Longitudinal analysis of MRI T2 knee cartilage laminar organization in a subset of patients from the osteoarthritis initiative: A texture approach

Cartilage magnetic resonance imaging T₂ relaxation time is sensitive to hydration, collagen content, and tissue anisotropy, and a potential imaging‐based biomarker for knee osteoarthritis. This longitudinal pilot study presents an improved cartilage flattening technique that facilitates texture analysis using gray‐level co‐occurrence matrices parallel and perpendicular to the cartilage layers, and the application of this technique to the knee cartilage of 13 subjects of the osteoarthritis initiative at baseline, 1‐year follow‐up, and 2‐year follow‐up. Cartilage flattening showed minimum distortion (～ 0.5 ms) of mean T₂ values between nonflattened and flattened T₂ maps. Gray‐level co‐occurrence matrices texture analysis of flattened T₂ maps detected a cartilage laminar organization at baseline, 1‐year follow‐up, and 2‐year follow‐up by yielding significant (P < 0.05) differences between texture parameters perpendicular and parallel to the cartilage layers. Tendencies showed higher contrast, dissimilarity, angular second moment, and energy perpendicular to the cartilage layers; and higher homogeneity, entropy, variance, and correlation parallel to them. Significant (P < 0.05) longitudinal texture changes were also detected reflecting subtle signs of a laminar disruption. Tendencies showed decreasing contrast, dissimilarity, and entropy; and increasing homogeneity, energy, and correlation. Results of this study warrant further investigation to complete the assessment of the usefulness of the presented methodology in the study of knee osteoarthritis. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.     

In vivo MRI of fresh stored osteochondral allograft transplantation with delayed gadolinium‐enhanced MRI of cartilage: Protocol considerations and recommendations

The protocol for delayed gadolinium‐enhanced MRI of cartilage (dGEMRIC) was adapted for the evaluation of transplanted osteochondral allograft cartilage. Eight patients with focal grade 4 cartilage defects of the femoral condyle were treated with single cylindrical osteochondral allografts. At 1 and 2 years, dGEMRIC image sequences were acquired and regions of interest (ROIs) were drawn in repair and native control cartilage. Mean T₁ values of region of interest were used to calculate established dGEMRIC metrics. The correlation was measured between the ΔR₁ and R₁‐Post metrics for repair and native cartilage. T₁ times were measured in deep and superficial zones of cartilage. A strong correlation was identified between full‐thickness, deep, and superficial ΔR₁ and R₁‐Post values for native cartilage and repair cartilage for all years (range: 0.893–1.0). The mean T₁ times and ΔR₁ rate between deep and superficial regions of articular cartilage were statistically different for all regions of the distal femora analyzed at 1 year and 2 years after osteochondral allograft transplantation (P < 0.05). The dGEMRIC pre‐Gadolinium scan is unnecessary when evaluating transplanted osteochondral allograft cartilage. The observation of stratified T₁ and ΔR₁ values indicates a need to re‐evaluate the methodology behind the placement of region of interest in dGEMRIC. Magn Reson Med, 2013. © 2012 Wiley Periodicals, Inc.     

In vivo transport of Gd-DTPA(2-) in human knee cartilage assessed by depth-wise dGEMRIC analysis

Purpose:

To investigate the transport of Gd‐DTPA^2? in different layers of femoral knee cartilage in vivo.

Materials and Methods:

T₁ measurements (1.5 Tesla) were performed in femoral knee cartilage of 23 healthy volunteers. The weight‐bearing central cartilage was analyzed before contrast and at eight time points after an intravenous injection of Gd‐DTPA^2?: 12–60 min (4 volunteers) and 1–4 h (19 volunteers). Three regions of interest were segmented manually: deep, middle, and superficial.

Results:

Before contrast injection, a depth‐wise variation of T₁ was observed with 50% higher values in the superficial region compared with the deep region. In the deep region, the uptake of Gd‐DTPA^2? was not detected until 36 min and the concentration increased until 240 min, whereas in the superficial region, the uptake was seen already at 12 min and the concentration decreased after 180 min (P < 0.01). There was a difference between medial and lateral compartment regarding bulk, but not superficial Gd‐DTPA^2? concentration. The bulk gadolinium concentration was negatively related to the cartilage thickness (r = ?0.68; P < 0.01).

Conclusion:

The depth‐wise and thickness dependent variations in Gd‐DTPA² transport influence the interpretation of bulk dGEMRIC analysis in vivo. In thick cartilage, incomplete penetration of Gd‐DTPA² will yield a falsely too long T₁. J. Magn. Reson. Imaging 2011;. © 2011 Wiley Periodicals, Inc.

     

Longitudinal quantitative MR imaging of cartilage morphology in the presence of gadopentetate dimeglumine (Gd‐DTPA)

MRI‐based cartilage morphometry can monitor cartilage loss in osteoarthritis. Intravenous Gd‐DTPA injection is needed for compositional (proteoglycan) cartilage imaging with delayed gadolinium enhanced MRI (dGEMRIC). However, longitudinal changes of cartilage morphology have not been compared in the presence and absence of Gd‐DTPA. Baseline and 2‐year follow‐up images were acquired in 41 female participants with definite medial radiographic osteoarthritis, both before and 2 h after Gd‐DTPA injection, and cartilage thickness was measured. In the absence of Gd‐DTPA, a 2.6% reduction in cartilage thickness was observed between baseline and follow‐up in the central subregion of the medial femorotibial compartment (standardized response mean [SRM] = ?0.33; P < 0.05), but only a 0.7% reduction (SRM = ?0.10; P = 0.51) in the presence of Gd‐DTPA. The findings suggest that morphometric cartilage measurement in the presence of Gd‐DTPA needs to undergo further validation, before one can recommend longitudinal dGEMRIC and morphological cartilage imaging to be performed in a single session. Magn Reson Med, 2009. © 2009 Wiley‐Liss, Inc.     

Reduction of residual dipolar interaction in cartilage by spin‐lock technique

The influence of radiofrequency (RF) spin‐lock pulse on the laminar appearance of articular cartilage in MR images was investigated. Spin‐lock MRI experiments were performed on bovine cartilage plugs on a 4.7 Tesla small‐bore MRI scanner, and on human knee cartilage in vivo on a 1.5 Tesla clinical scanner. When the normal to the surface of cartilage was parallel to B₀, a typical laminar appearence was exhibited in T₂‐weighted images of cartilage plugs, but was absent in T_1ρ‐weighted images of the same plugs. At the “magic angle” orientation (when the normal to the surface of cartilage was 54.7° with respect to B₀), neither the T₂ nor the T_1ρ images demonstrated laminae. At the same time, T_1ρ values were greater than T₂ at both orientations throughout the cartilage. T_1ρ dispersion (i.e., the dependence of the relaxation rate on the spin‐lock frequency ω₁) was observed, which reached a steady‐state value of close to 2 kHz in both parallel and magic‐angle orientations. These results suggest that residual dipolar interaction from motionally‐restricted water and relaxation processes, such as chemical exchange, contribute to T_1ρ dispersion in cartilage. Further, one can reduce the laminar appearance in human articular cartilage by applying spin‐lock RF pulses, which may lead to a more accurate diagnosis of degenerative changes in cartilage. Magn Reson Med 52:1103–1109, 2004. © 2004 Wiley‐Liss, Inc.     

An efficient subset of morphological measures for articular cartilage in the healthy and diseased human knee

The relationship between three‐dimensional, MRI‐based morphologic measurements commonly taken of knee cartilage was examined to determine whether a subset of variables fully reflects differences observed in cartilage in cross‐sectional and longitudinal studies. The benefits of a subset of measures include increased statistical power due to reduced multiple comparisons, improved understanding of relationships between the morphologic measures of articular knee cartilage, and greater efficiency in reporting results. One hundred fifty‐two women (77 healthy and 75 with knee osteoarthritis) had coronal 3‐T MR images of the knee acquired at baseline and at 24 months. Measures of femorotibial cartilage morphology (surface area, thickness, volume, etc.) were determined in the medial and lateral tibia and femur. Cartilage thickness (mean cartilage thickness over the total area of the [subchondral] bone), total subchondral bone area, and percentage of denuded area of the subchondral bone were found to explain over 90% of the cross‐sectional and longitudinal variation observed in other measures of cartilage morphology commonly reported in knee osteoarthritis. Hence, these three measures of cartilage morphology explain nearly all variation in a larger set of common cartilage morphology measures both cross‐sectionally and longitudinally, both in healthy and in osteoarthritic knees. These variables hence define an efficient subset for describing structural status and change in osteoarthritic cartilage. Magn Reson Med 63:680–690, 2010. © 2010 Wiley‐Liss, Inc.     

Quantitative cartilage degeneration associated with spontaneous osteoarthritis in a guinea pig model

Purpose:

To determine (i) the feasibility and intra‐ and inter‐scan reproducibility of T_1ρ MRI in assessing cartilage degeneration in a guinea pig model with naturally occurring joint disease that closely mimics human osteoarthritis (OA), (ii) demonstrate the sensitivity of T_1ρ MRI in assessing the age dependent cartilage degeneration in OA progression as compared to histopathological changes.

Materials and Methods:

Duncan‐Hartley guinea pigs were obtained at various ages and maintained under an IACUC approved protocol. The left hind stifle joint was imaged using T_1ρ MRI on a 9.4 Tesla Varian horizontal 20 cm bore scanner using a custom surface coil. Reproducibility of T_1ρ MRI was assessed using 4‐month‐old guinea pigs (N = 3). Three age cohorts; 3 month (N = 8), 5 month (N = 6), and 9 month (N = 5), were used to determine the age‐dependent osteoarthritic changes as measured by T_1ρ MRI. Validation of age‐dependent cartilage degeneration was confirmed by histology and Safranin‐O staining.

Results:

T_1ρ values obtained in the cartilage of the stifle joint in guinea pigs were highly reproducible with an inter‐scan mean coefficient of variation (CV) of 6.57% and a maximum intra‐scan CV of 9.29%. Mean cartilage T_1ρ values in animals with late stage cartilage degeneration were 56.3–56.9 ms (5–9 month cohorts) were both significantly (P < 0.01) higher than that obtained from 3‐month‐old cohort (44 ms) demonstrating an age‐dependent variation. T_1ρ was shown to be significantly greater than T₂. T_1ρ dispersion was observed in this animal model for the first time showing an increase of 45% between 500 Hz and 1500 Hz spin‐locking frequency. Cartilage thickness measurements were calculated from single mid‐coronal histology sections from same animals used for T_1ρ MRI. Thickness calculations showed insignificant differences between 3‐ and 5‐month cohorts and was significantly decreased by 9 months of age (P < 0.01). A moderate correlation (R² = 0.45) existed between T_1ρ values and signal intensity of Safranin‐O stain.

Conclusion:

The data presented demonstrate that T_1ρ MRI is highly reproducible in this spontaneous model of OA and may serve as a noninvasive tool to characterize joint cartilage degeneration during OA. Age‐dependent changes, verified with histological measurements of proteoglycan loss, correlated with T_1ρ across different age groups. T_1ρ has adequate dynamic range and is sensitive to detect and track the progression of cartilage degeneration in the guinea pig model before gross anatomical changes such as cartilage thinning has occurred. This study presents a technological advancement that would permit longitudinal studies of evaluating disease‐modifying therapies useful for treating human OA. J. Magn. Reson. Imaging 2012;35:891–898. © 2011 Wiley Periodicals, Inc.     

Changes in knee cartilage T2 values over 24 months in subjects with and without risk factors for knee osteoarthritis and their association with focal knee lesions at baseline: data from the osteoarthritis initiative

Purpose:

To examine the changes in knee cartilage T2 values over 24 months in subjects with and without risk factors for knee osteoarthritis (OA) and their association with focal knee lesions at baseline.

Materials and Methods:

Forty‐one subjects without and 101 subjects with OA risk factors (such as history of knee injury or surgery) were selected from the Osteoarthritis Initiative database (age: 45–55 years, no radiographic OA in the right knee). Baseline magnetic resonance imaging (MRI) of the right knee were assessed for prevalence and grade of focal knee lesions. Right knee cartilage T2 measurements were performed in five compartments (patella, medial/lateral femur/tibia) at baseline and at 24‐month follow‐up.

Results:

Compared to subjects without OA risk factors, those with OA risk factors showed no significant differences in baseline prevalence and grade of focal knee lesions (P > .05), but had significantly higher T2 values in the medial femur compartment at both timepoints (P < 0.05). T2 values averaged over all five compartments increased significantly over 24 months in both groups, but differences in T2 increase between the groups were not significant. Subjects with cartilage lesions showed significantly higher T2 values compared to subjects without cartilage lesions at both timepoints, but no accelerated T2 increase over 24 months (P > 0.05).

Conclusion:

Cartilage T2 values significantly increased over 24 months in subjects with and without OA risk factors, but neither the presence of OA risk factors nor the presence of cartilage lesions at baseline were associated with these T2 increases. J. Magn. Reson. Imaging 2012;370‐378. © 2011 Wiley Periodicals, Inc.     

Influence of knee positions on T2, T*2, and dGEMRIC mapping in porcine knee cartilage

We examined the influence of flexed knee positions on cartilage MR assessments. Sagittal T₂, T*₂, and delayed gadolinium‐enhanced MRI of cartilage (dGEMRIC) maps of the femoral cartilage were obtained in eight 6‐month‐old porcine femorotibial joints in the extended knee position (position A: flexion 0° and femoral shaft in parallel with the amplitude of static field), flexed knee position (position B: flexion 40° and femoral shaft oriented at 40° to the amplitude of static field), and oblique‐placed knee‐extended position (position C: flexion 0° and femoral shaft oriented at 40° to the amplitude of static field). Comparison of the MR parameters between positions A and C showed isolated influence of the magic‐angle effect, and comparison between positions A and B showed effects of knee flexion. Proteoglycan and hydroxyproline content in cartilage specimen at each region of interest had no significant correlation with T₂, T*₂, and dGEMRIC values. At the central zone, located on a weight‐bearing area and parallel to the amplitude of static field, T₂/T*₂/dGEMRIC values increased by 6.8/11/0.8% at position C and by 24/44/31% at position B compared with position A. There was a significant increase in T₂ and T*₂ values at position B compared with those at position A. The substantial changes in T₂, T*₂, and dGEMRIC were shown in response to knee flexion, presumably due to the compounding influence of the magic‐angle effect and change in the intra‐articular biomechanical condition. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.     

Delayed contrast‐enhanced MRI of cartilage: Comparison of nonionic and ionic contrast agents

The objective of this study was to evaluate if cartilage fixed charge density is the only factor determining the distribution of the measured delayed gadolinium‐enhanced magnetic resonance imaging of cartilage index, T₁(Gd‐DTPA^2?), across cartilage in the clinical delayed gadolinium‐enhanced magnetic resonance imaging of cartilage protocol. Nineteen subjects with osteoarthritis and 14 controls were included. Cartilage T₁(Gd) was measured following administration of 0.2 mmol kg^?1 of nonionic (Gd‐DTPA‐BMA) and, at a different date, anionic (Gd‐DTPA^2?). T₁(Gd‐DTPA‐BMA) was plotted against T₁(Gd‐DTPA^2?); a slope of 0 would indicate domination by charge effects; a nonzero slope would suggest that other factors influence T₁(Gd‐DTPA‐BMA), and hence potentially T₁(Gd‐DTPA^2?). The low slope of the curve found in osteoarthritis subjects (0.31) indicates that Gd‐DTPA‐BMA penetrated most osteoarthritis cartilage to the same extent, and T₁(Gd‐DTPA‐BMA) did not differentiate cartilages, which were differentiated by T₁(Gd‐DTPA^2?). The higher slopes in control subjects (0.88) are possibly due to inhibited transport of contrast agent into healthier cartilage, potentially exaggerated by the fast body clearance of the nonionic contrast agent. Overall, the use of anionic Gd‐DTPA^2? for delayed gadolinium‐enhanced magnetic resonance imaging of cartilage is indicated for better discrimination of the health status of cartilage. Future studies could be designed to use contrast‐enhanced dynamics to understand the transport properties of tissues in the joint and to evaluate the concentration of tissue constituents. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.     

Spatial distribution and relationship of T1ρ and T2 relaxation times in knee cartilage with osteoarthritis

T_1ρ and T₂ relaxation time constants have been proposed to probe biochemical changes in osteoarthritic cartilage. This study aimed to evaluate the spatial correlation and distribution of T_1ρ and T₂ values in osteoarthritic cartilage. Ten patients with osteoarthritis (OA) and 10 controls were studied at 3T. The spatial correlation of T_1ρ and T₂ values was investigated using Z‐scores. The spatial variation of T_1ρ and T₂ values in patellar cartilage was studied in different cartilage layers. The distribution of these relaxation time constants was measured using texture analysis parameters based on gray‐level co‐occurrence matrices (GLCM). The mean Z‐scores for T_1ρ and T₂ values were significantly higher in OA patients vs. controls (P < 0.05). Regional correlation coefficients of T_1ρ and T₂ Z‐scores showed a large range in both controls and OA patients (0.2–0.7). OA patients had significantly greater GLCM contrast and entropy of T_1ρ values than controls (P < 0.05). In summary, T_1ρ and T₂ values are not only increased but are also more heterogeneous in osteoarthritic cartilage. T_1ρ and T₂ values show different spatial distributions and may provide complementary information regarding cartilage degeneration in OA. Magn Reson Med, 2009. © 2009 Wiley‐Liss, Inc.     

Variable flip angle‐based fast three‐dimensional T1 mapping for delayed gadolinium‐enhanced MRI of cartilage of the knee: Need for B1 correction

Delayed gadolinium‐enhanced MRI of cartilage is a technique, which involves T₁ mapping to identify changes in the structural integrity of cartilage associated with osteoarthritis. Currently, the gold standard is 2D inversion recovery turbo spin echo, which suffers from long acquisition times and limited coverage. Three‐dimensional variable flip angle (VFA) is an alternate technique, which has been shown to be accurate when an estimate of T₁ is available a priori. This study validates the variable flip angle method for delayed gadolinium‐enhanced MRI of cartilage of the femoro‐tibial knee cartilage. When amplitude of (excitation) radiofrequency field inhomogeneities were minimized using nonselective pulses and amplitude of (excitation) radiofrequency field correction using an additional acquisition of a amplitude of (excitation) radiofrequency field map, the accuracy of T₁ measurements were improved, and slice‐to‐slice variations over the 3D volume were minimized. In conclusion, fast 3D T₁ mapping using the variable flip angle method with amplitude of (excitation) radiofrequency field correction appears to be an efficient and accurate method for delayed gadolinium‐enhanced MRI of cartilage of the knee. Magn Reson Med, 2011. © 2010 Wiley‐Liss, Inc.     

T2 measurement in articular cartilage: Impact of the fitting method on accuracy and precision at low SNR

T₂ relaxation time is a promising MRI parameter for the detection of cartilage degeneration in osteoarthritis. However, the accuracy and precision of the measured T₂ may be substantially impaired by the low signal‐to‐noise ratio of images available from clinical examinations. The purpose of this work was to assess the accuracy and precision of the traditional fit methods (linear least‐squares regression and nonlinear fit to an exponential) and two new noise‐corrected fit methods: fit to a noise‐corrected exponential and fit of the noise‐corrected squared signal intensity to an exponential. Accuracy and precision have been analyzed in simulations, in phantom measurements, and in seven repetitive acquisitions of the patellar cartilage in six healthy volunteers. Traditional fit methods lead to a poor accuracy for low T₂, with overestimations of the exact T₂ up to 500%. The noise‐corrected fit methods demonstrate a very good accuracy for all T₂ values and signal‐to‐noise ratio. Even more, the fit to a noise‐corrected exponential results in precisions comparable to the best achievable precisions (Cramér‐Rao lower bound). For in vivo images, the traditional fit methods considerably overestimate T₂ near the bone‐cartilage interface. Therefore, using an adequate fit method may substantially improve the sensitivity of T₂ to detect pathology in cartilage and change in T₂ follow‐up examinations. Magn Reson Med, 2010. © 2009 Wiley‐Liss, Inc.     

Kinematic biomechanical assessment of human articular cartilage transplants in the knee using 3-T MRI: an in vivo reproducibility study

The aims of this study were to examine the clinical feasibility and reproducibility of kinematic MR imaging with respect to changes in T ₂ in the femoral condyle articular cartilage. We used a flexible knee coil, which allows acquisition of data in different positions from 40° flexion to full extension during MR examinations. The reproducibility of T ₂ measurements was evaluated for inter-rater and inter-individual variability and determined as a coefficient of variation (CV) for each volunteer and rater. Three different volunteers were measured twice and regions of interest (ROIs) were selected by three raters at different time points. To prove the clinical feasibility of this method, 20 subjects (10 patients and 10 age- and sex-matched volunteers) were enrolled in the study. Inter-rater variability ranged from 2 to 9 and from 2 to 10% in the deep and superficial zones, respectively. Mean inter-individual variability was 7% for both zones. Different T ₂ values were observed in the superficial cartilage zone of patients compared with volunteers. Since repair tissue showed a different behavior in the contact zone compared with healthy cartilage, a possible marker for improved evaluation of repair tissue quality after matrix-associated autologous chondrocyte transplantation (MACT) may be available and may allow biomechanical assessment of cartilage transplants.     

Magnetic resonance imaging reflects cartilage proteoglycan degradation in the rabbit knee

Cartilage degeneration in osteoarthritis is initiated by a loss of proteoglycan. Intra-articular injection of papain causes a reversible loss of proteoglycan in rabbit knees. Rabbits were scanned with magnetic resonance imaging (MRI), using a 1.5T Signa superconducting magnet with 3 inch surface coil. Spin echo sequences were performed in the coronal and sagittal planes at 0, 24, 48, and 72 h after intra-articular injection of papain to obtain T₁, proton density, and T₂-weighted images. Cartilage proteoglycan content was measured biochemically and histochemically. Reduced articular cartilage thickness in the MR images of papain-treated knees corresponded to changes in cartilage proteoglycan content.     

Short TE MR Microscopy: Accurate measurement and zonal differentiation of normal hyaline cartilage

The purpose of this study was to use MR imaging to accurately measure the thickness of hyaline cartilage and determine the MR contrast parameters for differentiation of cartilage zones in normal human cartilage samples. Cartilage samples were examined using three dimensional spin-echo MR microscopy at 9.4 T with a voxel size of 31 × 31 × 300 μm. Effects of T₂ signal loss, susceptibility, and partial volume on measured thickness of cartilage were investigated. Thickness measurements were obtained on corresponding histological sections for comparison. Optimal contrast parameters for delineation of cartilage zones were evaluated using magnetization transfer, inversion recovery, T₁, and T₂ contrast. T₂ relaxation losses were identified as the primary source of discrepancy between the measured thickness of cortical bone and hyaline cartilage. Good contrast for zonal differentiation was obtained using T₁ weighting. We conclude that images obtained using short TE MR microscopy can be used to accurately measure cartilage and bone thickness in human specimens, and can demonstrate zones within normal cartilage.     

MR T2图评价膝关节软骨的初步探讨

目的 探讨MR T2图(T2 mapping)评价膝关节软骨生物组织构成变化的应用价值.方法 对20名健康志愿者运动前后双膝关节、19例骨性关节炎(OA)患者的患膝行矢状面SE序列8回波扫描.测量关节软骨各感兴趣区的T2值,比较志愿者运动前后及运动前浅、深层,以及志愿者与OA患者之间T2值的差异.原始图像经后处理后获得相应的T2图.运动前后T2值的比较采用配对t检验,运动前浅、深层及志愿者与OA患者间T2值的比较采用独立样本t检验.结果 志愿者运动前膝关节胫骨面软骨浅、深层的T2值分别为(48.8±6.3)ms、(44.3±5.7)ms;运动后分别为(43.4±5.0)ms、(40.3±6.1)ms,运动前后差异有统计学意义(t值分别为6.004和5.037,P值均<0.05);运动前胫骨面软骨浅、深层T2值差异有统计学意义(t=3.148,P<0.01).运动前股骨面软骨浅、深层的T2值分别为(52.1±5.7)ms、(47.7±5.3)ms;运动后分别为(47.2±4.5)ms、(43.6±4.1)ms;运动前后差异有统计学意义(t值分别为6.169和5.957,P值均<0.05);运动前股骨面软骨浅、深层T2值差异有统计学意义(t=3.384,P<0.01).相应的T2图显示了T2值变化的空间分布趋势.OA患者膝关节胫骨面关节软骨T2值为(56.0±9.1)ms,较志愿者要高,两组间比较差异有统计学意义(t=-3.446,P<0.01).结论 MR T2图可用于评价运动前后、OA时关节软骨生物组织构成的变化,对关节软骨退变诊断具有一定的临床指导价值.     

Early knee changes in dancers identified by ultra‐high‐field 7 T MRI

We aimed to determine whether a unique, ultra‐high‐field 7 T magnetic resonance imaging (MRI) scanner could detect occult cartilage and meniscal injuries in asymptomatic female dancers. This study had Institutional Review Board approval. We recruited eight pre‐professional female dancers and nine non‐athletic, female controls. We scanned the dominant knee on a 7 T MRI scanner using a three‐dimensional fast low‐angle shot sequence and a proton density, fast spin‐echo sequence to evaluate cartilage and menisci, respectively. Two radiologists scored cartilage (International Cartilage Repair Society classification) and meniscal (Stoller classification) lesions. We applied two‐tailed z‐ and t‐tests to determine statistical significance. There were no cartilage lesions in dancers or controls. For the medial meniscus, the dancers demonstrated higher mean MRI score (2.38 ± 0.61 vs 1.0 ± 0.97, P < 0.0001) and higher frequency of mean grade 2 lesions (88% vs 11%, P < 0.01) compared with the controls. For the lateral meniscus, there was no difference in score (0.5 ± 0.81 vs 0.5 ± 0.78, P = 0.78) in dancers compared with the control groups. Asymptomatic dancers demonstrate occult medial meniscal lesions. Because this has been described in early osteoarthritis, close surveillance of dancers' knee symptoms and function with appropriate activity modification may help maintain their long‐term knee health.     

Quantitative mapping of T2 using partial spoiling

Fast quantitative MRI has become an important tool for biochemical characterization of tissue beyond conventional T₁, T₂, and T₂*‐weighted imaging. As a result, steady‐state free precession (SSFP) techniques have attracted increased interest, and several methods have been developed for rapid quantification of relaxation times using steady‐state free precession. In this work, a new and fast approach for T₂ mapping is introduced based on partial RF spoiling of nonbalanced steady‐state free precession. The new T₂ mapping technique is evaluated and optimized from simulations, and in vivo results are presented for human brain at 1.5 T and for human articular cartilage at 3.0 T. The range of T₂ for gray and white matter was from 60 msec (for the corpus callosum) to 100 msec (for cortical gray matter). For cartilage, spatial variation in T₂ was observed between deep (34 msec) and superficial (48 msec) layers, as well as between tibial (33 msec), femoral, (54 msec) and patellar (43 msec) cartilage. Excellent correspondence between T₂ values derived from partially spoiled SSFP scans and the ones found with a reference multicontrast spin‐echo technique is observed, corroborating the accuracy of the new method for proper T₂ mapping. Finally, the feasibility of a fast high‐resolution quantitative partially spoiled SSFP T₂ scan is demonstrated at 7.0 T for human patellar cartilage. Magn Reson Med, 2011. © 2011 Wiley‐Liss, Inc.     

Non-traumatic anterior cruciate ligament abnormalities and their relationship to osteoarthritis using morphological grading and cartilage T2 relaxation times: data from the Osteoarthritis Initiative (OAI)

Objectives

The aim of this work was to study anterior cruciate ligament (ACL) degeneration in relation to MRI-based morphological knee abnormalities and cartilage T₂ relaxation times in subjects with symptomatic osteoarthritis.

Methods

Two radiologists screened the right knee MRI of 304 randomly selected participants in the Osteoarthritis Initiative cohort with symptomatic OA, for ACL abnormalities. Of the 52 knees with abnormalities, 28 had mucoid degeneration, 12 had partially torn ACLs, and 12 had completely torn ACLs. Fifty-three randomly selected subjects with normal ACLs served as controls. Morphological knee abnormalities were graded using the WORMS score. Cartilage was segmented and compartment-specific T₂ values were calculated.

Results

Compared to normal ACL knees, those with ACL abnormalities had a greater prevalence of, and more severe, cartilage, meniscal, bone marrow, subchondral cyst, and medial collateral ligament lesions (all p?2 measurements did not significantly differ by ACL status.

Conclusions

ACL abnormalities were associated with more severe degenerative changes, likely because of greater joint instability. T2 measurements may not be well suited to assess advanced cartilage degeneration.