: 10.1016/j.joca.2019.09.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 08/08/2019] [Accepted: 09/03/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate the degree of knee fat pad abnormalities after acute anterior cruciate ligament (ACL) tear via magnetic resonance fat pad scoring and to assess cross-sectionally its association with synovial fluid biomarkers and with early cartilage damage as quantified via T1ρ and T2 relaxation time measurements. DESIGN 26 patients with acute ACL tears underwent 3T MR scanning of the injured knee prior to ACL reconstruction. The presence and degree of abnormalities of the infrapatellar (IPFP) and the suprapatellar (SPFP) fat pads were scored on MR images along with grading of effusion-synovitis and synovial proliferations. Knee cartilage composition was assessed by 3T MR T1ρ and T2 mapping in six knee compartments. We quantified concentrations of 20 biomarkers in synovial fluid aspirated at the time of ACL reconstruction. Spearman rank partial correlations with adjustments for age and gender were employed to evaluate correlations of MR, particularly cartilage composition and fat pad abnormalities, and biomarker data. RESULTS The degree of IPFP abnormality correlated positively with the synovial levels of the inflammatory cytokine markers IFN-γ (ρpartial = 0.64, 95% CI (0.26-0.85)), IL-10 (ρpartial = 0.47, 95% CI (0.04-0.75)), IL-6 (ρpartial = 0.56, 95% CI (0.16-0.81)), IL-8 (ρpartial = 0.49, 95% CI (0.06-0.76)), TNF-α (ρpartial = 0.55, 95% CI (0.14-0.80)) and of the chondrodestructive markers MMP-1 and -3 (MMP-1: ρpartial = 0.57, 95% CI (0.17-0.81); MMP-3: ρpartial = 0.60, 95% CI (0.21-0.83)). IPFP abnormalities were significantly associated with higher T1ρ and T2 values in the trochlear cartilage (T1ρ: ρpartial = 0.55, 95% CI (0.15-0.80); T2: ρpartial = 0.58, 95% CI (0.18-0.81)) and with higher T2 values in the medial femoral, medial tibial as well as in patellar cartilage (0.45 ≤ ρpartial ≤ 0.59). Correlations between SPFP abnormalities and synovial markers were not significant except for IL-6 (ρpartial = 0.57, 95% CI (0.17-0.81)). CONCLUSIONS This exploratory study suggests that acute ACL rupture can be associated with damage to knee tissues such as the inferior fat pad of the knee. Such fat pad injury could be partially responsible for the apparent post-injury pro-inflammatory response noted in ACL-injured individuals. However, future longitudinal studies are needed to link ACL-rupture associated fat pad injury with important patient outcomes such as the development of posttraumatic osteoarthritis.
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Affiliation(s)
- U Heilmeier
- Department of Radiology and Biomedical Imaging, Musculoskeletal Quantitative Imaging Research, University of California San Francisco, San Francisco, CA, USA.
| | - K Mamoto
- Department of Radiology and Biomedical Imaging, Musculoskeletal Quantitative Imaging Research, University of California San Francisco, San Francisco, CA, USA; Department of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA; Department of Orthopaedic Surgery, Osaka City University Medical School, Osaka, Japan.
| | - K Amano
- Department of Radiology and Biomedical Imaging, Musculoskeletal Quantitative Imaging Research, University of California San Francisco, San Francisco, CA, USA.
| | - B Eck
- Department of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA.
| | - M Tanaka
- Department of Radiology and Biomedical Imaging, Musculoskeletal Quantitative Imaging Research, University of California San Francisco, San Francisco, CA, USA.
| | - J A Bullen
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA.
| | - B J Schwaiger
- Department of Radiology and Biomedical Imaging, Musculoskeletal Quantitative Imaging Research, University of California San Francisco, San Francisco, CA, USA.
| | - J L Huebner
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA.
| | - T V Stabler
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA.
| | - V B Kraus
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA.
| | - C B Ma
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA, USA.
| | - T M Link
- Department of Radiology and Biomedical Imaging, Musculoskeletal Quantitative Imaging Research, University of California San Francisco, San Francisco, CA, USA.
| | - X Li
- Department of Radiology and Biomedical Imaging, Musculoskeletal Quantitative Imaging Research, University of California San Francisco, San Francisco, CA, USA; Department of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA.
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Abstract
BACKGROUND Osteochondral defects represent a main risk factor for osteoarthritis of the ankle. OBJECTIVES The aim of this article is to provide an overview of current optimal clinical cartilage imaging techniques of the foot and ankle and to show typical osteochondral injuries on imaging. MATERIALS AND METHODS A thorough literature search was performed and was supported by personal experience. RESULTS Cartilage imaging of the foot and ankle remains challenging. However, advanced morphological and quantitative magnetic resonance (MR) imaging techniques may provide useful clinical information, for example, concerning cartilage repair surgery. Compared to MRI, MR arthrography (MR-A) and CT arthrography (CT-A) have higher sensitivity with respect to detection of osteochondral defects. Regarding smaller joints of the foot, mainly advanced osteoarthritic changes are detected on conventional radiography; only in rare cases, MR and CT imaging of these smaller joints is of relevance. CONCLUSIONS While at the smaller joints of the foot cartilage imaging only plays a minor role, at the ankle joint cross-sectional cartilage imaging using CT and MRI becomes more and more important for clinicians due to emerging therapeutic options, such as different osteochondral repair techniques.
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Affiliation(s)
- A S Gersing
- Institut für diagnostische und interventionelle Radiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland
| | - B J Schwaiger
- Institut für diagnostische und interventionelle Radiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland
| | - K Wörtler
- Institut für diagnostische und interventionelle Radiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland
| | - P M Jungmann
- Institut für diagnostische und interventionelle Radiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland. .,Klinik für Neuroradiologie, UniversitätsSpital Zürich, Universität Zürich, Frauenklinikstrasse 10, 8091, Zürich, Schweiz.
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Kretzschmar M, Nevitt MC, Schwaiger BJ, Joseph GB, McCulloch CE, Link TM. Spatial distribution and temporal progression of T2 relaxation time values in knee cartilage prior to the onset of cartilage lesions - data from the Osteoarthritis Initiative (OAI). Osteoarthritis Cartilage 2019; 27:737-745. [PMID: 30802496 PMCID: PMC6482329 DOI: 10.1016/j.joca.2018.10.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 10/02/2018] [Accepted: 10/11/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE To investigate compositional changes of knee cartilage at the site of newly appearing cartilage lesions and the surrounding cartilage 1-4 years prior to lesion onset using quantitative T2-measurements. METHODS Fifty-seven cartilage plates with newly appearing cartilage lesions from 45 knees (cases) and 52 plates from 26 control knees from the Osteoarthritis Initiative (OAI) cohort (controls) were evaluated. Using MRI T2-mapping, composition of local (the site of future lesions) and surrounding cartilage (remainder of the cartilage plate) was assessed 1-4 years prior to lesion onset. Analogous cartilage ROIs in control plates without cartilage lesions were assessed over 1-4 years. Mixed models were used to compare T2-means and change rates between local and surrounding cartilage within cases and controls, and to compare change rates in local and surrounding cartilage between cases and controls, adjusting for covariates. RESULTS Four years prior to lesion onset, we found that local cartilage ROIs had higher T2-values compared to the surrounding cartilage. No such differences were found in control plates. In cases mean local T2-values were persistantly elevated compared to the surrounding cartilage prior to lesion onset reaching significance 1 year prior (+2.94 ms, p = 0.012). T2-values of the surrounding cartilage were also persistantly higher in cases compared to controls, reaching significance 2 years prior to lesion onset (+3.61 ms, p = 0.003). CONCLUSION The findings of our study support the concept of compositional cartilage changes as a mechanism for cartilage degradation and that both diffuse and focal changes of cartilage composition within a cartilage plate precede the development of cartilage lesions.
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Affiliation(s)
- M Kretzschmar
- Musculoskeletal and Quantitative Imaging Group (MQIR), Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - MC Nevitt
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - BJ Schwaiger
- Musculoskeletal and Quantitative Imaging Group (MQIR), Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - GB Joseph
- Musculoskeletal and Quantitative Imaging Group (MQIR), Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - CE McCulloch
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - TM Link
- Musculoskeletal and Quantitative Imaging Group (MQIR), Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
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Gersing AS, Feuerriegel G, Holwein C, Suchowierski J, Karampinos DC, Haller B, Baum T, Schwaiger BJ, Kirschke JS, Rummeny EJ, Imhoff AB, Woertler K, Jungmann PM. T2-relaxation time of cartilage repair tissue is associated with bone remodeling after spongiosa-augmented matrix-associated autologous chondrocyte implantation. Osteoarthritis Cartilage 2019; 27:90-98. [PMID: 30248504 DOI: 10.1016/j.joca.2018.08.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 08/02/2018] [Accepted: 08/30/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate whether T2 relaxation time measurements of cartilage repair tissue and structural changes of the knee joint are associated with subchondral bone architecture after spongiosa-augmented matrix-associated autologous chondrocyte implantation (MACI). DESIGN Both knees of 25 patients (25.5 ± 7.8y; 10 women) were examined preoperatively and 2.7 years after unilateral spongiosa-augmented MACI with 3T magnetic resonance (MR) imaging. Cartilage composition was assessed using T2 relaxation time measurements, subchondral trabecular bone microstructure was quantified using a 3D phase-cycled balanced steady state free-precision sequence. Structural knee joint changes were assessed using the modified Whole-Organ Magnetic Resonance Imaging Score (WORMS). The Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score was used for the postoperative description of the area that underwent MACI. Correlations were assessed using Spearman's rank correlation coefficients. RESULTS Hypertrophy of the cartilage repair tissue was found in 2 of 25 patients, both after a MACI procedure at the patella, 21 patients showed congruent filling. In subchondral bone of the cartilage repair compartment, apparent trabecular thickness was significantly higher in compartments with elevated cartilage T2 (n = 17; 0.37 ± 0.05 mm) compared to those showing no difference in cartilage T2 compared to the same compartment in the contralateral knee (n = 8; 0.27 ± 0.05 mm; P = 0.042). Significant correlations were found between the overall progression of WORMS and the ipsilateral vs contralateral ratio of average trabecular thickness (r = 0.48, P = 0.031) and bone fraction (r = 0.57, P = 0.007). CONCLUSIONS After spongiosa-augmented MACI, T2 values of cartilage repair tissue and structural knee joint changes correlated with the quality of the underlying trabecular bone.
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Affiliation(s)
- A S Gersing
- Department of Radiology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
| | - G Feuerriegel
- Department of Radiology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
| | - C Holwein
- Department of Orthopaedic Sports Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany; Department of Trauma and Orthopaedic Surgery, BG Unfallklinik Murnau, Murnau, Germany.
| | - J Suchowierski
- Department of Orthopaedic Sports Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
| | - D C Karampinos
- Department of Radiology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
| | - B Haller
- Institute of Medical Informatics, Statistics and Epidemiology, Technical University of Munich, Munich, Germany.
| | - T Baum
- Department of Neuroradiology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
| | - B J Schwaiger
- Department of Radiology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
| | - J S Kirschke
- Department of Neuroradiology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
| | - E J Rummeny
- Department of Radiology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
| | - A B Imhoff
- Department of Orthopaedic Sports Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
| | - K Woertler
- Department of Radiology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
| | - P M Jungmann
- Department of Radiology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany; Department of Neuroradiology, University Hospital Zurich, University of Zurich, Switzerland.
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Schwaiger BJ, Gersing AS, Zimmer C, Prothmann S. The Curved MCA: Influence of Vessel Anatomy on Recanalization Results of Mechanical Thrombectomy after Acute Ischemic Stroke. AJNR Am J Neuroradiol 2015; 36:971-6. [PMID: 25634721 DOI: 10.3174/ajnr.a4222] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 11/17/2014] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Vessel anatomy is assumed to influence results of endovascular mechanical thrombectomy using stent retrievers. The purpose of this study was to analyze the influence of vessel curvature on recanalization results in patients with acute ischemic stroke caused by large-vessel occlusion. MATERIALS AND METHODS In 159 patients (70 ± 12.8 years of age; 79 women) treated for acute ischemic stroke after carotid T and/or MCA occlusion by using stent retrievers, the following angles were measured in standard anteroposterior angiograms to describe vessel anatomy: first, between the terminal ICA segment and the most downward curved M1 segment conterminous to the proximal face of the thrombus (ICA/M1 angle); second, between the most proximal M1 segment and the segment immediately conterminous to the thrombus (M1/M1 angle); and additionally, in patients with distal M1/proximal M2 occlusion, the angle of the last curvature proximal of the thrombus (M1/M2 angle). Angles of patients with-versus-without successful recanalization were compared. RESULTS Patients without successful recanalization (TICI 0-2a) showed significantly larger ICA/M1 angles (mean, 110°± 23.8° versus 69°± 28.7°, P < .001) and significantly larger M1/M1 angles (56°± 29.2° versus 29°± 26.6°, P = .001) than patients with successful recanalization (TICI 2b/3). In patients without successful recanalization after a distal M1 or proximal M2 occlusion, the M1/M2 angle was significantly larger than that in patients with successful recanalization (117° ± 34.3° versus 67° ± 29.5°, P = .006). CONCLUSIONS This retrospective analysis showed that mechanical thrombectomy in the anterior circulation was significantly less often successful in patients with large vessel angles. Therefore, vessel curvature significantly influences the results of mechanical thrombectomy with stent retrievers for treatment of acute ischemic stroke. Further work is needed to understand the underlying causality.
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Affiliation(s)
- B J Schwaiger
- From the Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany.
| | - A S Gersing
- From the Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | - C Zimmer
- From the Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | - S Prothmann
- From the Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
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Schwaiger BJ, Gersing AS, Baum T, Noël PB, Zimmer C, Bauer JS. Bone mineral density values derived from routine lumbar spine multidetector row CT predict osteoporotic vertebral fractures and screw loosening. AJNR Am J Neuroradiol 2014; 35:1628-33. [PMID: 24627455 DOI: 10.3174/ajnr.a3893] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND PURPOSE Established methods of assessing bone mineral density are associated with additional radiation exposure to the patient. In this study, we aimed to validate a method of assessing bone mineral density in routine multidetector row CT of the lumbar spine. MATERIALS AND METHODS In 38 patients, bone mineral density was assessed in quantitative CT as a standard of reference and in sagittal reformations derived from standard multidetector row CT studies without IV contrast. MDCT-to-quantitative CT conversion equations were calculated and then applied to baseline multidetector row scans of another 62 patients. After a mean follow-up of 15 ± 6 months, patients were re-assessed for incidental fractures and screw loosening after spondylodesis (n = 49). RESULTS We observed conversion equations bone mineral densityMDCT = 0.78 × Hounsfield unitMDCTmg/mL (correlation with bone mineral densityquantitative CT, R(2) = 0.92, P < .001) for 120 kV(peak) tube voltage and bone mineral densityMDCT = 0.86 × Hounsfield unitMDCTmg/mL (R(2) = 0.81, P < .001) for 140 kVp, respectively. Seven patients (11.3%) had existing osteoporotic vertebral fractures at baseline, while 8 patients (12.9%) showed incidental osteoporotic vertebral fractures. Screw loosening was detected in 28 patients (57.1% of patients with spondylodesis). Patients with existing vertebral fractures showed significantly lower bone mineral densityMDCT than patients without fractures (P < .01). At follow-up, patients with incidental fractures and screw loosening after spondylodesis, respectively, showed significantly lower baseline bone mineral densityMDCT (P < .001 each). CONCLUSIONS This longitudinal study demonstrated that converted bone mineral density values derived from routine lumbar spine multidetector row CT adequately differentiated patients with and without osteoporotic fractures and could predict incidental fractures and screw loosening after spondylodesis.
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Affiliation(s)
- B J Schwaiger
- From the Abteilung für Neuroradiologie (B.J.S., A.S.G., C.Z., J.S.B.)
| | - A S Gersing
- From the Abteilung für Neuroradiologie (B.J.S., A.S.G., C.Z., J.S.B.)
| | - T Baum
- Institut für Radiologie (T.B., P.B.N.), Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | - P B Noël
- Institut für Radiologie (T.B., P.B.N.), Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | - C Zimmer
- From the Abteilung für Neuroradiologie (B.J.S., A.S.G., C.Z., J.S.B.)
| | - J S Bauer
- From the Abteilung für Neuroradiologie (B.J.S., A.S.G., C.Z., J.S.B.)
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Stehling C, Baum T, Schwaiger BJ, Müller-Höcker C, Nevitt MC, McCulloch CE, Heindel W, Link TM. Vergleich von Knorpel T2 Relaxationszeiten verschiedener Kniekompartimente mit morphologischen Knieveränderungen bei 3 Tesla: Analyse bei 217 asymptomatischen Personen der Osteoarthritis Initiative. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Stehling C, Schwaiger BJ, Müller-Höcker C, Krug R, Kuo D, Lane NE, Nevitt MC, Lynch J, McCulloch CE, Link TM. Veränderungen der Knorpel T2 Relaxationzeit einzelner Kniekompartimente bei körperlicher Aktivität: 24 Monate Verlaufskontrolle bei 182 asymptomatischen Personen der Osteoarthritis Initiative. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Stehling C, Müller-Höcker C, Schwaiger BJ, Lane NE, Nevitt MC, McCulloch CE, Link TM. Knorpel T2 Relaxationzeiten und Knieveränderungen bei 3 Tesla sagen Veränderungen von klinischen Parametern über 2 Jahre voraus: Analyse von 217 asymptomatischen Personen der Osteoarthritis Initiative. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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