Three-dimensional T1rho-weighted MRI at 1.5 Tesla

PURPOSE: To design and implement a magnetic resonance imaging (MRI) pulse sequence capable of performing three-dimensional T(1rho)-weighted MRI on a 1.5-T clinical scanner, and determine the optimal sequence parameters, both theoretically and experimentally, so that the energy deposition by the radiofrequency pulses in the sequence, measured as the specific absorption rate (SAR), does not exceed safety guidelines for imaging human subjects. MATERIALS AND METHODS: A three-pulse cluster was pre-encoded to a three-dimensional gradient-echo imaging sequence to create a three-dimensional, T(1rho)-weighted MRI pulse sequence. Imaging experiments were performed on a GE clinical scanner with a custom-built knee-coil. We validated the performance of this sequence by imaging articular cartilage of a bovine patella and comparing T(1rho) values measured by this sequence to those obtained with a previously tested two-dimensional imaging sequence. Using a previously developed model for SAR calculation, the imaging parameters were adjusted such that the energy deposition by the radiofrequency pulses in the sequence did not exceed safety guidelines for imaging human subjects. The actual temperature increase due to the sequence was measured in a phantom by a MRI-based temperature mapping technique. Following these experiments, the performance of this sequence was demonstrated in vivo by obtaining T(1rho)-weighted images of the knee joint of a healthy individual. RESULTS: Calculated T(1rho) of articular cartilage in the specimen was similar for both and three-dimensional and two-dimensional methods (84 +/- 2 msec and 80 +/- 3 msec, respectively). The temperature increase in the phantom resulting from the sequence was 0.015 degrees C, which is well below the established safety guidelines. Images of the human knee joint in vivo demonstrate a clear delineation of cartilage from surrounding tissues. CONCLUSION: We developed and implemented a three-dimensional T(1rho)-weighted pulse sequence on a 1.5-T clinical scanner.     

Quantification of T(2) relaxation changes in articular cartilage with in situ mechanical loading of the knee

PURPOSE: To devise a method for producing in vivo MRI images of the knee under physiologically significant loading, and to compare and evaluate the changes in cartilage characteristics before and during in situ compression of the knee. MATERIAL AND METHODS: A total of 26 asymptomatic subjects were imaged on a 1.5 Tesla Philips Intera scanner using a commercially available knee coil. Routine anatomical images were followed by T(2) map acquisition. These scans were repeated following in situ compression of the knee using a MR compatible loading jig. RESULTS: Following loading to body weight, several regions of femoral cartilage show early alteration of T(2) relaxation time, most significantly in the medial and lateral peripheral zones. There were no significant changes in the tibial cartilage. CONCLUSIONS: The results establish the feasibility of measuring changes on MRI with in situ axial loading.     

Evaluation of optimised 3D turbo spin echo and gradient echo MR pulse sequences of the knee at 3T and 1.5T

IntroductionTo investigate the impact of parameter optimisation for novel three-dimensional 3D sequences at 1.5T and 3T on resultant image quality.MethodsFollowing institutional review board approval and acquisition of informed consent, MR phantom and knee joint imaging on healthy volunteers (n = 16) was performed with 1.5 and 3T MRI scanners, respectively incorporating 8- and 15-channel phased array knee radiofrequency coils. The MR phantom and healthy volunteers were prospectively scanned over a six-week period. Acquired sequences included standard two-dimensional (2D) turbo spin echo (TSE) and novel three-dimensional (3D) TSE PDW (SPACE) both with and without fat-suppression, and T21W gradient echo (TrueFISP) sequences. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were measured for knee anatomical structures. Two musculoskeletal radiologists evaluated anatomical structure visualisation and image quality. Quantitative and qualitative findings were investigated for differences using Friedman tests. Inter- and intra-observer agreements were determined with κ statistics.ResultsPhantom and healthy volunteer images revealed higher SNR for sequences acquired at 3T (p-value <0.05). Generally, the qualitative findings ranked images acquired at 3T higher than corresponding images acquired at 1.5T (p < 0.05). 3D image data sets demonstrated less sensitivity to partial volume averaging artefact (PVA) compared to 2D sequences. Inter- and intra-observer agreements for evaluation across all sequences ranged from 0.61 to 0.79 and 0.71 to 0.92, respectively.ConclusionBoth 2D and 3D images demonstrated higher image quality at 3T than at 1.5T. Optimised 3D sequences performed better than the standard 2D PDW TSE sequence for contrast resolution between cartilage and joint fluid, with reduced PVA artefact.Implications for practiceWith rapid advances in MRI scanner technology, including hardware and software, the optimisation of 3D MR pulse sequences to reduce scan time while maintaining image quality, will improve diagnostic accuracy and patient management in musculoskeletal MRI.     

光学相干断层扫描与3.0T MRI、超声法测量兔膝关节软骨厚度的比较

 目的 探索使用光学相干断层扫描技术(optical coherence tomography,OCT)无创测量兔膝关节软骨厚度的可行性。方法 选择标准化饲养成年雄性新西兰大白兔40只(80膝关节),记号笔标记不同样本同一测量点,分别采用OCT技术、3.0 T MRI、超声测量方法,由专业技师对软骨厚度进行测量,比较OCT技术与其他两种方法测量兔膝关节软骨厚度的差异。结果 同一测量点OCT技术、3.0T MRI、超声法软骨厚度测量数值结果分别为(0.31±0.03)mm、(0.30±0.05)mm、(0.33±0.06)mm, OCT与超声(t=1.995,P=0.051 )、MRI(t=1.955,P=0.054)测量数据比较差异无统计学意义。单个样本同一测量点,OCT、3.0T MRI、超声测量平均结果获得时间分别为(2.5±0.3)min、(6.3±0.7)min、(3.3±0.6)min。三种测量方法的精确度分别为0.001 mm、0.01 mm、0.01 mm。结论 光学相干断层扫描技术测量兔膝关节软骨厚度具有精确、快速、重复性好、人为误差小的特点,值得在组织工程软骨修复关节软骨缺损动物实验中广泛推广。     

Bone motion analysis from dynamic MRI: acquisition and tracking

RATIONALE AND OBJECTIVES: For diagnosis, preoperative planning and postoperative guides, an accurate estimate of joint kinematics is required. It is important to acquire joint motion actively with real-time protocols. MATERIALS AND METHODS: We bring together MRI developments and new image processing methods in order to automatically extract active bone kinematics from multi-slice real-time dynamic MRI. We introduce a tracking algorithm based on 2D/3D registration and a procedure to validate the technique by using both dynamic and sequential MRI, providing a gold standard bone position measurement. RESULTS: We present our technique for optimizing jointly the tracking method and the acquisition protocol to overcome the trade-off in acquisition time and tracking accuracy. As a case study, we apply this methodology on a human hip joint. CONCLUSION: The final protocol (bFFE, TR/TE 3.5/1.1 ms, Flip angle 80 degrees , pixel size 4.7 x 2.6 mm, partial Fourier reduction factor of 0.65 in read direction, SENSE acceleration factor of 2, frame rate = 6.7 frames/s) provides sufficient morphological data for bone tracking to be carried out with an accuracy of 3 degrees in terms of joint angle.     

Three-dimensional delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) at 1.5T and 3.0T

PURPOSE: To implement and validate a three-dimensional (3D) T1 measurement technique that is suitable for delayed gadolinium (Gd)-enhanced MRI of cartilage (dGEMRIC) and can be easily implemented with clinically available pulse sequences at 1.5T and 3.0T. MATERIALS AND METHODS: A 3D inversion-recovery prepared spoiled gradient-echo (IR-SPGR) imaging pulse sequence with variable TR was used to implement a 3D T1 measurement protocol. The 3D T1 measurements were validated against a gold-standard single-slice 2D IR T1 measurement protocol in both phantoms and in vivo, in both asymptomatic volunteers and volunteers with osteoarthritis (OA). RESULTS: T1 measurements in phantoms showed a statistically significant correlation between the 2D and 3D measurements at 1.5T (R2=0.993, P<0.001) and 3.0T (R2=0.996, P<0.001). In vivo application demonstrated the feasibility of using this 3D IR-SPGR sequence to evaluate the molecular status of articular cartilage throughout the knee joint with 0.63x0.63x3.0 mm spatial resolution within a 20-minute acquisition, even with the measurement parameters set for the higher T1(Gd) of cartilage at 3T (range=400-900 msec mean T1 within a region of interest (ROI) in cartilage, compared to 200-600 msec mean T1 at 1.5T). CONCLUSION: This 3D T1 measurement protocol may prove useful for the evaluation and follow-up of cartilage dGEMRIC indices in clinical studies of OA.     

Tibiofemoral kinematics following successful anterior cruciate ligament reconstruction using dynamic multiple resonance imaging

BACKGROUND: The aim of anterior cruciate ligament reconstruction is to reduce excess joint laxity, hoping to restore normal tibiofemoral kinematics and therefore improve joint stability. It remains unclear if successful ACL reconstruction restores normal tibiofemoral kinematics and whether it is this that is associated with a good result. STUDY: Case series. PURPOSE: To assess the kinematics of the anterior cruciate ligament-reconstructed knee using open-access MRI. METHODS: Tibiofemoral motion was assessed using open-access MRI, weightbearing through the arc of flexion from 0 degrees to 90 degrees in 10 patients with isolated reconstruction of the anterior cruciate ligament (hamstring autograft) in one knee and a normal contralateral knee. Midmedial and midlateral sagittal images were analyzed in all positions of flexion in both knees to assess the tibiofemoral relationship. Sagittal laxity was also assessed by performing the Lachman test while the knees were scanned dynamically using open-access MRI. RESULTS: The amount of excursion between the tibial and femoral joint surfaces was similar between the normal and reconstructed knees, but the relationship of tibia to femur was always different for each position of knee flexion assessed-the lateral tibia being about 5 mm more anterior in the anterior cruciate ligament-reconstructed knees. This anterior tibial position is statistically significantly different at 0 degrees (P <.0006), 20 degrees (P =.0004), 45 degrees (P =.002), and 90 degrees of flexion (P <.006). Anteroposterior laxity was similar between normal and anterior cruciate ligament-reconstructed knees. CONCLUSION: Anterior cruciate ligament reconstruction reduces sagittal laxity to within normal limits but does not restore normal tibiofemoral kinematics despite a successful outcome.     

Adaptive 4D MR imaging using navigator-based respiratory signal for MRI-guided therapy.

For real-time 3D visualization of respiratory organ motion for MRI-guided therapy, a new adaptive 4D MR imaging method based on navigator echo and multiple gating windows was developed. This method was designed to acquire a time series of volumetric 3D images of a cyclically moving organ, enabling therapy to be guided by synchronizing the 4D image with the actual organ motion in real time. The proposed method was implemented in an open-configuration 0.5T clinical MR scanner. To evaluate the feasibility and determine optimal imaging conditions, studies were conducted with a phantom, volunteers, and a patient. In the phantom study the root mean square (RMS) position error in the 4D image of the cyclically moving phantom was 1.9 mm and the imaging time was approximately 10 min when the 4D image had six frames. In the patient study, 4D images were successfully acquired under clinical conditions and a liver tumor was discriminated in the series of frames. The image quality was affected by the relations among the encoding direction, the slice orientation, and the direction of motion of the target organ. In conclusion, this study has shown that the proposed method is feasible and capable of providing a real-time dynamic 3D atlas for surgical navigation with sufficient accuracy and image quality.     

Accuracy of a 3D temporal scanning system for gait analysis: Comparative with a marker-based photogrammetry system

BackgroundCombining the accuracy of marker-based stereophotogrammetry and the usability and comfort of markerless human movement analysis is a difficult challenge. 3D temporal scanners are a promising solution, since they provide moving meshes with thousands of vertices that can be used to analyze human movements.Research questionCan a 3D temporal scanner be used as a markerless system for gait analysis with the same accuracy as traditional, marker-based stereophotogrammetry systems?MethodsA comparative study was carried out using a 3D temporal scanner synchronized with a marker-based stereophotogrammetry system. Two gait cycles of twelve healthy adults were measured simultaneously, extracting the positions of key anatomical points from both systems, and using them to analyze the 3D kinematics of the pelvis, right hip and knee joints. Measurement differences of marker positions and joint angles were described by their root mean square. A t-test was performed to rule out instrumental errors, and an F-test to evaluate the amplifications of marker position errors in dynamic conditions.ResultsThe differences in 3D landmark positions were between 1.9 and 2.4 mm in the reference pose. Marker position errors were significantly increased during motion in the medial-lateral and vertical directions. The angle relative errors were between 3% and 43% of the range of motion, with the greatest difference being observed in hip axial rotation.SignificanceThe differences in the results obtained between the 3D temporal scanner and the marker-based system were smaller than the usual errors due to lack of accuracy in the manual positioning of markers on anatomical landmarks and to soft-tissue artefacts. That level of accuracy is greater than other markerless systems, and proves that such technology is a good alternative to traditional, marker-based motion capture.     

Ultra-high-field MRI of knee joint at 7.0T: preliminary experience

RATIONALE AND OBJECTIVES: To measure signal-to-noise ratio (SNR), contrast, and relaxation times (T1 and T2) in human knee joint at 7.0T whole-body scanner. MATERIALS AND METHODS: MRI experiments were performed on a 7.0T Siemens whole-body scanner using an 18-cm diameter transmit/receive knee coil. Normalized SNR and relaxation times (T1 and T2) were computed on all volunteers (healthy, n=5) for femoral, tibial, and patellar cartilage. RESULTS: Average T1 values of femoral, tibial, and patellar cartilages were found as 1.55, 1.76, and 1.62 seconds, respectively. Average T2 values of femoral, tibial, and patellar cartilages were found as 51.3, 43.9, and 39.7 milliseconds, respectively. No statistically significant differences were observed between T1 and T2 values of different cartilage tissues (P>.08 for all comparisons). Compared with previously reported relaxation times of cartilage tissue at 3.0T, an approximately 35% increase was observed in T1 values, whereas no significant change was observed in T2. Regional analysis was also performed to investigate the change in relaxation parameters for weight-bearing vs. non-weight-bearing areas. A statistically significant difference was observed in T2 of tibial cartilage (P=.009). The rest of the comparisons yielded insignificant differences (P>.32). CONCLUSION: Our preliminary results demonstrate the feasibility of acquiring high resolution three-dimensional images of knee joint (with and without fat suppression) at 7.0T whole-body scanner.     

Measurement of cervical spinal cord cross-sectional area by MRI using edge detection and partial volume correction

PURPOSE: To detail a procedure to accurately measure upper cervical cord cross-sectional area (CSA), using MRI, by correcting for partial volume averaging (PVA), and to assess the usefulness of the procedure for measuring cervical cord atrophy rates in longitudinal studies. MATERIALS AND METHODS: Analysis of errors associated with measuring CSA in the presence of PVA is given. A numerical phantom image is produced, including simulated acquisition noise, to assess accuracy of the method in idealized conditions, and to verify the results of the error analysis. A phantom, consisting of 11 rods of known CSA, was scanned 10 times and measurement accuracy assessed. A total of 10 normal subjects were scanned twice to assess the reproducibility under experimental conditions. RESULTS: The measurement error for the numerical phantom increased with increased simulated acquisition noise, as predicted by the analysis. Measurement of the plastic phantom revealed a systematic overestimate in CSA due to limited scanner accuracy of 3.15%. The scan-rescan error for the CSA of the cervical spine in the 10 normal subjects was 0.55%. CONCLUSION: Correcting for PVA allows accurate measurement of the upper cervical cord CSA and accurate measurement of a standard phantom to guard against scanner drift in longitudinal studies of cord CSA.     

The effect of quality control on the function of magnetic resonance imaging (MRI), using American College of Radiology (ACR) phantom

Objective

To study image quality of MRI scanner using the American College of Radiology (ACR) phantom.

Stride-to-stride variability of knee motion in patients with knee osteoarthritis

PURPOSE: Individuals with knee osteoarthritis (OA) experience pain, frontal plane joint laxity and instability. Co-contraction can control laxity and instability but may place constraints on the variability of the knee's motion during gait. Slight variation among gait cycles is normal, but reduced variability of joint motions could be detrimental. The purpose of this study was to quantify knee motion variability during gait and assess the influence of muscle activity, frontal plane laxity, and pain on knee movement variability in patients with medial knee OA. METHODS: Fifteen subjects with unilateral medial knee OA and 15 age and gender matched uninjured subjects underwent gait analysis, with electromyography to compute co-contraction. Stress radiographs were obtained for measuring frontal plane laxity. Knee motion variability was assessed from the phase angle (knee angle versus angular velocity) during early stance. RESULTS: Despite altered involved side knee kinematics and kinetics, individuals with knee OA showed involved side frontal plane variability which was not significantly different from the control group, but was significantly lower than the variability of the uninvolved knee's motion. Laxity and medial co-contraction influenced the amount of joint motion variability in the involved knee of the OA subjects. Pain did not influence variability. CONCLUSION: Patients with medial knee OA displayed altered involved knee kinematics and kinetics, although stride-to-stride variability of knee motion was unchanged. Evidence of excessive joint motion variability on the uninvolved side, however, may provide insight into the development of OA in the contralateral cognate joint.     

High-resolution ultrashort echo time (UTE) imaging on human knee with AWSOS sequence at 3.0 T

Purpose:

To demonstrate the technical feasibility of high‐resolution (0.28–0.14 mm) ultrashort echo time (UTE) imaging on human knee at 3T with the acquisition‐weighted stack of spirals (AWSOS) sequence.

Materials and Methods:

Nine human subjects were scanned on a 3T MRI scanner with an 8‐channel knee coil using the AWSOS sequence and isocenter positioning plus manual shimming.

Results:

High‐resolution UTE images were obtained on the subject knees at TE = 0.6 msec with total acquisition time of 5.12 minutes for 60 slices at an in‐plane resolution of 0.28 mm and 10.24 minutes for 40 slices at an in‐plane resolution of 0.14 mm. Isocenter positioning, manual shimming, and the 8‐channel array coil helped minimize image distortion and achieve high signal‐to‐noise ratio (SNR).

Conclusion:

It is technically feasible on a clinical 3T MRI scanner to perform UTE imaging on human knee at very high spatial resolutions (0.28–0.14 mm) within reasonable scan time (5–10 min) using the AWSOS sequence. J. Magn. Reson. Imaging 2012;35:204‐210. © 2011 Wiley Periodicals, Inc.     

Gait analysis system for assessment of dynamic loading axis of the knee

The purpose of this study was (1) to demonstrate a computer-assisted gait analysis system that can visualize the locus of the dynamic loading axis on the proximal tibia joint surface, and (2) to assess the accuracy of this system in a patient with bilateral knee osteoarthritis (OA). This system uses force plate data, CT skeletal structure data and motion capture data obtained from an infrared position sensor. The relative positions between bones and markers were used to calculate skeletal model movement based on movement of the markers. The locus of the dynamic loading axis on the knee joint was defined as the point on the proximal tibia joint surface that intersected with the loading axis of the lower limb, which passed through the centre of the femoral head and the centroid of multiple points surrounded by the distal tibia joint surface contour. To assess the accuracy of this system, open MRI was used to evaluate positions of skin markers against bones in six healthy volunteers. The locus in a patient was affected by differences between the varus knee with medial compartment OA on the non-operative side and the knee treated with high tibial osteotomy (HTO) on the opposite side. At knee flexion angles of 0 degrees, 15 degrees and 30 degrees, the mean value of measurement error for point locations on the locus was within 5.6% of joint width in the lateral direction (JWLD) on the proximal tibia joint. This system can provide clinically useful information for evaluation of the dynamic loading axis on the knee joint surface.     

Adaptations in trabecular bone microarchitecture in Olympic athletes determined by 7T MRI

PURPOSE: To produce in vivo high-resolution images of the knee and to determine the feasibility of using 7T MR to detect changes in trabecular bone microarchitecture in elite athletes (Olympic fencers) who undergo high impact activity. MATERIALS AND METHODS: The dominant knees of four males from the U.S. Olympic Fencing Team and three matched healthy male controls were scanned in a 7T whole-body scanner using a quadrature knee coil with three-dimensional (3D) fast low angle shot (FLASH): 50 axial images at the distal femur (0.156 mm x 0.156 mm) and 80 axial images at the knee joint (0.195 mm x 0.195 mm). Bone volume fraction (BVF) and marrow volume fraction (MVF) images were computed and fuzzy distance transform (FDT) and digital topological analysis (DTA) were applied to determine: trabecular number (Tb.N), trabecular thickness (Tb.Th), and trabecular separation (Tb.Sp); BVF (BV/TV); trabecular and marrow space surface-to-curve ratio (SC, marker of plate to rod ratio); and trabecular and marrow space erosion index (EI, inverse marker for network connectivity). Quadriceps muscle volume (MV) was calculated as well. We calculated group means and performed two-tailed t-tests to determine statistical significance. RESULTS: Compared to controls, fencers had: decreased Tb.Sp (P = 0.0082 at femur, P = 0.051 at joint); increased Tb.N (P < 0.05 at both femur and joint) and BV/TV (P < 0.001 at both femur and joint); increased trabecular SC and decreased marrow space SC (P < 0.01 at both femur and joint); decreased trabecular EI and increased marrow space EI (P < 0.01 at both femur and joint); and increased MV (P = 0.038). There was no difference in Tb.Th at the distal femur (P = 0.92) or joint (P = 0.71) between groups. CONCLUSION: To our knowledge, this is the first study to perform 7T MRI of the knee in vivo. Elite athletes who undergo high impact activity have increased MV and improved trabecular bone structure compared to controls.     

Development of three-dimensional kinematic analysis system for artificial knee implants using X-ray fluoroscopic imaging

To achieve quantitative assessment of 3D dynamic motion of artificial knee implants under clinical conditions, we developed a 3D kinematic analysis system using X-ray fluoroscopic imaging. The 3D pose-estimation technique for knee implants was built on a 2D/3D registration algorithm, which determines the spatial pose for each femoral and tibial component from the knee implant contours and computer-assisted design (CAD) models of the implant. In order to validate the accuracy of the 3D pose estimation and the system, computer simulation and in vitro tests were performed using images of knee implants taken in 10 different poses with respect to X-ray focus. Computer simulation tests showed that the root mean square errors (RMSE) for all variables were less than 1.0 mm 1.0 degrees. In vitro tests showed that the RMSE for translation perpendicular to the X-ray image plane was about 1.5 mm, while the accuracy of the remaining two translational and three rotational variables was found to be sufficient for analyzing knee kinematics. Computation time in 3D pose estimation was then obtained in less than 30 seconds for each frame. In clinical application, dynamic movement in deep knee bending was quantitatively analyzed, and the feasibility and effectiveness of the system was demonstrated.     

Long-term follow-up after patellar tendon shortening for flexed knee gait in bilateral spastic cerebral palsy

BackgroundFlexed knee gait is a common gait dysfunction in individuals with bilateral spastic cerebral palsy (BSCP) and is often addressed with single event multilevel surgery (SEMLS). SEMLS has been shown to have positive short-term effects especially on sagittal knee joint kinematics with less knee flexion during stance phase. However, mid- and long-term observations are rare, and results are reported in discrete parameters or summary statistics where temporal aspects are not considered.Research questionDoes the improved knee joint kinematics after patellar tendon shortening (PTS) as part of SEMLS persist in the long-term in individuals with BSCP?MethodsData of instrumented gait analysis of twelve participants (females/males: 5/7, mean age: 15.3 ± 3.4 years) with BSCP treated with PTS as part of SEMLS were retrospectively analyzed. Participants had had follow-up gait analysis 1, 5 and 7 years or more after surgery. Three-dimensional lower extremity kinematics of walking at a self-selected speed were collected using a 12-camera motion capture system and 4 embedded force plates. One-dimensional statistical parametric mapping (SPM) was used for data analysis, permitting time point comparisons of continuous data.ResultsTime point comparison revealed no significant differences in the sagittal plane for knee joint kinematics (p > 0.05) over the tree measurement time points. Hip and ankle joint kinematics as well as normalised walking speed remained stable over the observation period.SignificanceThis is the first study investigating lower extremity kinematics in patients with BSCP and flexed knee gait after SEMLS with SPM. Results demonstrate that positive effects on sagittal knee joint kinematics of PTS as part of SEMLS persist up to 9 years after surgery and progressivity does not reoccur. Thus, if clinical examination indicates an operation in individuals with BSCP, improved kinematics through SEMLS persist into adulthood. With the relatively new statistical procedure SPM gait can be displayed and analysed in established joint angle curves making them easier to understand (e.g. physiotherapists, movement scientists, physicians).     

Advantages and limitations of prospective head motion compensation for MRI using an optical motion tracking device

RATIONALE AND OBJECTIVES: Subject motion appears to be a limiting factor in numerous magnetic resonance (MR) imaging (MRI) applications. In particular, head tremor, which often accompanies stroke, may render certain high-resolution two- (2D) and three-dimensional (3D) techniques inapplicable. The reason for that is head movement during acquisition. The study objective is to achieve a method able to compensate for complete motion during data acquisition. The method should be usable for every sequence and easily implemented on different MR scanners. MATERIALS AND METHODS: The possibility of interfacing the MR scanner with an external optical motion-tracking system capable of determining the object's position with submillimeter accuracy and an update rate of 60 Hz is shown. Movement information on the object position (head) is used to compensate for motion in real time by updating the field of view (FOV) by recalculating the gradients and radiofrequency parameter of the MR scanner during acquisition of k-space data, based on tracking data. RESULTS: Results of rotation phantom, in vivo experiments, and implementation of three different MRI sequences, 2D spin echo, 3D gradient echo, and echo planar imaging, are presented. Finally, the proposed method is compared with the prospective motion correction software available on the scanner software. CONCLUSION: A prospective motion correction method that works in real time only by updating the FOV of the MR scanner is presented. Results show the feasibility of using an external optical motion-tracking system to compensate for strong and fast subject motion during acquisition.     

Tibiofemoral kinematics of the anterior cruciate ligament (ACL)-deficient weightbearing, living knee employing vertical access open "interventional" multiple resonance imaging

BACKGROUND: Our current understanding of tibiofemoral kinematics in the anterior cruciate ligament (ACL)-deficient knee is very limited. Using vertical open-access MRI, it is possible to accurately analyze tibiofemoral motion in patients with isolated rupture of the ACL. STUDY: Prospective cohort study. PURPOSE: To assess if ACL rupture alters normal knee weightbearing kinematics. METHODS: Tibiofemoral motion was assessed through the arc of flexion from 0 degrees to 90 degrees in 10 patients with isolated rupture of the ACL in one knee and a normal contralateral knee. Midmedial and midlateral sagittal images were analyzed in all positions of flexion in both knees to assess the tibiofemoral relationship. RESULTS: In the lateral compartment of the knee, the tibial plateau is persistently subluxed anteriorly throughout the arc of flexion from 0 degrees to 90 degrees (flexion facet center to posterior tibial cortex distance of 15.8 mm +/- 2.9 in ACL-deficient knees compared to 21.4 mm +/- 1.4 in normal knees at 0 degrees extension, P <.0001) when compared to normal knees. The medial tibiofemoral relationship is unchanged compared to normal knees. CONCLUSION: Rupture of the ACL changes tibiofemoral kinematics producing anterior subluxation of the lateral tibial plateau. CLINICAL SIGNIFICANCE: Altered kinematics may explain, at least in part, the increased incidence of secondary osteoarthritis in patients with ACL rupture.