T2* mapping and delayed gadolinium-enhanced magnetic resonance imaging in cartilage (dGEMRIC) of glenohumeral cartilage in asymptomatic volunteers at 3 T

Objectives

To establish baseline T2* and T1_Gd values of glenohumeral cartilage at 3 T.

Methods

Forty asymptomatic volunteers (mean age: 24.8?±?2.2 years) without shoulder abnormalities were included. The MRI protocol comprised a double-echo steady-state (DESS) sequence for morphological cartilage evaluation, a gradient-echo multiecho sequence for T2* assessment, and a gradient-echo dual-flip-angle sequence for T1_Gd mapping. Statistical assessment involved a one-way analysis of variance (ANOVA) to identify the differences between various regions of the glenohumeral joint and intraclass correlation (ICC) analysis comparing repetitive T2* and T1_Gd measures to assess intra- and interobserver reliability.

Results

Both techniques revealed significant differences between superior and inferior glenohumeral cartilage demonstrating higher T2* (26.2 ms vs. 23.2 ms, P value?<?0.001) and T1_Gd (750.1 ms vs. 720.2 ms, P value?=?0.014) values in the superior regions. No trend was observed in the anterior-posterior measurement (P value range: 0.279–1.000). High intra- and interobserver agreement (ICC value range: 0.895–0.983) was noted for both T2* and T1_Gd mapping.

Conclusions

T2* and T1_Gd mapping are reliable in the assessment of glenohumeral cartilage. The values from this study can be used for comparison to identify cartilage degeneration in patients suffering from shoulder joint abnormalities.

Key Points

? T2* mapping and dGEMRIC are sensitive to collagen degeneration and proteoglycan depletion. ? This study aimed to establish baseline T2*/dGEMRIC values of glenohumeral cartilage. ? Both techniques revealed significant differences between superior and inferior glenohumeral cartilage. ? High intra-/interreader agreement was noted for both T2* mapping and dGEMRIC. ? These baseline normal values should be useful when identifying potential degeneration.     

Magnetic resonance imaging and histology of ovine hip joint cartilage in two age populations: a sheep model with assumed healthy cartilage

Objective

To compare morphologically normal appearing cartilage in two age groups with delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) and correlate magnetic resonance imaging (MRI) findings with histology.

Materials and methods

Twenty femoral head specimens collected from ten lambs (group I) and ten young adult sheep (group II) underwent dGEMRIC and histological assessment. A region of 2 cm² with morphologically normal-appearing cartilage was marked with a surgical suture for subsequent matching of MRI and histological sections. The MRI protocol included a three-dimensional (3D) double-echo steady-state sequence for morphological cartilage assessment, a B1 pre-scan with various flip angles for B1 field heterogeneity correction, and 3D volumetric interpolated breathhold examination for T1_Gd mapping (dGEMRIC). Histological analysis was performed according to the Mankin scoring system.

Results

A total of 303 regions of interest (ROI; 101 MRI reformats matching 101 histological sections) was assessed. Twenty-six ROIs were excluded owing to morphologically apparent cartilage damage or insufficient MR image quality. Therefore, 277 ROIs were analyzed. Histological analyses revealed distinct degenerative changes in various cartilage samples of group II (young adult sheep). Corresponding T1_Gd values were significantly lower in the group of sheep (mean T1_Gd?=?540.4 ms) compared with the group of lambs (mean T1_Gd?=?623.6 ms; p?<?0.001).

Conclusions

Although morphologically normal, distinct cartilage degeneration may be present in young adult sheep cartilage. dGEMRIC can reveal these changes and may be a tool for the assessment of early cartilage degeneration.     

Three-dimensional delayed gadolinium-enhanced magnetic resonance imaging of hip joint cartilage at 3T: A prospective controlled study

Purpose

To assess acetabular and femoral hip joint cartilage with three-dimensional (3D) delayed gadolinium-enhanced magnetic resonance imaging (dGEMRIC) in patients with degeneration of hip joint cartilage and asymptomatic controls with morphologically normal appearing cartilage.

Methods and materials

A total of 40 symptomatic patients (18 males, 22 females; mean age: 32.8 ± 10.2 years, range: 18–57 years) with different hip joint deformities including femoroacetabular impingement (n = 35), residual hip dysplasia (n = 3) and coxa magna due to Legg–Calve–Perthes disease in childhood (n = 2) underwent high-resolution 3D dGEMRIC for the evaluation of acetabular and femoral hip joint cartilage. Thirty-one asymptomatic healthy volunteers (12 males, 19 females; mean age: 24.5 ± 1.8 years, range: 21–29 years) without underlying hip deformities were included as control. MRI was performed at 3 T using a body matrix phased array coil. Region of interest (ROI) analyses for T1_Gd assessment was performed in seven regions in the hip joint, including anterior to superior and posterior regions.

Results

T1_Gd mapping demonstrated the typical pattern of acetabular cartilage consistent with a higher glycosaminoglycan (GAG) content in the main weight-bearing area. T1_Gd values were significantly higher in the control group than in the patient group whereas significant differences in T1_Gd values corresponding to the amount of cartilage damage were noted both in the patient group and in the control group.

Conclusions

Our study demonstrates the potential of high-resolution 3D dGEMRIC at 3 T for separate acetabular and femoral hip joint cartilage assessment in various forms of hip joint deformities.     

Image registration improves human knee cartilage T1 mapping with delayed gadolinium-enhanced MRI of cartilage (dGEMRIC)

Objectives

To evaluate the effect of automated registration in delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) of the knee on the occurrence of movement artefacts on the T1 map and the reproducibility of region-of-interest (ROI)-based measurements.

Methods

Eleven patients with early-stage knee osteoarthritis and ten healthy controls underwent dGEMRIC twice at 3?T. Controls underwent unenhanced imaging. ROIs were manually drawn on the femoral and tibial cartilage. T1 calculation was performed with and without registration of the T1-weighted images. Automated three-dimensional rigid registration was performed on the femur and tibia cartilage separately. Registration quality was evaluated using the square root Cramér–Rao lower bound (CRLB_σ). Additionally, the reproducibility of dGEMRIC was assessed by comparing automated registration with manual slice-matching.

Results

Automated registration of the T1-weighted images improved the T1 maps as the 90% percentile of the CRLB_σ was significantly (P?<?0.05) reduced with a median reduction of 55.8 ms (patients) and 112.9 ms (controls). Manual matching and automated registration of the re-imaged T1 map gave comparable intraclass correlation coefficients of respectively 0.89/0.90 (patients) and 0.85/0.85 (controls).

Conclusions

Registration in dGEMRIC reduces movement artefacts on T1 maps and provides a good alternative to manual slice-matching in longitudinal studies.

Key Points

? Quantitative MRI is increasingly used for biomedical assessment of knee articular cartilage ? Image registration leads to more accurate quantification of cartilage quality and damage ? Movement artefacts in delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) are reduced ? Automated image registration successfully aligns baseline and follow-up dGEMRIC examinations ? Reproducibility of dGEMRIC with registration is similar to that using manual slice-matching     

7 Tesla quantitative hip MRI: T1, T2 and T2* mapping of hip cartilage in healthy volunteers

Objectives

To evaluate the technical feasibility and applicability of quantitative MR techniques (delayed gadolinium-enhanced MRI of cartilage (dGEMRIC), T2 mapping, T2* mapping) at 7 T MRI for assessing hip cartilage.

Methods

Hips of 11 healthy volunteers were examined at 7 T MRI with an 8-channel radiofrequency transmit/receive body coil using multi-echo sequences for T2 and T2* mapping and a dual flip angle gradient-echo sequence before (T1₀) and after intravenous contrast agent administration (T1_Gd; 0.2 mmol/kg Gd-DTPA^2? followed by 0.5 h of walking and 0.5 h of rest) for dGEMRIC. Relaxation times of cartilage were measured manually in 10 regions of interest. Pearson’s correlations between R1_delta?=?1/T1_Gd???1/T1₀ and T1_Gd and between T2 and T2* were calculated. Image quality and the delineation of acetabular and femoral cartilage in the relaxation time maps were evaluated using discrete rating scales.

Results

High correlations were found between R1_delta and T1_Gd and between T2 and T2* relaxation times (all p?<?0.01). All techniques delivered diagnostic image quality, with best delineation of femoral and acetabular cartilage in the T2* maps (mean 3.2 out of a maximum of 4 points).

Conclusions

T1, T2 and T2* mapping of hip cartilage with diagnostic image quality is feasible at 7 T. To perform dGEMRIC at 7 T, pre-contrast T1 mapping can be omitted.

Key Points

? dGEMRIC of hip cartilage with diagnostic image quality is feasible at 7 T. ? To perform dGEMRIC at 7 T, pre-contrast T1 mapping can be omitted. ? T2(*) mapping of hip cartilage with diagnostic image quality is feasible at 7 T. ? T2 and T2* relaxation times of cartilage were highly correlated at 7 T. ? Best delineation of femoral and acetabular cartilage was found in T2* maps.

     

Validity of gradient-echo three-dimensional delayed gadolinium-enhanced magnetic resonance imaging of hip joint cartilage: A histologically controlled study

Objective

To validate gradient-echo three-dimensional (3D) delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) by means of histological analyses in the assessment of hip joint cartilage.

Materials and methods

Twenty-one femoral head specimens collected from 21 patients (7 males, 14 females, mean age: 60.9 ± 9.6 years; range: 37.6–77.3 years), who underwent total hip replacement for symptomatic hip joint osteoarthritis, underwent MRI and histological assessment. A region of 2 cm² at the weight-bearing area was marked with four pins to enable multi-planar MRI reformatting to be matched with histological sections. MRI was performed at 3 T with a 3D double-echo steady-state (DESS) sequence for morphological cartilage assessment and 3D Volumetric Interpolated Breathhold Examination (VIBE) for T1_Gd mapping. Histological sections were evaluated according to the Mankin score system. Total Mankin score, grade of toluidine staining (sensitive for glycosaminoglycan content) and a modified Mankin score classification system with four sub-groups of cartilage damage were correlated with MRI data.

Results

Spearman's rho correlation analyses revealed a statistically significant correlation between T1_Gd mapping and histological analyses in all categories including total Mankin score (r = −0.658, p-value ≤ 0.001), toluidine staining (r = −0.802, p-value < 0.001) and modified Mankin score (r = −0.716, p-value < 0.001). The correlation between morphological MRI and histological cartilage assessment was statistically significant but inferior to the biochemical cartilage MRI (r-values ranging from −0.411 to 0.525, p-values < 0.001).

Conclusions

Gradient-echo dGEMRIC is reliable while offering the unique features of high image resolution and 3D biochemically sensitive MRI for the assessment of early cartilage degeneration.     

Cartilage quality in rheumatoid arthritis: comparison of T2* mapping, native T1 mapping, dGEMRIC, ΔR1 and value of pre-contrast imaging

Purpose

To prospectively evaluate four non-invasive markers of cartilage quality—T2* mapping, native T1 mapping, dGEMRIC and ΔR1—in healthy volunteers and rheumatoid arthritis (RA) patients.

Materials and methods

Cartilage of metacarpophalangeal (MCP) joints II were imaged in 28 consecutive subjects: 12 healthy volunteers [9 women, mean (SD) age 52.67 (9.75) years, range 30–66] and 16 RA patients with MCP II involvement [12 women, mean (SD) age 58.06 (12.88) years, range 35–76]. Sagittal T2* mapping was performed with a multi-echo gradient-echo on a 3?T MRI scanner. For T1 mapping the dual flip angle method was applied prior to native T1 mapping and 40?min after gadolinium application (delayed gadolinium-enhanced MRI of cartilage, dGEMRIC, T1_Gd). The difference in the longitudinal relaxation rate induced by gadolinium (ΔR1) was calculated. The area under the receiver operating characteristic curve (AROC) was used to test for differentiation of RA patients from healthy volunteers.

Results

dGEMRIC (AUC 0.81) and ΔR1 (AUC 0.75) significantly differentiated RA patients from controls. T2* mapping (AUC 0.66) and native T1 mapping (AUC 0.66) were not significantly different in RA patients compared to controls.

Conclusions

The data support the use of dGEMRIC for the assessment of MCP joint cartilage quality in RA. T2* and native T1 mapping are of low diagnostic value. Pre-contrast T1 mapping for the calculation of ΔR1 does not increase the diagnostic value of dGEMRIC.     

Value of precontrast T1 for dGEMRIC of native articular cartilage

Purpose

To evaluate if the difference between pre‐ and post‐Gd‐DTPA^2‐ relaxation rate (ΔR₁) provides better differentiation of osteoarthritic patients (OA) from healthy subjects (HS) with dGEMRIC, as compared to post‐Gd‐DTPA^2‐ spin‐lattice relaxation time (T_1Gd).

Materials and Methods

Seventeen OA and 14 HS underwent pre‐ and 90 minutes postcontrast (Gd‐DTPA^2‐) magnetic resonance imaging (MRI) of the knee, using inversion recovery fast spin‐echo and/or Lock–Locker sequences for T₁ mapping. Effect sizes for T_1pre, T_1Gd, and ΔR₁ were calculated, and receiver operating characteristic (ROC) curve and regression analysis were also performed to assess the effectiveness of each parameter in the separation of OA and HS.

Results

T_1Gd and ΔR₁ were almost identical in terms of areas under ROC curves (0.903 and 0.914, respectively), and effect sizes (1.34 and 1.31, respectively). These were significantly higher than T_1pre. In addition, a high inverse correlation was observed between ΔR₁ vs. T_1Gd (R = 0.96).

Conclusion

Either T_1Gd or ΔR₁ could be used as an index in the evaluation of native cartilage. However, considering the practical logistical cost involved in terms of time and effort to acquire precontrast T₁ measurements, our data further support the continued use of T_1Gd as the dGEMRIC index in the evaluation of native cartilage. J. Magn. Reson. Imaging 2009;29:494–497. © 2009 Wiley‐Liss, Inc.     

Delayed gadolinium-enhanced MRI of the meniscus (dGEMRIM) in patients with knee osteoarthritis: relation with meniscal degeneration on conventional MRI,reproducibility, and correlation with dGEMRIC

Objectives

To assess (1) whether normal and degenerated menisci exhibit different T1_GD on delayed gadolinium-enhanced MRI of the meniscus (dGEMRIM), (2) the reproducibility of dGEMRIM and (3) the correlation between meniscus and cartilage T1_GD in knee osteoarthritis (OA) patients.

Methods

In 17 OA patients who underwent dGEMRIM twice within 7 days, meniscus and cartilage T1_GD was calculated. Meniscus pathology was evaluated on conventional MRI. T1_GD in normal and degenerated menisci were compared using a Student’s t-test. Reproducibility was assessed using ICCs. Pearson’s correlation was calculated between meniscus and cartilage T1_GD.

Results

A trend towards lower T1_GD in degenerated menisci (mean: 402 ms; 95 % CI: 359–444 ms) compared to normal menisci (mean: 448 ms; 95 % CI: 423–473 ms) was observed (p?=?0.05). Meniscus T1_GD ICCs were 0.85–0.90. The correlation between meniscus and cartilage T1_GD was moderate in the lateral (r?=?0.52–0.75) and strong in the medial compartment (r?=?0.78–0.94).

Conclusions

Our results show that degenerated menisci have a clear trend towards lower T1_GD compared to normal menisci. Since these results are highly reproducible, meniscus degeneration may be assessed within one delayed gadolinium-enhanced MRI simultaneously with cartilage. The strong correlation between meniscus and cartilage T1_GD suggests concomitant degeneration in both tissues in OA, but also suggests that dGEMRIC may not be regarded entirely as sulphated glycosaminoglycan specific.

Key Points

? dGEMRIM T1 _GD can possibly be used to assess meniscal degeneration; ? dGEMRIM yields highly reproducible meniscal T1 _GD in early stage osteoarthritic patients; ? Concomitant degeneration of cartilage and meniscus tissue occurs in early stage osteoarthritis; ? dGEMRIC cannot be regarded as entirely sulphated glycosaminoglycan specific.     

dGEMRIC and subsequent T1 mapping of the hip at 1.5 Tesla: normative data on zonal and radial distribution in asymptomatic volunteers

Purpose:

To characterize the zonal distribution of three‐dimensional (3D) T1 mapping in the hip joint of asymptomatic adult volunteers.

Materials and Methods:

This study included 10 volunteers (3 males and 7 females with a mean age of 26.5 years; range, 24–31 years). MRI protocol included standard sequences for hip imaging and a dual‐flip‐angle 3D gradient‐echo (GRE) sequence with volumetric interpolated breathhold examination (VIBE) postcontrast administration. Seven radial cuts were created clockwise around the femoral neck by using multi‐planar reconstruction.

Results:

Analysis of the radial distribution revealed an increase of T1‐values toward the superior regions. T1‐values differed between the peripheral and central portions. The standard deviation (SD) ranged from 76.2 ms to 124.1 ms in the peripheral zone, and from 69.1 ms to 112.9 ms in the central zone. In both zones, SD was low in the superior regions compared with the anterior and posterior regions of the joint. Based on the high intra‐ (0.95) and interobserver (0.87) agreement, normative data from this study will prepare the foundation for further studies of dGEMRIC and T1 in the hip.

Conclusion:

We noted a radial T1 mapping pattern with higher values in the superior zone that was not statistically significant and a notable trend in zonal distribution between peripheral and central zones. These findings are critical while outlining future studies for detailed objective evaluation of zonal cartilage lesions due to varying pathologies. J. Magn. Reson. Imaging 2011;. © 2011 Wiley‐Liss, Inc.     

Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC), after slipped capital femoral epiphysis

Objective

The aim of this study was to assess the glycosaminoglycan (GAG) content in hip joint cartilage in mature hips with a history of slipped capital femoral epiphysis (SCFE) using delayed gadolinium-enhanced MRI of cartilage (dGEMRIC).

Methods

28 young-adult subjects (32 hips) with a mean age of 23.8 ± 4.0 years (range: 18.1-30.5 years) who were treated for mild or moderate SCFE in adolescence were included into the study. Hip function and clinical symptoms were evaluated with the Harris hip score (HHS) system at the time of MRI. Plain radiographic evaluation included Tonnis grading, measurement of the minimal joint space width (JSW) and alpha-angle measurement. The alpha-angle values were used to classify three sub-groups: group 1 = subjects with normal femoral head-neck offset (alpha-angle <50°), group 2 = subjects with mild offset decrease (alpha-angle 50°-60°), and group 3 = subjects with severe offset decrease (alpha-angle >60°).

Results

There was statistically significant difference noted for the T1_Gd values, lateral and central, between group 1 and group 3 (p-values = 0.038 and 0.041). The T1_Gd values measured within the lateral portion were slightly lower compared with the T1_Gd values measured within the central portion that was at a statistically significance level (p-value <0.001). HHS, Tonnis grades and JSW revealed no statistically significant difference.

Conclusion

By using dGEMRIC in the mid-term follow-up of SCFE we were able to reveal degenerative changes even in the absence of joint space narrowing that seem to be related to the degree of offset pathology. The dGEMRIC technique may be a potential diagnostic modality in the follow-up evaluation of SCFE.     

High resolution fast T1 mapping technique for dGEMRIC

Purpose

To determine the feasibility of using a high resolution isotropic three‐dimensional (3D) fast T1 mapping sequence for delayed gadolinium‐enhanced MRI of cartilage (dGEMRIC) to assess osteoarthritis in the hip.

Materials and Methods

T1 maps of the hip were acquired using both low and high resolution techniques following the administration of 0.2 mmol/kg Gd‐DTPA^2‐ in 35 patients. Both T1 maps were generated from two separate spoiled GRE images. The high resolution T1 map was reconstructed in the anatomically equivalent plane as the low resolution map. T1 values from the equivalent anatomic regions containing femoral and acetabular cartilages were measured on the low and high resolution maps and compared using regression analysis.

Results

In vivo T1 measurements showed a statistically significant correlation between the low and high resolution acquisitions at 1.5 Tesla (R² = 0.958, P < 0.001). These results demonstrate the feasibility of using a fast two‐angle T1 mapping (F2T1) sequence with isotropic spatial resolution (0.8 × 0.8 × 0.8 mm) for quantitative assessment of biochemical status in articular cartilage of the hip.

Conclusion

The high resolution 3D F2T1 sequence provides accurate T1 measurements in femoral and acetabular cartilages of the hip, which enables the biochemical assessment of articular cartilage in any plane through the joint. It is a powerful tool for researchers and clinicians to acquire high resolution data in a reasonable scan time (< 30 min). J. Magn. Reson. Imaging 2009;30:896–900. © 2009 Wiley‐Liss, Inc.     

Repeatability of T1‐quantification in dGEMRIC for three different acquisition techniques: Two‐dimensional inversion recovery,three‐dimensional look locker,and three‐dimensional variable flip angle

Purpose:

To evaluate the repeatability of the dGEMRIC (delayed gadolinium enhanced MRI of cartilage) method in osteoarthritis‐prone knee joints for three different T1 quantification techniques: two‐dimensional inversion recovery (2D‐IR), three‐dimensional Look‐Locker (3D‐LL), and three‐dimensional variable flip angle (3D‐VFA).

Materials and Methods:

Nine subjects were examined twice, with a 2‐week interval, using all three measurement techniques. Four regions of interest were defined in the central medial and lateral femoral cartilage. The repeatability was evaluated for each measurement technique. For the 3D techniques, the variation between different slices was also evaluated.

Results:

Repeatability expressed by root‐mean‐square coefficient of variation (CV_RMS) showed similar results for 2D‐IR and 3D‐LL (5.4–8.4%). For 3D‐VFA CV_RMS was higher (9.3–15.2%). Intraclass correlation coefficient showed both 2D‐IR and 3D‐LL reliability to be moderate, while 3D‐VFA reliability was low. Inter‐slice CV_RMS and ICC was of the same magnitude as the repeatability. No clear differences could be interpreted between the condyles.

Conclusion:

Both 2D‐IR and 3D‐LL perform well in generating repeatable dGEMRIC results, while 3D‐VFA results are somewhat inferior. Furthermore, repeatability results in this study are similar to previously published results for healthy subjects. Finally, the positioning of the analyzed images is crucial to generate reliable repeatability results. J. Magn. Reson. Imaging 2010;31:1203–1209. © 2010 Wiley‐Liss, Inc.     

Hip dGEMRIC in asymptomatic volunteers and patients with early osteoarthritis: the influence of timing after contrast injection.

Eight asymptomatic volunteers and 10 patients with early hip osteoarthritis (OA) were investigated with hip delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) at 30, 65, 100, and 135 min after IV injection with Gd-DTPA(2-). In asymptomatic volunteers there was a decrease in the dGEMRIC index (T(1)(Gd)) between 30 and 100 min. In patients the wash-in of Gd-DTPA(2-) was faster, with a low T(1)(Gd) at 30 min that did not change significantly over time. Therefore, earlier time points showed a larger separation in T(1)(Gd) between asymptomatic and OA hips, with more convenient timing logistics. However, T(1)(Gd) at 30 min had a larger standard deviation (SD) in the OA group, possibly due to variability of the steep slope of wash-in. This sensitivity to the imaging window may be less desirable for longitudinal studies in which reproducibility is a concern. At all time points, T(1)(Gd) was 20-30% lower in patients than in asymptomatic volunteers (P < 0.003), which demonstrates the sensitivity of dGEMRIC to early hip OA.     

Delayed gadolinium‐enhanced MRI of cartilage in the ankle at 3 T: Feasibility and preliminary results after matrix‐associated autologous chondrocyte implantation

Purpose:

To demonstrate the feasibility of delayed gadolinium‐enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) in the ankle at 3 T and to obtain preliminary data on matrix associated autologous chondrocyte (MACI) repair tissue.

Materials and Methods:

A 3D dual flip angle sequence was used with an eight‐channel multipurpose coil at 3 T to obtain T1 maps both pre‐ and postintravenous contrast agent (Magnevist, 0.2 mM/kg). Postcontrast T1 over time was evaluated in three volunteers; a modified dGEMRIC protocol was then used to assess 10 cases after MACI in the ankle.

Results:

Forty‐five minutes were found sufficient for maximum T1 decrease. MACI cases had a precontrast mean T1 of 1050 ± 148.4 msec in reference cartilage (RC) and 1080 ± 165.6 msec in repair tissue (RT). Postcontrast T1 decreased to 590 ± 134.0 msec in RC and 554 ± 133.0 msec in RT. There was no significant difference between the delta relaxation rates in RT (9.44 × 10^?4 s^?1) and RC (8.04 × 10^?4 s^?1, P = 0.487). The mean relative delta relaxation rate was 1.34 ± 0.83.

Conclusion:

It is feasible to assess the thin cartilage layers of the ankle with dGEMRIC at 3 T; MACI can yield RT with properties similar to articular cartilage. J. Magn. Reson. Imaging 2010;31:732–739. © 2010 Wiley‐Liss, Inc.

     

The in vivo effects of unloading and compression on T1-Gd (dGEMRIC) relaxation times in healthy articular knee cartilage at 3.0 Tesla

Purpose

The purpose was to investigate the in vivo effects of unloading and compression on T1-Gd relaxation times in healthy articular knee cartilage.

Materials and methods

Ten volunteers were enrolled, and dGEMRIC images of their right knee joints were obtained using 3.0-T MR at three timepoints: directly following exercise (“baseline”), approximately 15 min after unloading (“unloading”) and during application of a compressive force (50% of the body weight) generated by a loading device via a footplate (“compression”).

Results

Our analysis of variance of pooled data from all cartilage zones demonstrated a significant mean T1-Gd decrease of 56.6 ms between baseline and compression (p?<?0.001), and a significant mean decrease of 42.1 ms between unloading and compression (p?<?0.001). No significant difference was found between baseline and unloading. Higher mean T1-Gd values were observed in the cartilage contact zone (central femoral and tibial zones; 698.3?±?162.2 ms) than in the non-contact zone (anterior and posterior femoral and tibial zones, and dorsal femoral zone; 662.9?±?149.3 ms; p?<?0.01).

Conclusion

T1-Gd times appear to be sensitive to mechanical cartilage stress, and thus, further studies are warranted that investigate the relationship between the biochemical load response and the biomechanical properties of articular cartilage.     

Signal polarity restoration in a 3D inversion recovery sequence used with delayed gadolinium‐enhanced magnetic resonance imaging of cartilage (dGEMRIC)

Purpose:

To develop an image reconstruction algorithm that restores the signal polarity in a three‐dimensional inversion‐recovery (3D‐IR) sequence used in delayed gadolinium‐enhanced MRI of cartilage (dGEMRIC). This approach effectively doubles the dynamic range of data used for T1 curve fitting.

Materials and Methods:

We applied this reconstruction algorithm to a 3D‐IR TFE sequence used for T1 mapping, validated the technique in a phantom study, and performed T1‐map calculations in postosteochondral allograft transplant (OAT) patients. In addition, we performed a signal simulation study to assess the algorithm's capability to reduce the number of inversion times used in the 3D‐IR TFE sequence.

Results:

In comparison to a standard T1‐mapping algorithm that uses the magnitude of the MRI signal, the proposed algorithm improves the reliability of T1 relaxation fits to the inversion‐recovery three‐parameter function. The signal simulation study shows that the number of TI inversion times can be reduced to as few as four, without compromising the accuracy of T1 calculations.

Conclusion:

This algorithm can be applied to any 2D‐ or 3D‐IR acquisition sequence used in conjunction with dGEMRIC. Application of the algorithm improves the reliability of T1 calculations and allows the number of TIs to be reduced, leading to shorter scan times in dGEMRIC. J. Magn. Reson. Imaging 2012;36:1248–1255. © 2012 Wiley Periodicals, Inc.     

Local flip angle correction for improved volume T1‐quantification in three‐dimensional dGEMRIC using the look‐locker technique

Purpose

To present an evaluation method for three‐dimensional Look‐Locker (3D‐LL) based T1 quantification, calculating correct T1 values independent of local flip angle (FA) variations. The method was evaluated both in phantoms and in vivo in a delayed Gadolinium Enhanced MRI of Cartilage (dGEMRIC) study with 33 subjects.

Materials and Methods

T1 was measured with 3D‐LL, using both local FA correction and a precalculated FA slice profile, and compared with standard constant FA correction, for all slices in phantoms and in both femur condyles in vivo. T1 measured using two‐dimensional Inversion Recovery (2D‐IR) was used as gold standard.

Results

Due to the FA being slice dependent, the standard constant FA correction results in erroneous T1 (systematic error = 109.1 ms in vivo), especially in the outer slices. With local FA correction, the calculated T1 is excellent for all slices in phantoms (<5% deviation from 2D‐IR). In vivo the performance is lower (systematic error = ?57.5 ms), probably due to imperfect inversion. With precalculated FA correction the performance is very good also in vivo (systematic error = 13.3 ms).

Conclusion

With the precalculated FA correction method, the 3D‐LL sequence is robust enough for in vivo dGEMRIC, even outside the centermost slices. J. Magn. Reson. Imaging 2009;30:834–841. © 2009 Wiley‐Liss, Inc.

     

Mid-term evaluation of the effects of dynamic neutralization system on lumbar intervertebral discs using quantitative molecular MR imaging

Purpose:

To evaluate the mid‐term effects of implant of dynamic neutralization system (Dynesys) on disc tissue in patients with lumbar discopathy, through the quantification of glycosaminoglycans (GAG) concentration, both in treated and adjacent levels, by analysis of delayed gadolinium‐enhanced MRI contrast (dGEMRIC) images.

Materials and Methods:

Ten patients with low back pain underwent the dGEMRIC diagnostic protocol before, 6‐months and after 2 years from surgery. Each patient was also evaluated with visual analog (VAS), Oswestry, and Prolo scales both at presurgery and during follow‐up. From dGEMRIC images, a ΔT1 parametric map was obtained for each disc, as quantitative indicator of its GAG concentration, and divided in 13 sectors, which were classified at presurgery as normal or abnormal, based on a 70‐ms threshold. Evolution of ΔT1 was studied during the follow‐up.

Results:

Nine of ten patients completed the follow‐up. VAS, Oswestry, and Prolo grades showed an improvement. This was accompanied by a reduction of ΔT1 in abnormal segments while normal segments showed a pattern of initial worsening at 6 months, followed by an improvement after 2 years.

Conclusion:

Our study confirmed the improvement in clinical evaluation, and for the first time related this to the changes in discs GAG concentration. J. Magn. Reson. Imaging 2012;35:1145‐1151. © 2011 Wiley Periodicals, Inc.     

Delayed contrast enhanced MRI of meniscus with ionic and non-ionic agents

Purpose:

To evaluate the potential difference in post‐contrast T₁ relaxation time of the meniscus (T_1Gd) between osteoarthritic patients (OA) and healthy subjects (HS), and to verify if charge density has any influence on meniscal T_1Gd.

Materials and Methods:

We performed a retrospective analysis of meniscal T₁ relaxation time on data previously acquired for studying articular cartilage with both ionic and non‐ionic contrast media. MR imaging was performed in 10 OA and 8 HS at 120 min following administration of double‐dose ionic Gd‐DTPA^2? on one day and non‐ionic Gd‐DTPA‐BMA on a different day. A three‐dimensional Look‐Locker sequence with echo time of 2 ms was used for data acquisition to allow T₁ mapping of the meniscus.

Results:

Compared with HS, significantly lower meniscal T_1Gd was observed in OA with either ionic Gd‐DTPA^2? (P < 0.01) or non‐ionic Gd‐DTPA‐BMA (P < 0.001) contrast agent. There was a correlation between meniscal T₁(Gd‐DTPA^2?) versus T₁(Gd‐DTPA‐BMA). Meniscal T₁(Gd‐DTPA‐BMA) showed a larger difference and smaller overlap between OA and HS. No significant differences in either pre‐contrast T₁ or post‐contrast T_1Gd were observed between inner and outer zones of the meniscus with either agent.

Conclusion:

Significant differences in meniscal T_1Gd between OA and HS were observed with both ionic and non‐ionic contrast agents, suggesting that charge density is not responsible for the observed differences. J. Magn. Reson. Imaging 2011;33:731–735. © 2011 Wiley‐Liss, Inc.