Articular cartilage deformation determined in an intact tibiofemoral joint by displacement‐encoded imaging

This study demonstrates the in vitro displacement and strain of articular cartilage in a cyclically‐compressed and intact joint using displacement‐encoded imaging with stimulated echoes (DENSE) and fast spin echo (FSE). Deformation and strain fields exhibited complex and heterogeneous patterns. The displacements in the loading direction ranged from ?1688 to ?1481 μm in the tibial cartilage and from ?1601 to ?764 μm in the femoral cartilage. Corresponding strains ranged from ?9.8% to 0.7% and from ?4.3% to 0.0%. The displacement and strain precision were determined to be 65 μm and less than 0.2%, respectively. Displacement‐encoded magnetic resonance imaging is capable of determining the nonuniform displacements and strains in the articular cartilage of an intact joint to a high precision. Knowledge of these nonuniform strains is critical for the in situ characterization of normal and diseased tissue, as well as the comprehensive evaluation of repair constructs designed using regenerative medicine. Magn Reson Med, 2009. © 2009 Wiley‐Liss, Inc.     

Rapid estimation of cartilage T2 based on double echo at steady state (DESS) with 3 Tesla

The double‐echo‐steady‐state (DESS) sequence generates two signal echoes that are characterized by a different contrast behavior. Based on these two contrasts, the underlying T2 can be calculated. For a flip‐angle of 90°, the calculated T2 becomes independent of T1, but with very low signal‐to‐noise ratio. In the present study, the estimation of cartilage T2, based on DESS with a reduced flip‐angle, was investigated, with the goal of optimizing SNR, and simultaneously minimizing the error in T2. This approach was validated in phantoms and on volunteers. T2 estimations based on DESS at different flip‐angles were compared with standard multiecho, spin‐echo T2. Furthermore, DESS‐T2 estimations were used in a volunteer and in an initial study on patients after cartilage repair of the knee. A flip‐angle of 33° was the best compromise for the combination of DESS‐T2 mapping and morphological imaging. For this flip angle, the Pearson correlation was 0.993 in the phantom study (～20% relative difference between SE‐T2 and DESS‐T2); and varied between 0.429 and 0.514 in the volunteer study. Measurements in patients showed comparable results for both techniques with regard to zonal assessment. This DESS‐T2 approach represents an opportunity to combine morphological and quantitative cartilage MRI in a rapid one‐step examination. Magn Reson Med, 2009. © 2009 Wiley‐Liss, Inc.     

Delayed gadolinium‐enhanced magnetic resonance imaging (dGEMRIC) of hip joint cartilage in femoroacetabular impingement (FAI): Are pre‐ and postcontrast imaging both necessary?

The purpose of this study was to assess if delayed gadolinium MRI of cartilage using postcontrast T₁ (T_1Gd) is sufficient for evaluating cartilage damage in femoroacetabular impingement without using noncontrast values (T₁₀). T_1Gd and ΔR₁ (1/T_1Gd ? 1/T₁₀) that include noncontrast T₁ measurements were studied in two grades of osteoarthritis and in a control group of asymptomatic young‐adult volunteers. Differences between T_1Gd and ΔR₁ values for femoroacetabular impingement patients and volunteers were compared. There was a very high correlation between T_1Gd and ΔR₁ in all study groups. In the study cohort with Tonnis grade 0, correlation (r) was ?0.95 and ?0.89 with Tonnis grade 1 and ?0.88 in asymptomatic volunteers, being statistically significant (P < 0.001) for all groups. For both T_1Gd and ΔR₁, a statistically significant difference was noted between patients and control group. Significant difference was also noted for both T_1Gd and ΔR₁ between the patients with Tonnis grade 0 osteoarthritis and those with grade 1 changes. Our results prove a linear correlation between T_1Gd and ΔR₁, suggesting that T_1Gd assessment is sufficient for the clinical utility of delayed gadolinium MRI of cartilage in this setting and additional time‐consuming T₁₀ evaluation may not be needed. Magn Reson Med, 2009. © 2009 Wiley‐Liss, Inc.     

Clinical application of scaffolds for cartilage tissue engineering

The purpose of this paper is to review the basic science and clinical literature on scaffolds clinically available for the treatment of articular cartilage injuries. The use of tissue-engineered grafts based on scaffolds seems to be as effective as conventional ACI clinically. However, there is limited evidence that scaffold techniques result in homogeneous distribution of cells. Similarly, few studies exist on the maintenance of the chondrocyte phenotype in scaffolds. Both of which would be potential advantages over the first generation ACI. The mean clinical score in all of the clinical literature on scaffold techniques significantly improved compared with preoperative values. More than 80% of patients had an excellent or good outcome. None of the short- or mid-term clinical and histological results of these tissue-engineering techniques with scaffolds were reported to be better than conventional ACI. However, some studies suggest that these methods may reduce surgical time, morbidity, and risks of periosteal hypertrophy and post-operative adhesions. Based on the available literature, we were not able to rank the scaffolds available for clinical use. Firm recommendations on which cartilage repair procedure is to be preferred is currently not known on the basis of these studies. Randomized clinical trials and longer follow-up periods are needed for more widespread information regarding the clinical effectiveness of scaffold-based, tissue-engineered cartilage repair.     

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.     

Ultrashort TE spectroscopic imaging (UTESI): Application to the imaging of short T2 relaxation tissues in the musculoskeletal system

Purpose

To investigate ultrashort TE spectroscopic imaging (UTESI) of short T2 tissues in the musculoskeletal (MSK) system.

Materials and Methods

Ultrashort TE pulse sequence is able to detect rapidly decaying signals from tissues with a short T2 relaxation time. Here a time efficient spectroscopic imaging technique based on a multiecho interleaved variable TE UTE acquisition is proposed for high‐resolution spectroscopic imaging of the short T2 tissues in the MSK system. The projections were interleaved into multiple groups with the data for each group being collected with progressively increasing TEs. The small number of projections in each group sparsely but uniformly sampled k‐space. Spectroscopic images were generated through Fourier transformation of the time domain images at variable TEs. T2* was quantified through exponential fitting of the time domain images or line shape fitting of the magnitude spectrum. The feasibility of this technique was demonstrated in volunteer and cadaveric specimen studies on a clinical 3T scanner.

Results

UTESI was applied to six cadaveric specimens and four human volunteers. High spatial resolution and contrast images were generated for the deep radial and calcified layers of articular cartilage, menisci, ligaments, tendons, and entheses, respectively. Line shape fitting of the UTESI magnitude spectroscopic images show a short T2* of 1.34 ± 0.56 msec, 4.19 ± 0.68 msec, 3.26 ± 0.34 msec, 1.96 ± 0.47 msec, and 4.21 ± 0.38 msec, respectively.

Conclusion

UTESI is a time‐efficient method to image and characterize the short T2 tissues in the MSK system with high spatial resolution and high contrast. J. Magn. Reson. Imaging 2009;29:412–421. © 2009 Wiley‐Liss, Inc.

     

膝关节半月板撕裂的MRI诊断

目的探讨膝关节半月板撕裂的MR I表现及MR I诊断价值。方法行MR I检查并行关节镜检查或手术的患者98例,对其结果进行对照分析。结果在98例196个半月板中,与关节镜检查及手术结果比较,MR I诊断半月板撕裂的准确性为95.9%。结论MR I是诊断膝关节半月板撕裂理想的非创伤性的检查方法。     

Conditional loss of PTEN leads to skeletal abnormalities and lipoma formation

To understand the role of tumor suppressor PTEN in cartilage development, we have generated chondrocyte specific PTEN deletion mice using Col2a1Cre and PTEN(loxp/loxp) mice. PTEN mutant mice are viable and fertile, nonetheless, develop kyphosis over time. Histological analyses show mutant vertebrae and intervertebral discs are larger and therefore the spines are longer than in control mice. In addition, the growth plates are thicker, invading trabecular bone areas are deeper, and marrow adipocyte populations are higher in PTEN mutant mice. Furthermore, the growth plates, not normally fused in mouse long bones, are fused in PTEN mutants. Intriguingly, PTEN mice develop lipomas and show abnormal accumulation of fat tissues along spines. Cell tracking assays have confirmed that lipomas and a portion of fat tissues were derived from Col2a1Cre PTEN(loxp/loxp) cells. Further analyses have suggested that the phenotypes of PTEN mutant likely attribute to PTEN's negatively regulating role in PI3K/Akt pathway.     

家猪体外胰蛋白酶消化关节软骨：7.0TMR T1ρ加权成像与量化分析

背景：T1ρ驰豫时间是探测软骨生化改变的最具吸引力的新的磁共振参数。早期骨关节炎主要表现为蛋白多糖的丢失以及胶原的轻微改变。目的：应用T1ρ成像技术与弛豫时间图量化分析方法,评价体外胰蛋白酶消化与未消化家猪髌骨软骨T1ρ驰豫时间的改变。设计、时间及地点：同体对照观察,于2007-02/2008-01在丹麦奥胡斯大学医院骨科与磁共振研究中心完成。材料：丹麦雌性长白猪10头,左右侧髌骨共20个。方法：选择10头家猪,取右侧髌骨10个为对照组,浸泡于PBS中4 h后取出。取左侧髌骨10个为消化组,浸泡于含有胰蛋白酶的PBS溶液中,4 h后取出。利用7.0T磁共振机,分别采用自旋锁定自动补偿脉冲簇的三维SE序列进行扫描,获得关节软骨的T1ρ加权图像。重构T1ρ弛豫时间图,测定关节软骨T1ρ值。取两组髌骨软骨标本行番红O/固绿染色进行组织学观察。主要观察指标：①T1ρ弛豫时间图量化分析结果。②两组软骨标本组织学结果。结果：经酶诱导消化的体外家猪髌骨关节软骨T1ρ加权图像成像清晰,呈分层状表现,对比度好,无异常伪影。大体观察两组关节软骨T1ρ加权图像,见局部的信号异常改变。重构T1ρ弛豫时间图并量化测定分析显示,消化组软骨表层T1ρ值高于对照组,差异具有显著性意义（P 〈 0.05）,其全层、深层与钙化层之间的比较差异无显著性意义（P 〉 0.05）。结论：经胰蛋白酶诱导消化可引起退变软骨T1ρ驰豫时间改变,特别是在软骨的表层变化明显,提示T1ρ驰豫时间是较敏感、特异性的检测指标,可进一步应用于关节软骨退变的早期诊断。