Imaging of the wrist at 1.5 Tesla using isotropic three-dimensional fast spin echo cube

PURPOSE

To compare three-dimensional fast spin echo Cube (3D-FSE-Cube) with conventional 2D-FSE in MR imaging of the wrist.

MATERIALS AND METHODS

The wrists of 10 volunteers were imaged in a 1.5 Tesla MRI scanner using an eight-channel wrist coil. The 3D-FSE-Cube images were acquired in the coronal plane with 0.5-mm isotropic resolution. The 2D-FSE images were acquired in both coronal and axial planes for comparison. An ROI was placed in fluid, cartilage, and muscle for SNR analysis. Comparable coronal and axial images were selected for each sequence, and paired images were randomized and graded for blurring, artifact, anatomic details, and overall image quality by three blinded musculoskeletal radiologists.

RESULTS

SNR of fluid, cartilage and muscle at prescribed locations were higher using 3D-FSE-Cube, without reaching statistical significance. Fluid-cartilage CNR was also higher with 3D-FSE-Cube, but not statistically significant. Blurring, artifact, anatomic details, and overall image quality were significantly better on coronal 3D-FSE-Cube images (P < 0.001), but significantly better on axial 2D-FSE images compared with axial 3D-FSE-Cube reformats (P < 0.01).

CONCLUSION

Isotropic data from 3D-FSE-Cube allows reformations in arbitrary scan planes, which may make multiple 2D acquisitions unnecessary, and improve depiction of complex wrist anatomy. However, axial reformations suffer from blurring, likely due to T2 decay during the long echo train, limiting overall image quality in this plane.

Routine 3D magnetic resonance imaging of joints

Due to its high spatial resolution and excellent tissue contrast, magnetic resonance imaging (MRI) has become the most commonly used imaging method to evaluate joints. Most musculoskeletal MRI is performed using 2D fast spin-echo sequences. However, 3D sequences have also been used for joint imaging and have the advantage of acquiring thin continuous slices through joints, which reduces the effects of partial volume averaging. With recent advances in MR technology, 3D sequences with isotropic resolution have been developed. These sequences allow high-quality multiplanar reformat images to be obtained following a single acquisition, thereby eliminating the need to repeat sequences with identical tissue contrast in different planes. Preliminary results on the diagnostic performance of 3D isotropic resolution sequences are encouraging. However, additional studies are needed to determine whether these sequences can replace currently used 2D fast spin-echo sequences for providing comprehensive joint assessment in clinical practice.

Strains across the acetabular labrum during hip motion: a cadaveric model

BACKGROUND

Labral tears commonly cause disabling intra-articular hip pain and are commonly treated with hip arthroscopy. However, the function and role of the labrum are still unclear.

HYPOTHESES

(1) Flexion, adduction, and internal rotation (a position clinically defined as the position for physical examination known as the impingement test) places greatest circumferential strain on the anterolateral labrum and posterior labrum; (2) extension with external rotation (a position clinically utilized during physical examination to assess for posterior impingement and for anterior instability) places significant circumferential strains on the anterior labrum; (3) abduction with external rotation during neutral flexion-extension (the position the extremity rests in when a patient lies supine) places the greatest load on the lateral labrum.

STUDY DESIGN

Descriptive laboratory study.

METHODS

Twelve cadaveric hips (age, 79 years) without labral tears or arthritis were studied. Hips were dissected free of soft tissues, except the capsuloligamentous structures. Differential variable reluctance transducers were placed in the labrum anteriorly, anterolaterally, laterally, and posteriorly to record circumferential strains in all 4 regions as the hip was placed in 36 different positions.

RESULTS

The posterior labrum had the greatest circumferential strains identified; the peak was in the flexed position, in adduction or neutral abduction-adduction. The greatest strains anteriorly were in flexion with adduction. The greatest strains anterolaterally were in full extension. External rotation had greater strains than neutral rotation and internal rotation. The greatest strains laterally were at 90° of flexion with abduction, and external or neutral rotation. In the impingement position, the anterolateral strain increased the most, while the posterior labrum showed decreased strain (greatest magnitude of strain change). When the hip is externally rotated and in neutral flexion-extension or fully extended, the posterior labrum has significantly increased strain, while the anterolateral labrum strain is decreased.

CONCLUSION

These are the first comprehensive strain data (of circumferential strain) analyzing the whole hip labrum. For the intact labrum, the greatest strain change was at the posterior acetabulum, whereas clinically, acetabular labral tears occur most frequently anterolaterally or anteriorly. The results are consistent with the impingement test as an assessment of anterolateral acetabular labral stress. The hyperextension-rotation test, often used clinically to assess anterior hip instability and posterior impingement, did not show a change in strain anteriorly, but did reveal an increase in strain posteriorly.

CLINICAL RELEVANCE

Although this study does not include muscular forces across the hip joint, it does provide a clue as to the stresses about the labrum through the complete range of motions of the hip, which may help in providing a better understanding of the cause of labral tears and in the protection of labral repairs.

Three-dimensional fluid-suppressed T2-prep flow-independent peripheral angiography using balanced SSFP

Accurate depiction of the vessels of the lower leg, foot or hand benefits from suppression of bright MR signal from lipid (such as bone marrow) and long-T1 fluid (such as synovial fluid and edema). Signal independence of blood flow velocities, good arterial/muscle contrast and arterial/venous separation are also desirable. The high SNR, short scan times and flow properties of balanced steady-state free precession (SSFP) make it an excellent candidate for flow-independent angiography. In this work, a new magnetization-prepared 3D SSFP sequence for flow-independent peripheral angiography is presented. The technique combines a number of component techniques (phase-sensitive fat detection, inversion recovery, T2-preparation and square-spiral phase-encode ordering) to achieve high-contrast peripheral angiograms at only a modest scan time penalty over simple 3D SSFP. The technique is described in detail, a parameter optimization performed and preliminary results presented achieving high contrast and 1-mm isotropic resolution in a normal foot.

Articular cartilage in the knee: current MR imaging techniques and applications in clinical practice and research

Magnetic resonance (MR) imaging is the most important imaging modality for the evaluation of traumatic or degenerative cartilaginous lesions in the knee. It is a powerful noninvasive tool for detecting such lesions and monitoring the effects of pharmacologic and surgical therapy. The specific MR imaging techniques used for these purposes can be divided into two broad categories according to their usefulness for morphologic or compositional evaluation. To assess the structure of knee cartilage, standard spin-echo (SE) and gradient-recalled echo (GRE) sequences, fast SE sequences, and three-dimensional SE and GRE sequences are available. These techniques allow the detection of morphologic defects in the articular cartilage of the knee and are commonly used in research for semiquantitative and quantitative assessments of cartilage. To evaluate the collagen network and proteoglycan content in the knee cartilage matrix, compositional assessment techniques such as T2 mapping, delayed gadolinium-enhanced MR imaging of cartilage (or dGEMRIC), T1ρ imaging, sodium imaging, and diffusion-weighted imaging are available. These techniques may be used in various combinations and at various magnetic field strengths in clinical and research settings to improve the characterization of changes in cartilage.

Comparison of quadriceps angle measurements using short-arm and long-arm goniometers: correlation with MRI

OBJECTIVE

To compare the reliability of quadriceps-angle (Q-angle) measurements performed using a short-arm goniometer and a long-arm goniometer and to assess the accuracy of goniometer-based Q-angle measurements compared with anatomic Q angles derived from magnetic resonance imaging (MRI).

DESIGN

An intra- and interobserver reliability study.

SETTING

University hospital.

PARTICIPANTS

Eighteen healthy subjects with no history of knee pain, trauma, or prior surgery were examined.

METHODS

Two physicians, blinded to subject identity, measured Q angles on both knees of all subjects using 2 goniometers: (1) a short-arm goniometer and (2) a long-arm goniometer. Q angles were derived from axial MRIs of the subjects' hip and knees.

MAIN OUTCOME MEASUREMENTS

The intra- and interobserver reliabilities of each goniometer were assessed using the intraclass correlation coefficient (ICC). The comparison between clinical and MRI-based Q angles was assessed by using the ICC and a paired t-test.

RESULTS

Intra- and interobserver reliabilities of the long-arm goniometer (intraobserver ICC, 0.92; interobserver ICC, 0.88) were better than those of the short-arm goniometer (intraobserver ICC, 0.78; interobserver ICC, 0.56). Although both goniometers measured Q angles that were moderately correlated to the MRI-based measurements (ICC, 0.40), the clinical Q angles were underestimated compared with the MRI-based anatomic Q angles (P < .05).

CONCLUSION

The results of this study suggest that, although reproducible Q-angle measurements can be performed using standardized patient positioning and a long-arm goniometer, methods to improve the accuracy of clinical Q-angle measurements are needed.

Imaging near metal with a MAVRIC-SEMAC hybrid

The recently developed multi-acquisition with variable resonance image combination (MAVRIC) and slice-encoding metal artifact correction (SEMAC) techniques can significantly reduce image artifacts commonly encountered near embedded metal hardware. These artifact reductions are enabled by applying alternative spectral and spatial-encoding schemes to conventional spin-echo imaging techniques. Here, the MAVRIC and SEMAC concepts are connected and discussed. The development of a hybrid technique that utilizes strengths of both methods is then introduced. The presented technique is shown capable of producing minimal artifact, high-resolution images near total joint replacements in a clinical setting.

Cross-relaxation imaging of human articular cartilage

In this article, cross-relaxation imaging is applied to human ex vivo knee cartilage, and correlations of the cross-relaxation imaging parameters with macromolecular content in articular cartilage are reported. We show that, unlike the more commonly used magnetization transfer ratio, the bound pool fraction, the cross-relaxation rate (k) and the longitudinal relaxation time (T(1)) vary with depth and can therefore provide insight into the differences between the top and bottom layers of articular cartilage. Our cross-relaxation imaging model is more sensitive to macromolecular content in the top layers of cartilage, with bound pool fraction showing moderate correlations with proteoglycan content, and k and T(1) exhibiting moderate correlations with collagen.

Patellar maltracking correlates with vastus medialis activation delay in patellofemoral pain patients

BACKGROUND

Delayed onset of vastus medialis (VM) activity compared with vastus lateralis activity is a reported cause for patellofemoral pain. The delayed onset of VM activity in patellofemoral pain patients likely causes an imbalance in muscle forces and lateral maltracking of the patella; however, evidence relating VM activation delay to patellar maltracking is sparse. The aim of this study was to investigate the relationship between VM activation delay and patellar maltracking measures in pain-free controls and patellofemoral pain patients.

HYPOTHESIS

Patellar tilt and bisect offset, measures of patellar tracking, correlate with VM activation delay in patellofemoral pain patients classified as maltrackers.

STUDY DESIGN

Case control study; Level of evidence, 3.

METHODS

Vasti muscle activations were recorded in pain-free (n = 15) and patellofemoral pain (n = 40) participants during walking and jogging. All participants were scanned in an open-configuration magnetic resonance scanner in an upright weightbearing position to acquire the position of the patella with respect to the femur. Patellar tilt and bisect offset were measured, and patellofemoral pain participants were classified into normal tracking and maltracking groups.

RESULTS

Correlations between VM activation delay and patellar maltracking measures were statistically significant in only the patellofemoral pain participants classified as maltrackers with both abnormal tilt and abnormal bisect offset (R(2) = .89, P < .001, with patellar tilt during walking; R(2) = .75, P = .012, with bisect offset during jogging). There were no differences between the means of activation delays in pain-free and all patellofemoral pain participants during walking (P = .516) or jogging (P = .731).

CONCLUSION

There was a relationship between VM activation delay and patellar maltracking in the subgroup of patellofemoral pain participants classified as maltrackers with both abnormal tilt and abnormal bisect offset.

CLINICAL RELEVANCE

A clinical intervention such as VM retraining may be effective in only a subset of patellofemoral pain participants-namely, those with excessive tilt and excessive bisect offset measures. The results highlight the importance of appropriate classification of patellofemoral pain patients before selection of a clinical intervention.

Differences in patellofemoral kinematics between weight-bearing and non-weight-bearing conditions in patients with patellofemoral pain

Patellar maltracking is thought to be one source of patellofemoral pain. Measurements of patellar tracking are frequently obtained during non-weight-bearing knee extension; however, pain typically arises during highly loaded activities, such as squatting, stair climbing, and running. It is unclear whether patellofemoral joint kinematics during lightly loaded tasks replicate patellofemoral joint motion during weight-bearing activities. The purpose of this study was to: evaluate differences between upright, weight-bearing and supine, non-weight-bearing joint kinematics in patients with patellofemoral pain; and evaluate whether the kinematics in subjects with maltracking respond differently to weight-bearing than those in nonmaltrackers. We used real-time magnetic resonance imaging to visualize the patellofemoral joint during dynamic knee extension from 30° to 0° of knee flexion during two conditions: upright, weight-bearing and supine, non-weight-bearing. We compared patellofemoral kinematics measured from the images. The patella translated more laterally during the supine task compared to the weight-bearing task for knee flexion angles between 0° and 5° (p = 0.001). The kinematics of the maltrackers responded differently to joint loading than those of the non-maltrackers. In subjects with excessive lateral patellar translation, the patella translated more laterally during upright, weight-bearing knee extension for knee flexion angles between 25° and 30° (p = 0.001). However, in subjects with normal patellar translation, the patella translated more laterally during supine, non-weight-bearing knee extension near full extension (p = 0.001). These results suggest that patellofemoral kinematics measured during supine, unloaded tasks do not accurately represent the joint motion during weight-bearing activities.

Magnetic resonance imaging near metal implants

The desire to apply magnetic resonance imaging (MRI) techniques in the vicinity of embedded metallic hardware is increasing. The soft-tissue contrast available with MR techniques is advantageous in diagnosing complications near an increasing variety of MR-safe metallic hardware. Near such hardware, the spatial encoding mechanisms utilized in conventional MRI methods are often severely compromised. Mitigating these encoding difficulties has been the focus of numerous research investigations over the past two decades. Such approaches include view-angle tilting, short echo-time projection reconstruction acquisitions, single-point imaging, prepolarized MRI, and postprocessing image correction. Various technical advances have also enabled the recent development of two alternative approaches that have shown promising clinical potential. Here, the physical principals and proposed solutions to the problem of MRI near embedded metal are discussed.

Slice encoding for metal artifact correction with noise reduction

Magnetic resonance imaging (MRI) near metallic implants is often hampered by severe metal artifacts. To obtain distortion-free MR images near metallic implants, SEMAC (Slice Encoding for Metal Artifact Correction) corrects metal artifacts via robust encoding of excited slices against metal-induced field inhomogeneities, followed by combining the data resolved from multiple SEMAC-encoded slices. However, as many of the resolved data elements only contain noise, SEMAC-corrected images can suffer from relatively low signal-to-noise ratio. Improving the signal-to-noise ratio of SEMAC-corrected images is essential to enable SEMAC in routine clinical studies. In this work, a new reconstruction procedure is proposed to reduce noise in SEMAC-corrected images. A singular value decomposition denoising step is first applied to suppress quadrature noise in multi-coil SEMAC-encoded slices. Subsequently, the singular value decomposition-denoised data are selectively included in the correction of through-plane distortions. The experimental results demonstrate that the proposed reconstruction procedure significantly improves the SNR without compromising the correction of metal artifacts.

Prediction of glycosaminoglycan content in human cartilage by age, T1ρ and T2 MRI

OBJECTIVE

A relationship between T1ρ relaxation time and glycosaminoglycan (GAG) content has been demonstrated in chemically degraded bovine cartilage, but has not been demonstrated with quantitative biochemistry in human cartilage. A relationship has also been established between T2 relaxation time in cartilage and osteoarthritis (OA) severity. We hypothesized that T1ρ relaxation time would be associated with GAG content in human cartilage with normal T2 relaxation times.

METHODS

T2 relaxation time, T1ρ relaxation time, and glycosaminoglycan as a percentage of wet weight (sGAG) were measured for top and bottom regions at 7 anatomical locations in 21 human cadaver patellae. For our analysis, T2 relaxation time was classified as normal or elevated based on a threshold defined by the mean plus one standard deviation of the T2 relaxation time for all samples.

RESULTS

In the normal T2 relaxation time subset, T1ρ relaxation time correlated with sGAG content in the full-thickness and bottom regions, but only marginally in the top region alone. sGAG content decreased significantly with age in all regions.

CONCLUSION

In the subset of cartilage specimens with normal T2 relaxation time, T1ρ relaxation time was inversely associated with sGAG content, as hypothesized. A predictive model, which accounts for T2 relaxation time and the effects of age, might be able to determine longitudinal trends in GAG content in the same person based on T1ρ relaxation time maps.

Phase-sensitive sodium B1 mapping

Quantitative sodium MRI requires accurate knowledge of factors affecting the sodium signal. One important determinant of sodium signal level is the transmit B(1) field strength. However, the low signal-to-noise ratio typical of sodium MRI makes accurate B(1) mapping in reasonable scan times challenging. A new phase-sensitive B(1) mapping technique has recently been shown to work better than the widely used dual-angle method in low-signal-to-noise ratio situations and over a broader range of flip angles. In this work, the phase-sensitive B(1) mapping technique is applied to sodium, and its performance compared to the dual-angle method through both simulation and phantom studies. The phase-sensitive method is shown to yield higher quality B(1) maps at low signal-to-noise ratio and greater consistency of measurement than the dual-angle method. An in vivo sodium B(1) map of the human breast is also shown, demonstrating the phase-sensitive method's feasibility for human studies.

In vivo sodium imaging of human patellar cartilage with a 3D cones sequence at 3 T and 7 T

PURPOSE

To compare signal-to-noise ratios (SNRs) and T*(2) maps at 3 T and 7 T using 3D cones from in vivo sodium images of the human knee.

MATERIALS AND METHODS

Sodium concentration has been shown to correlate with glycosaminoglycan content of cartilage and is a possible biomarker of osteoarthritis. Using a 3D cones trajectory, 17 subjects were scanned at 3 T and 12 at 7 T using custom-made sodium-only and dual-tuned sodium/proton surface coils, at a standard resolution (1.3 x 1.3 x 4.0 mm(3)) and a high resolution (1.0 x 1.0 x 2.0 mm(3)). We measured the SNR of the images and the T*(2) of cartilage at both 3 T and 7 T.

RESULTS

The average normalized SNR values of standard-resolution images were 27.1 and 11.3 at 7 T and 3 T. At high resolution, these average SNR values were 16.5 and 7.3. Image quality was sufficient to show spatial variations of sodium content. The average T*(2) of cartilage was measured as 13.2 +/- 1.5 msec at 7 T and 15.5 +/- 1.3 msec at 3 T.

CONCLUSION

We acquired sodium images of patellar cartilage at 3 T and 7 T in under 26 minutes using 3D cones with high resolution and acceptable SNR. The SNR improvement at 7 T over 3 T was within the expected range based on the increase in field strength. The measured T*(2) values were also consistent with previously published values.

Cartilage morphology at 3.0T: assessment of three-dimensional magnetic resonance imaging techniques

PURPOSE

To compare six new three-dimensional (3D) magnetic resonance (MR) methods for evaluating knee cartilage at 3.0T.

MATERIALS AND METHODS

We compared: fast-spin-echo cube (FSE-Cube), vastly undersampled isotropic projection reconstruction balanced steady-state free precession (VIPR-bSSFP), iterative decomposition of water and fat with echo asymmetry and least-squares estimation combined with spoiled gradient echo (IDEAL-SPGR) and gradient echo (IDEAL-GRASS), multiecho in steady-state acquisition (MENSA), and coherent oscillatory state acquisition for manipulation of image contrast (COSMIC). Five-minute sequences were performed twice on 10 healthy volunteers and once on five osteoarthritis (OA) patients. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were measured from the volunteers. Images of the five volunteers and the five OA patients were ranked on tissue contrast, articular surface clarity, reformat quality, and lesion conspicuity. FSE-Cube and VIPR-bSSFP were compared to IDEAL-SPGR for cartilage volume measurements.

RESULTS

FSE-Cube had top rankings for lesion conspicuity, overall SNR, and CNR (P < 0.02). VIPR-bSSFP had top rankings in tissue contrast and articular surface clarity. VIPR and FSE-Cube tied for best in reformatting ability. FSE-Cube and VIPR-bSSFP compared favorably to IDEAL-SPGR in accuracy and precision of cartilage volume measurements.

CONCLUSION

FSE-Cube and VIPR-bSSFP produce high image quality with accurate volume measurement of knee cartilage.

Accelerated slice encoding for metal artifact correction

PURPOSE

To demonstrate accelerated imaging with both artifact reduction and different contrast mechanisms near metallic implants.

MATERIALS AND METHODS

Slice-encoding for metal artifact correction (SEMAC) is a modified spin echo sequence that uses view-angle tilting and slice-direction phase encoding to correct both in-plane and through-plane artifacts. Standard spin echo trains and short-TI inversion recovery (STIR) allow efficient PD-weighted imaging with optional fat suppression. A completely linear reconstruction allows incorporation of parallel imaging and partial Fourier imaging. The signal-to-noise ratio (SNR) effects of all reconstructions were quantified in one subject. Ten subjects with different metallic implants were scanned using SEMAC protocols, all with scan times below 11 minutes, as well as with standard spin echo methods.

RESULTS

The SNR using standard acceleration techniques is unaffected by the linear SEMAC reconstruction. In all cases with implants, accelerated SEMAC significantly reduced artifacts compared with standard imaging techniques, with no additional artifacts from acceleration techniques. The use of different contrast mechanisms allowed differentiation of fluid from other structures in several subjects.

CONCLUSION

SEMAC imaging can be combined with standard echo-train imaging, parallel imaging, partial-Fourier imaging, and inversion recovery techniques to offer flexible image contrast with a dramatic reduction of metal-induced artifacts in scan times under 11 minutes.

Fabrication of custom-shaped grafts for cartilage regeneration

PURPOSE

to create a custom-shaped graft through 3D tissue shape reconstruction and rapid-prototype molding methods using MRI data, and to test the accuracy of the custom-shaped graft against the original anatomical defect.

METHODS

An iatrogenic defect on the distal femur was identified with a 1.5 Tesla MRI and its shape was reconstructed into a three-dimensional (3D) computer model by processing the 3D MRI data. First, the accuracy of the MRI-derived 3D model was tested against a laser-scan based 3D model of the defect. A custom-shaped polyurethane graft was fabricated from the laser-scan based 3D model by creating custom molds through computer aided design and rapid-prototyping methods. The polyurethane tissue was laser-scanned again to calculate the accuracy of this process compared to the original defect.

RESULTS

The volumes of the defect models from MRI and laser-scan were 537 mm3 and 405 mm3, respectively, implying that the MRI model was 33% larger than the laser-scan model. The average (±SD) distance deviation of the exterior surface of the MRI model from the laser-scan model was 0.4 ± 0.4 mm. The custom-shaped tissue created from the molds was qualitatively very similar to the original shape of the defect. The volume of the custom-shaped cartilage tissue was 463 mm3 which was 15% larger than the laser-scan model. The average (±SD) distance deviation between the two models was 0.04 ± 0.19 mm.

CONCLUSIONS

This investigation proves the concept that custom-shaped engineered grafts can be fabricated from standard sequence 3-D MRI data with the use of CAD and rapid-prototyping technology. The accuracy of this technology may help solve the interfacial problem between native cartilage and graft, if the grafts are custom made for the specific defect. The major source of error in fabricating a 3D custom-shaped cartilage graft appears to be the accuracy of a MRI data itself; however, the precision of the model is expected to increase by the utilization of advanced MR sequences with higher magnet strengths.

Accuracy of 3D cartilage models generated from MR images is dependent on cartilage thickness: laser scanner based validation of in vivo cartilage

Cartilage morphology change is an important biomarker for the progression of osteoarthritis. The purpose of this study was to assess the accuracy of in vivo cartilage thickness measurements from MR image-based 3D cartilage models using a laser scanning method and to test if the accuracy changes with cartilage thickness. Three-dimensional tibial cartilage models were created from MR images (in-plane resolution of 0.55 mm and thickness of 1.5 mm) of osteoarthritic knees of ten patients prior to total knee replacement surgery using a semi-automated B-spline segmentation algorithm. Following surgery, the resected tibial plateaus were laser scanned and made into 3D models. The MR image and laser-scan based models were registered to each other using a shape matching technique. The thicknesses were compared point wise for the overall surface. The linear mixed-effects model was used for statistical test. On average, taking account of individual variations, the thickness measurements in MRI were overestimated in thinner (<2.5 mm) regions. The cartilage thicker than 2.5 mm was accurately predicted in MRI, though the thick cartilage in the central regions was underestimated. The accuracy of thickness measurements in the MRI-derived cartilage models systemically varied according to native cartilage thickness.

Three-dimensional T(1), T(2) and proton density mapping with inversion recovery balanced SSFP

By combining a balanced steady-state free precession (bSSFP) readout with an initial inversion pulse, all three contrast parameters, T(1), T(2) and proton density (M(0)), may be rapidly calculated from the signal progression in time. However, here it is shown that this technique is quite sensitive to variation in the applied transmit RF (B(1)) field, leading to pronounced errors in calculated values. Two-dimensional (2D) acquisitions are taxed to accurately quantify the relaxation, as the short RF pulses required by SSFP's rapid TR contain a broad spectrum of excitation angles. A 3D excitation using a large diameter excitation coil was able to correctly quantify the parameters. While the extreme B(1) sensitivity was previously problematic and has precluded use of IR-bSSFP for relaxometry, in this work these obstacles were significantly reduced, allowing the rapid quantification of T(1), T(2) and M(0). The results may further be used to simulate image contrast from common sequences, such as a T(1)-weighted or fluid-attenuated inversion recovery (FLAIR) examination.

New resource for the computation of cartilage biphasic material properties with the interpolant response surface method

Cartilage material properties are important for understanding joint function and diseases, but can be challenging to obtain. Three biphasic material properties (aggregate modulus, Poisson's ratio and permeability) can be determined using an analytical or finite element model combined with optimisation to find the material properties values that best reproduce an experimental creep curve. The purpose of this study was to develop an easy-to-use resource to determine biphasic cartilage material properties. A Cartilage Interpolant Response Surface was generated from interpolation of finite element simulations of creep indentation tests. Creep indentation tests were performed on five sites across a tibial plateau. A least-squares residual search of the Cartilage Interpolant Response Surface resulted in a best-fit curve for each experimental condition with corresponding material properties. These sites provided a representative range of aggregate moduli (0.48-1.58 MPa), Poisson's ratio (0.00-0.05) and permeability (1.7 x 10(- 15)-5.4 x 10(- 15) m(4)/N s) values found in human cartilage. The resource is freely available from https://simtk.org/home/va-squish.

SEMAC: Slice Encoding for Metal Artifact Correction in MRI

Magnetic resonance imaging (MRI) near metallic implants remains an unmet need because of severe artifacts, which mainly stem from large metal-induced field inhomogeneities. This work addresses MRI near metallic implants with an innovative imaging technique called "Slice Encoding for Metal Artifact Correction" (SEMAC). The SEMAC technique corrects metal artifacts via robust encoding of each excited slice against metal-induced field inhomogeneities. The robust slice encoding is achieved by extending a view-angle-tilting (VAT) spin-echo sequence with additional z-phase encoding. Although the VAT compensation gradient suppresses most in-plane distortions, the z-phase encoding fully resolves distorted excitation profiles that cause through-plane distortions. By positioning all spins in a region-of-interest to their actual spatial locations, the through-plane distortions can be corrected by summing up the resolved spins in each voxel. The SEMAC technique does not require additional hardware and can be deployed to the large installed base of whole-body MRI systems. The efficacy of the SEMAC technique in eliminating metal-induced distortions with feasible scan times is validated in phantom and in vivo spine and knee studies.

Knee joint: comprehensive assessment with 3D isotropic resolution fast spin-echo MR imaging--diagnostic performance compared with that of conventional MR imaging at 3.0 T

PURPOSE

To determine whether a three-dimensional isotropic resolution fast spin-echo sequence (FSE-Cube) has similar diagnostic performance as a routine magnetic resonance (MR) imaging protocol for evaluating the cartilage, ligaments, menisci, and osseous structures of the knee joint in symptomatic patients at 3.0 T.

MATERIALS AND METHODS

This prospective, HIPAA-compliant, institutional review board-approved study was performed with a waiver of informed consent. FSE-Cube was added to the routine 3.0-T MR imaging protocol performed in 100 symptomatic patients (54 male patients with a median age of 32 years and 46 female patients with a median age of 33 years) who subsequently underwent arthroscopic knee surgery. All MR imaging studies were independently reviewed twice by two musculoskeletal radiologists. During the first review, the routine MR imaging protocol was used to detect cartilage lesions, ligament tears, meniscal tears, and bone marrow edema lesions. During the second review, FSE-Cube with multiplanar reformations was used to detect these joint abnormalities. With arthroscopic results as the reference standard, the sensitivity and specificity of FSE-Cube and the routine MR imaging protocol in the detection of cartilage lesions, anterior cruciate ligament tears, and meniscal tears were calculated. Permutation tests were used to compare sensitivity and specificity values.

RESULTS

FSE-Cube had significantly higher sensitivity (P = .039) but significantly lower specificity (P = .003) than the routine MR imaging protocol for detecting cartilage lesions. There were no significant differences (P = .183-.999) in sensitivity and specificity between FSE-Cube and the routine MR imaging protocol in the detection of anterior cruciate ligament tears, medial meniscal tears, or lateral meniscal tears. FSE-Cube depicted 96.2% of medial collateral ligament tears, 100% of lateral collateral ligament tears, and 85.3% of bone marrow edema lesions identified on images obtained with the routine MR imaging protocol.

CONCLUSION

FSE-Cube has similar diagnostic performance as a routine MR imaging protocol for detecting cartilage lesions, cruciate ligament tears, collateral ligament tears, meniscal tears, and bone marrow edema lesions within the knee joint at 3.0 T.

Recent advances in MRI of articular cartilage

OBJECTIVE

MRI is the most accurate noninvasive method available to diagnose disorders of articular cartilage. Conventional 2D and 3D approaches show changes in cartilage morphology. Faster 3D imaging methods with isotropic resolution can be reformatted into arbitrary planes for improved detection and visualization of pathology. Unique contrast mechanisms allow us to probe cartilage physiology and detect changes in cartilage macromolecules.

CONCLUSION

MRI has great promise as a noninvasive comprehensive tool for cartilage evaluation.