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Feng C, Xu Y, Cheng X, Gao S, Huang X, Huang S, Su Y. Magnetic resonance-enhanced high-resolution three-dimensional water-selective cartilage sequence visualization of hip vessels in children. INTERNATIONAL ORTHOPAEDICS 2024; 48:1391-1399. [PMID: 37442823 DOI: 10.1007/s00264-023-05883-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023]
Abstract
PURPOSE Hip vessel examination provides key information on many hip-related pediatric diseases, and it has an important role in the evaluation of femoral head (FH) blood supply and diagnosis of avascular necrosis (AVN). The aim of this study was to investigate the feasibility of MR-enhanced high-resolution three-dimensional water-selective cartilage (3D-WATSc) sequence in visualizing the vessels of the hip joint in children. PATIENTS AND METHODS Children with hip disease were randomly enrolled prospectively at our hospital from January 2021 to August 2022. We performed our institution's hip MRI protocol and enhanced high-resolution 3D-WATSc sequence. The 3D-WATSc images were reconstructed and analyzed, and images of the normal hip were categorized into grades 0-3. The abnormal hip images were compared with those of the normal side using the χ2 test. RESULTS Twenty-four patients with unilateral hip abnormalities were included in this study. The cartilaginous vascular canal and ossification centre vessels of normal FHs were observed in 18 patients (75%) and met the grade 3 standard. An abnormal cartilaginous canal was observed in 16 patients (67%); meanwhile, 18 patients (75%) had abnormal extrachondral vessels. Comparison of high-resolution 3D-WATSc images with those of the normal side provided effective abnormal vascular information in 95.8% of patients. CONCLUSIONS Enhanced high-resolution 3D-WATSc can visualize the blood vessels of the hip in children. This may provide a new method for the vascular study of various pediatric hip diseases.
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Affiliation(s)
- Chuan Feng
- Radiology Department, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing, China
| | - Ye Xu
- Radiology Department, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing, China
| | - Xiang Cheng
- Radiology Department, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing, China
| | - Sijie Gao
- Radiology Department, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing, China
| | - Xinyan Huang
- Radiology Department, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing, China
| | - Shiyu Huang
- Radiology Department, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing, China
| | - Yuxi Su
- Orthopedics Department, Children's Hospital of Chongqing Medical University; Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Jiangxi Hospital Affiliated Children's Hospital of Chongqing Medical University, China, 136# Zhongshan 2road Yuzhong District, Chongqing, 400014, China.
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Tóth F, Nissi MJ, Armstrong AR, Buko EO, Johnson CP. Epiphyseal cartilage vascular architecture at the distal humeral osteochondritis dissecans predilection site in juvenile pigs. J Orthop Res 2024; 42:737-744. [PMID: 37971288 PMCID: PMC10978299 DOI: 10.1002/jor.25732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 09/08/2023] [Accepted: 11/14/2023] [Indexed: 11/19/2023]
Abstract
Failure of endochondral ossification due to interruption of the vascular supply to the epiphyseal cartilage is a critical step in the development of osteochondritis dissecans (OCD). Herein we describe the vascular architecture of the distal humeral epiphyseal cartilage in pigs and identify characteristic features that have been associated with sites predisposed to OCD development across species. Distal humeral specimens were harvested from pigs (n = 5, ages = 1, 10, 18, 30, and, 42 days old) and imaged at 9.4T magnetic resonance imaging (MRI) using a 3D gradient recalled echo sequence. The MRI data were processed using a quantitative susceptibility mapping (QSM) pipeline to visualize the vascular architecture. Specimens were also evaluated histologically to identify the presence of ischemic epiphyseal cartilage necrosis (osteochondrosis [OC]-latens) and associated failure of endochondral ossification (OC-manifesta). The QSM data enabled visualization of two distinct vascular beds arising from the perichondrium at the lateral and medial aspects of the distal humeral epiphysis. Elongated vessels originating from these beds coursed axially to supply the lateral and medial thirds of epiphyseal cartilage. At 18 days of age and older, a shift from perichondrial to transosseous blood supply was noted axially, which appeared more pronounced on the lateral side. This shift coincided with histologic identification of OC-latens (30- and 42-day-old specimens) and OC-manifesta (18- and 42-day-old specimens) lesions in the corresponding regions. The vascular anatomy and its evolution at the distal humeral epiphysis closely resembles that previously reported at predilection sites of knee OCD, suggesting a shared pathophysiology between the knee and elbow joints.
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Affiliation(s)
- Ferenc Tóth
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, Minnesota, USA
| | - Mikko J Nissi
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Alexandra R Armstrong
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, Minnesota, USA
| | - Erick O Buko
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, Minnesota, USA
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Casey P Johnson
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, Minnesota, USA
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
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Löffler MT, Wu PH, Kazakia GJ. MR-based techniques for intracortical vessel visualization and characterization: understanding the impact of microvascular disease on skeletal health. Curr Opin Endocrinol Diabetes Obes 2023; 30:192-199. [PMID: 37335282 PMCID: PMC10461604 DOI: 10.1097/med.0000000000000819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
PURPOSE OF REVIEW The relationships between bone vasculature and bone microstructure and strength remain incompletely understood. Addressing this gap will require in vivo imaging capabilities. We describe the relevant vascular anatomy of compact bone, review current magnetic resonance imaging (MRI)-based techniques that allow in vivo assessment of intracortical vasculature, and finally present preliminary studies that apply these techniques to investigate changes in intracortical vessels in aging and disease. RECENT FINDINGS Ultra-short echo time MRI (UTE MRI), dynamic contrast-enhanced MRI (DCE-MRI), and susceptibility-weighted MRI techniques are able to probe intracortical vasculature. Applied to patients with type 2 diabetes, DCE-MRI was able to find significantly larger intracortical vessels compared to nondiabetic controls. Using the same technique, a significantly larger number of smaller vessels was observed in patients with microvascular disease compared to those without. Preliminary data on perfusion MRI showed decreased cortical perfusion with age. SUMMARY Development of in vivo techniques for intracortical vessel visualization and characterization will enable the exploration of interactions between the vascular and skeletal systems, and further our understanding of drivers of cortical pore expansion. As we investigate potential pathways of cortical pore expansion, appropriate treatment and prevention strategies will be clarified.
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Affiliation(s)
- Maximilian T. Löffler
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA; 185 Berry St, Suite 350, San Francisco, CA 94107, Tel: (415) 514-9655
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Freiburg im Breisgau, Germany
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Po-Hung Wu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA; 185 Berry St, Suite 350, San Francisco, CA 94107, Tel: (415) 514-9655
| | - Galateia J. Kazakia
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA; 185 Berry St, Suite 350, San Francisco, CA 94107, Tel: (415) 514-9655
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Du J, Li K, Wang W, Jhonatan FY, Zhang W, Yang H, Huang L. Qualitative and quantitative diagnosis of intramuscular hemangioma subtypes: Diagnostic performance comparison of ESWAN and conventional MRI. Acta Radiol 2021; 64:208-216. [PMID: 34918569 DOI: 10.1177/02841851211065145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Preoperative identification of intramuscular hemangioma (IMH) subtypes (capillary hemangioma, cavernous hemangioma, and mixed hemangioma) is urgently necessary. Enhanced T2*-weighted angiography (ESWAN) is sensitive to vessels and metabolites and can be used to diagnose IMH subtypes. PURPOSE To compare the diagnostic performances of ESWAN and conventional magnetic resonance imaging (MRI) for qualitative and quantitative diagnosis of IMH subtypes. MATERIAL AND METHODS In total, 23 patients with IMHs were examined using conventional MRI and ESWAN. The signal intensity ratios (SIRs) of conventional MRI and ESWAN were measured. RESULTS There was no significant difference for volume among the three subtypes (P = 0.124, P = 0.145). Various shapes and MRI signals were shown in the three subtypes of IMH. There was no significant difference for SIRs of conventional MRI (P = 0.558, P = 0.259, P = 0.385, P = 0.347). However, there was a significant difference for SIRs of ESWAN parameters (P = 0.050, P < 0.001, P = 0.005, P = 0.002). Capillary hemangiomas can be diagnosed when R2* SIR is <0.912 and intratumoral susceptibility signal (ITSS) percentage is <29.085%. Cavernous hemangiomas should be considered when R2* SIR is >0.912, ITSS percentage >35.226%, and phase SIR >2.536. In addition, mixed hemangiomas should be considered when T2* SIR is >0.662 and R2* SIR <1.618. CONCLUSION Conventional MRI can only display the volume, shape, and signal of IMHs. 3D-MinIP imaging of ESWAN can show the veins and minor hemorrhage. SIRs of ESWAN parameters including T2* value, R2* value, phase value, and percentage of ITSS can be used to quantitatively diagnose capillary hemangiomas, cavernous hemangiomas, and mixed hemangiomas.
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Affiliation(s)
- Jun Du
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, PR China
- Department of Orthopedic Magnetic Resonance Chamber, The First Affiliated Hospital of Soochow University, Suzhou, PR China
| | - Kun Li
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, PR China
| | - Wei Wang
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, PR China
| | - Felix Young Jhonatan
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, PR China
| | - Weisheng Zhang
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, PR China
| | - Huilin Yang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, PR China
| | - Lixin Huang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, PR China
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Jiang Z, Johnson CP, Nykänen O, Nissi M, Lau YK, Wu M, Casal ML, Smith LJ. Epiphyseal cartilage canal architecture and extracellular matrix remodeling in mucopolysaccharidosis VII dogs at the onset of postnatal growth. Connect Tissue Res 2021; 62:698-708. [PMID: 33334202 PMCID: PMC8272733 DOI: 10.1080/03008207.2020.1865939] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Purpose: Mucopolysaccharidosis (MPS) VII is a genetic, lysosomal storage disease characterized by abnormal accumulation of glycosaminoglycans in cells and tissues. MPS VII patients exhibit multiple failures of endochondral ossification during postnatal growth, including markedly delayed cartilage-to-bone conversion in the vertebrae and long bones. Cartilage canals provide the template for vascularization at the onset of secondary ossification. The objective of this study was to investigate whether abnormal cartilage canal architecture and enzyme-mediated extracellular matrix (ECM) remodeling contribute to delayed cartilage-to-bone conversion in MPS VII.Materials and Methods: The epiphyseal cartilage canal networks of 9-day-old healthy control and MPS VII-affected dog vertebrae were characterized using high-resolution, contrast-free quantitative susceptibility mapping magnetic resonance imaging. Relative expression levels of matrix metalloproteinases (MMPs) 9, 13 and 14 were examined using immunohistochemistry, while tartrate-resistant acid phosphatase (TRAP) and alkaline phosphatase (ALP) were examined using in situ enzyme staining.Results: Interestingly, the density, number, connectivity and thickness of cartilage canals was not significantly different between MPS VII and control vertebrae. Immunohistochemistry revealed diminished MMP-9, but normal MMP-13 and 14 expression by epiphyseal cartilage chondrocytes, while ALP and TRAP enzyme expression by chondrocytes and chondroclasts, respectively, were both diminished in MPS VII.Conclusions: Our findings suggest that while the epiphyseal cartilage canal network in MPS VII is normal at the onset of secondary ossification, expression of enzymes required for cartilage resorption and replacement with mineralized ECM, and initiation of angiogenesis, is impaired.
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Affiliation(s)
- Zhirui Jiang
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA,Deparment of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Casey P. Johnson
- Department of Veterinary Clinical Sciences, University of Minnesota, Saint Paul, MN, USA,Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Olli Nykänen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Mikko Nissi
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland,Department of Diagnostic Radiology, University of Oulu, Oulu, Finland
| | - Yian Khai Lau
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA,Deparment of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Meilun Wu
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA,Deparment of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Margret L. Casal
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia PA, USA
| | - Lachlan J. Smith
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA,Deparment of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA,Correspondence: Lachlan J. Smith, Ph.D., Associate Professor, Department of Neurosurgery, University of Pennsylvania, 371 Stemmler Hall, 3450 Hamilton Walk, Philadelphia, PA, 19104 USA, , Phone: +1 215 746 2169, Fax: +1 215 573 2133
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Pagliazzi G, Ellermann JM, Carlson CS, Shea KG, Arendt EA. Trochlear Development in Children From 1 Month to 10 Years of Age: A Descriptive Study Utilizing Analysis by Magnetic Resonance Imaging. Orthop J Sports Med 2021; 9:23259671211028269. [PMID: 34552991 PMCID: PMC8450999 DOI: 10.1177/23259671211028269] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 02/24/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Understanding the morphology of cartilage/bony maturation in preadolescents may help explain adult trochlear variation. PURPOSE To study trochlear morphology during maturation in children and infants using magnetic resonance imaging (MRI). STUDY DESIGN Descriptive laboratory study. METHODS Twenty-four pediatric cadaveric knees (10 male and 14 female knees; age, 1 month to 10 years) were included. High-resolution imaging of the distal femoral secondary ossification center was performed using 7-T or 9.4-T MRI scanners. Three-dimensional MRI scans were produced, and images were reformatted; 3 slices in the axial, sagittal, and coronal planes images were analyzed, with coronal and sagittal imaging used for image orientation. Biometric analysis included lateral and medial trochlear height (TH); cartilaginous sulcus angle (CSA); osseous sulcus angle (OSA); trochlear depth; and trochlear facet (TF) length symmetry. Sex comparisons were considered when ≥1 specimen from both sexes of the same age was available; these included 11 knees spanning 4 age groups (ages 1, 3, 4, and 7 years). RESULTS The analysis of trochlear morphology showed a lateral TH greater than the medial TH at all ages. The thickest cartilage was found on the lateral TF in the younger specimens. Regarding the development of osseous and cartilaginous trochlear contour, a cartilaginous sulcus was present in the 3-month-old specimen and continued to deepen up to the age of 4 years. The shape of the osseous center evolved from round (1 month) to oval (9 months) to rectangular (2 years); no distinct bony trochlear sulcus was present, although a well-formed cartilaginous sulcus was present. The first evidence of formation of a bony sulcus was at 4 years. By the age of 7 to 8 years, the bony contour of the adult distal femur resembled its cartilaginous contour. Female samples had a shallower CSA and OSA than did the male ones in all samples that had a defined OSA. CONCLUSION Female trochlear grooves tended to be shallower (flatter). The lateral trochlea was higher (TH) and wider (TF length) during growth than was the medial trochlea in both sexes; furthermore, the development of the osseous sulcus shape lagged behind the development of the cartilaginous sulcus shape in the authors' study population. CLINICAL RELEVANCE Bony anatomy of the trochlear groove did not match the cartilaginous anatomy in preadolescent children, suggesting that caution should be used when interpreting bony anatomy in this age group.
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Affiliation(s)
- Gherardo Pagliazzi
- Rizzoli Orthopaedic Institute, Bologna, Italy
- Lugano Regional Hospital, Lugano, Switzerland
| | - Jutta M. Ellermann
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Cathy S. Carlson
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Kevin G. Shea
- Department of Orthopaedic Surgery, Stanford University, Stanford, California, USA
| | - Elizabeth A. Arendt
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA
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Susceptibility Weighted Imaging for evaluation of musculoskeletal lesions. Eur J Radiol 2021; 138:109611. [PMID: 33677418 DOI: 10.1016/j.ejrad.2021.109611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/14/2021] [Accepted: 02/22/2021] [Indexed: 11/23/2022]
Abstract
The presence of blood or calcium in the musculoskeletal (MSK) system may be linked to specific pathological conditions. The ability of MRI for calcium detection is usually limited compared with other techniques such as CT. In a similar manner, the accuracy of MRI for detection and evaluation of hemorrhage in soft tissues is closely linked to the degree of degradation of blood products. Blood and calcium are substances that cause local inhomogeneity of the magnetic field resulting in susceptibility artifacts. To try to evaluate these substances, specific MRI sequences which are highly sensitive to these local magnetic field inhomogeneities such as Susceptibility Weighted Imaging (SWI) have been developed and successfully applied in the Central Nervous System, but scarcely used in MSK. SWI may increase the overall sensitivity of MRI to detect blood and calcium in several clinical scenarios such as degenerative joint disease or bone and soft tissue lesion assessment and discriminate between both compounds, something which is not always possible with conventional MRI approaches. In this paper, physical basis and technical adjustment for SWI acquisition at MSK are detailed reviewing the potential application of SWI in different MSK clinical scenarios.
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Weston P, Morales C, Dunning M, Parry A, Carrera I. Susceptibility weighted imaging at 1.5 Tesla magnetic resonance imaging in dogs: Comparison with T2*-weighted gradient echo sequence and its clinical indications. Vet Radiol Ultrasound 2020; 61:566-576. [PMID: 32663373 DOI: 10.1111/vru.12894] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 04/16/2020] [Accepted: 04/19/2020] [Indexed: 12/30/2022] Open
Abstract
Susceptibility weighted imaging (SWI) is a high resolution, fully velocity-compensated, three-dimensional gradient echo (GE) MRI technique. In humans, SWI has been reported to be more sensitive than T2*-weighted GE sequences in the identification of both intracranial hemorrhage and intra-vascular deoxyhemoglobin. However, published clinical studies comparing SWI to T2*-weighted GE sequences in dogs are currently lacking. The aim of this retrospective, observational study was to compare SWI and T2*-weighted GE sequences in a group of dogs with intracranial disease. Medical records were searched for dogs that underwent a brain MRI examination that included T2*-weighted GE and SWI sequences. The presence and appearance of non-vascular and vascular signal voids observed on T2*-weighted GE and SWI were compared. Thirty-two dogs were included with the following diagnoses: presumed and confirmed intracranial neoplasia (27), cerebrovascular accidents (3), and trauma (2). Hemorrhagic lesions were significantly more conspicuous on SWI than T2*-weighted GE sequences (P < .0001). Venous structures were well defined in all SWI sequences, and poorly defined in all dogs on T2*-weighted GE. Susceptibility weighted imaging enabled identification of vascular abnormalities in 30 of 32 (93.8%) dogs, including: neovascularization in 19 of 32 (59.4%) dogs, displacement of perilesional veins in five of 32 (15.6%) dogs, and apparent dilation of perilesional veins in 10 of 32 (31.3%) dogs. Presence of neovascularization was significantly associated with T1-weighted post-contrast enhancement (P = .0184). Hemorrhagic lesions and venous structures were more conspicuous on SWI compared to T2*-weighted GE sequences. Authors recommend adding SWI to standard brain protocols in dogs for detecting hemorrhage and identifying venous abnormalities for lesion characterization.
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Affiliation(s)
| | | | - Mark Dunning
- Willows Referral Centre, Solihull, UK.,School of Veterinary Medicine and Science, University of Nottingham, Nottingham, UK
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Back W, de Jong LH, Vrancken A, van Nes A, Wolschrijn C, Verdonschot N. Biomechanical loading of the porcine femorotibial joint during maximal movements: An exploratory, ex vivo study. Vet J 2020; 261:105480. [PMID: 32741492 DOI: 10.1016/j.tvjl.2020.105480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 06/01/2020] [Accepted: 06/02/2020] [Indexed: 10/24/2022]
Abstract
Thus far, there is a lack of scientific investigation regarding the hypothesis that biomechanical factors contribute to the cross-species pathogenesis of osteochondrosis (OC). Therefore, the aim of this pilot study was to investigate whether high (peak) pressures occur in the porcine femorotibial (FT) joint. In this experimental, ex vivo study, the right hind limbs of seven weaned piglets were subjected to maximal joint excursions, as a priori radiologically estimated. Subsequently, the intra-articular pressures were measured using sensors placed in both the medial and the lateral compartments of the FT joint. The overall highest individual peak pressure was found in the lateral FT joint during maximal extension (2611 kPa; group mean ± standard deviation (SD) 982.3 ± 988.2 kPa). In the medial FT joint, the highest individual peak pressure was found during maximal adduction (1481 kPa; group mean ± SD 664.9 ± 393.2 kPa). Moreover, nearly 30% of the ex vivo peak pressures were above published thresholds for cartilage catabolism (>500 kPa/0.5 MPa), but not for interfering with cell viability (>5 MPa). In conclusion, this ex vivo study on FT joint pressures in weaned piglets showed that FT joint movements at maximal excursions are related to concomitant internal peak joint pressures. More studies should be performed to evaluate the possible biomechanical relation of these observations with osteochondrosis, which would allow the design of preventive measures in the pig industry, to avoid extreme limb movements and concomitant joint peak pressures in vivo.
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Affiliation(s)
- W Back
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 112-114, NL-3584 CM Utrecht, The Netherlands; Department of Surgery and Anaesthesiology of Domestic Animals, Ghent University, Salisburylaan 133, B-9820 Merelbeke, Belgium.
| | - L H de Jong
- Department of Pathobiology, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 1, NL-3584 CL Utrecht, The Netherlands
| | - A Vrancken
- Orthopaedic Research Laboratory, Radboud University Medical Center, Geert Grooteplein Zuid 10, NL-6525 GA Nijmegen, The Netherlands
| | - A van Nes
- Department of Farm Animal Health, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 7, NL-3584 CL Utrecht, The Netherlands
| | - C Wolschrijn
- Department of Pathobiology, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 1, NL-3584 CL Utrecht, The Netherlands
| | - N Verdonschot
- Orthopaedic Research Laboratory, Radboud University Medical Center, Geert Grooteplein Zuid 10, NL-6525 GA Nijmegen, The Netherlands; Department of Biomechanical Engineering, Faculty of Engineering Technology, University of Twente, 7500 AE Enschede, The Netherlands
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Ellermann JM, Ludwig KD, Nissi MJ, Johnson CP, Strupp JP, Wang L, Zbýň Š, Tóth F, Arendt E, Tompkins M, Shea K, Carlson CS. Three-Dimensional Quantitative Magnetic Resonance Imaging of Epiphyseal Cartilage Vascularity Using Vessel Image Features: New Insights into Juvenile Osteochondritis Dissecans. JB JS Open Access 2019; 4:JBJSOA-D-19-00031. [PMID: 32043049 PMCID: PMC6959910 DOI: 10.2106/jbjs.oa.19.00031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
We introduce a quantitative measure of epiphyseal cartilage vascularity and examine vessel networks during human skeletal maturation. Understanding early morphological changes in the distal femoral condyle is expected to provide information on the pathogenesis of developmental diseases such as juvenile osteochondritis dissecans. Methods Twenty-two cadaveric knees from donors ranging from 1 month to 10 years of age were included in the study. Images of bone, cartilage, and vascularity were acquired simultaneously with a 3-dimensional gradient-recalled-echo magnetic resonance imaging (MRI) sequence. The secondary ossification center volume and total epiphysis cartilage volume ratio and articular-epiphyseal cartilage complex and epiphyseal cartilage widths were measured. Epiphyseal cartilage vascularity was visualized for 9 data sets with quantitative susceptibility mapping and vessel filtering, resulting in 3-dimensional data to inform vessel network segmentation and to calculate vascular density. Results Three distinct, non-anastomosing vascular networks (2 peripheral and 1 central) supply the distal femoral epiphyseal cartilage. The central network begins regression as early as 3 months and is absent by 4 years. From 1 month to 3 years, the ratio of central to peripheral vascular area density decreased from 1.0 to 0.5, and the ratio of central to peripheral vascular skeletal density decreased from 0.9 to 0.6. A narrow, peripheral vascular rim was present at 8 years but had disappeared by 10 years. The secondary ossification center progressively acquires the shape of the articular-epiphyseal cartilage complex by 8 years of age, and the central areas of the medial and lateral femoral condyles are the last to ossify. Conclusions Using cadaveric pediatric knees, we provide quantitative, 3-dimensional measures of epiphyseal cartilage vascular regression during skeletal development using vessel image features. Central areas with both early vascular regression and delayed ossification correspond to predilection sites of juvenile osteochondritis dissecans in this limited case series. Our findings highlight specific vascular vulnerabilities that may lead to improved understanding of the pathogenesis and better-informed clinical management decisions in developmental skeletal diseases. Clinical Relevance This paradigm shift in understanding of juvenile osteochondritis dissecans etiology and disease progression may critically impact future patient management. Our findings highlight specific vascular vulnerabilities during skeletal maturation in a group of active young patients seen primarily by orthopaedic surgeons and sports medicine professionals.
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Affiliation(s)
- Jutta M Ellermann
- Center for Magnetic Resonance Research (CMRR) (J.M.E., K.D.L., M.J.N., C.P.J., J.P.S., L.W., and S.Z.), Department of Radiology, and Department of Orthopaedic Surgery (E.A. and M.T.), Medical School, University of Minnesota, Minneapolis, Minnesota
| | - Kai D Ludwig
- Center for Magnetic Resonance Research (CMRR) (J.M.E., K.D.L., M.J.N., C.P.J., J.P.S., L.W., and S.Z.), Department of Radiology, and Department of Orthopaedic Surgery (E.A. and M.T.), Medical School, University of Minnesota, Minneapolis, Minnesota
| | - Mikko J Nissi
- Center for Magnetic Resonance Research (CMRR) (J.M.E., K.D.L., M.J.N., C.P.J., J.P.S., L.W., and S.Z.), Department of Radiology, and Department of Orthopaedic Surgery (E.A. and M.T.), Medical School, University of Minnesota, Minneapolis, Minnesota.,Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Casey P Johnson
- Center for Magnetic Resonance Research (CMRR) (J.M.E., K.D.L., M.J.N., C.P.J., J.P.S., L.W., and S.Z.), Department of Radiology, and Department of Orthopaedic Surgery (E.A. and M.T.), Medical School, University of Minnesota, Minneapolis, Minnesota.,Departments of Veterinary Population Medicine (F.T.) and Veterinary Clinical Sciences (C.P.J.,C.S.C.), College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota
| | - John P Strupp
- Center for Magnetic Resonance Research (CMRR) (J.M.E., K.D.L., M.J.N., C.P.J., J.P.S., L.W., and S.Z.), Department of Radiology, and Department of Orthopaedic Surgery (E.A. and M.T.), Medical School, University of Minnesota, Minneapolis, Minnesota
| | - Luning Wang
- Center for Magnetic Resonance Research (CMRR) (J.M.E., K.D.L., M.J.N., C.P.J., J.P.S., L.W., and S.Z.), Department of Radiology, and Department of Orthopaedic Surgery (E.A. and M.T.), Medical School, University of Minnesota, Minneapolis, Minnesota
| | - Štefan Zbýň
- Center for Magnetic Resonance Research (CMRR) (J.M.E., K.D.L., M.J.N., C.P.J., J.P.S., L.W., and S.Z.), Department of Radiology, and Department of Orthopaedic Surgery (E.A. and M.T.), Medical School, University of Minnesota, Minneapolis, Minnesota
| | - Ferenc Tóth
- Departments of Veterinary Population Medicine (F.T.) and Veterinary Clinical Sciences (C.P.J.,C.S.C.), College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota
| | - Elizabeth Arendt
- Center for Magnetic Resonance Research (CMRR) (J.M.E., K.D.L., M.J.N., C.P.J., J.P.S., L.W., and S.Z.), Department of Radiology, and Department of Orthopaedic Surgery (E.A. and M.T.), Medical School, University of Minnesota, Minneapolis, Minnesota
| | - Marc Tompkins
- Center for Magnetic Resonance Research (CMRR) (J.M.E., K.D.L., M.J.N., C.P.J., J.P.S., L.W., and S.Z.), Department of Radiology, and Department of Orthopaedic Surgery (E.A. and M.T.), Medical School, University of Minnesota, Minneapolis, Minnesota
| | - Kevin Shea
- Department of Orthopaedic Surgery, Stanford University, Stanford, California
| | - Cathy S Carlson
- Departments of Veterinary Population Medicine (F.T.) and Veterinary Clinical Sciences (C.P.J.,C.S.C.), College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota
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11
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Tóth F, Johnson CP, Mills B, Nissi MJ, Nykänen O, Ellermann J, Ludwig KD, Tompkins M, Carlson CS. Evaluation of the Suitability of Miniature Pigs as an Animal Model of Juvenile Osteochondritis Dissecans. J Orthop Res 2019; 37:2130-2137. [PMID: 31115932 PMCID: PMC6739150 DOI: 10.1002/jor.24353] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 05/14/2019] [Indexed: 02/04/2023]
Abstract
Juvenile osteochondritis dissecans (JOCD) is a developmental disease characterized by formation of intra-articular (osteo)chondral flaps or fragments. Evidence-based treatment guidelines for JOCD are currently lacking. An animal model would facilitate study of JOCD and evaluation of diagnostic and treatment approaches. The purpose of this study was to assess the suitability of miniature pigs as a model of JOCD at the distal femur. First, stifle (knee) joints harvested from three juvenile miniature pigs underwent magnetic resonance imaging (MRI) to establish the vascular architecture of the distal femoral epiphyseal cartilage. Second, vessels supplying the axial or abaxial aspects of the medial femoral condyle were surgically interrupted in four additional juvenile miniature pigs, and the developing epiphyseal cartilage lesions were monitored using three consecutive MRI examinations over nine weeks. The miniature pigs were then euthanized, and their distal femora were harvested for histological evaluation. Vascular architecture of the distal femoral epiphyseal cartilage in the miniature pigs was found to be nearly identical to that of juvenile human subjects, characterized by separate vascular beds supplying the axial and abaxial aspects of the condyles. Surgical interruption of the vascular supply to the abaxial aspect of the medial femoral condyle resulted in ischemic cartilage necrosis (a precursor lesion of JOCD) in 75% (3/4) of the miniature pigs. Cartilage lesions were identified during the first MRI performed 3 weeks post-operatively. No clinically apparent JOCD-like lesions developed. In conclusion, miniature pigs are suitable for modeling JOCD precursor lesions. Further investigation of the model is warranted to assess induction of clinically apparent JOCD lesions. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:2130-2137, 2019.
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Affiliation(s)
- Ferenc Tóth
- Department of Veterinary Population Medicine, University of Minnesota, St. Paul, MN
| | - Casey P. Johnson
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN
| | - Benigno Mills
- Department of Veterinary Population Medicine, University of Minnesota, St. Paul, MN
| | - Mikko J. Nissi
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland,Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - Olli Nykänen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Jutta Ellermann
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN
| | - Kai D. Ludwig
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN
| | - Marc Tompkins
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN
| | - Cathy S. Carlson
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN
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12
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Tóth F, Tompkins MA, Shea KG, Ellermann JM, Carlson CS. Identification of Areas of Epiphyseal Cartilage Necrosis at Predilection Sites of Juvenile Osteochondritis Dissecans in Pediatric Cadavers. J Bone Joint Surg Am 2018; 100:2132-2139. [PMID: 30562294 PMCID: PMC6738538 DOI: 10.2106/jbjs.18.00464] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The pathogenesis of human juvenile osteochondritis dissecans (JOCD) remains poorly understood, with multiple factors implicated, including ischemia, repetitive trauma, and genetic predisposition. Similarities in the predilection site and the diagnostic and clinical features of JOCD to the well-characterized veterinary counterpart, osteochondrosis dissecans, suggest that, similar to the animal disease, the pathogenesis JOCD may also be initiated in the first few years of life, when disruption of blood supply to the epiphyseal growth cartilage leads to failure of endochondral ossification. To gather data in support of the hypothesis that JOCD and osteochondrosis dissecans have a shared pathogenesis, biopsy specimens obtained from predilection sites of JOCD in juvenile human cadavers were histologically examined to determine whether they contained lesions similar to those found in animals diagnosed with subclinical osteochondrosis dissecans. METHODS In this descriptive laboratory study, 59 biopsy specimens (6 mm in diameter) were harvested from the central aspect (i.e., the notch side) of the femoral condyles of 26 human cadavers (1 month to 11 years old). Specimens were histologically evaluated for the presence of areas of cartilage necrosis and the morphology of cartilage canal blood vessels. RESULTS Locally extensive areas of necrotic epiphyseal cartilage were identified in 4 specimens obtained from 3 donors (ages 2 to 4 years). Areas of cartilage necrosis accompanied by focal failure of endochondral ossification or surrounded by subchondral bone were identified in biopsy specimens from 4 donors (ages 4 to 9 years). CONCLUSIONS The identification of epiphyseal cartilage necrosis identical to that described in animals with subclinical osteochondrosis, found in biopsy specimens obtained from femoral predilection sites of JOCD in pediatric cadavers, suggests a shared pathogenesis of JOCD in humans and osteochondrosis dissecans in animals. CLINICAL RELEVANCE These findings imply that the pathogenesis of human JOCD likely starts 5 to 10 years prior to the development of clinical symptoms. Enhanced understanding of the temporal features of JOCD pathogenesis provides an opportunity for earlier diagnosis and treatment, likely resulting in improved outcomes for this condition in the future.
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Affiliation(s)
- Ferenc Tóth
- Department of Veterinary Population Medicine, University of Minnesota, St. Paul, Minnesota
| | - Marc A Tompkins
- Department of Orthopaedic Surgery, University of Minnesota Medical School, Minneapolis, Minnesota
- TRIA Orthopedic Center, Minneapolis, Minnesota
| | - Kevin G Shea
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California
| | - Jutta M Ellermann
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, Minnesota
| | - Cathy S Carlson
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, Minnesota
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13
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Johnson CP, Wang L, Tóth F, Aruwajoye O, Kirkham B, Carlson CS, Kim HKW, Ellermann JM. Quantitative susceptibility mapping detects neovascularization of the epiphyseal cartilage after ischemic injury in a piglet model of legg-calvé-perthes disease. J Magn Reson Imaging 2018; 50:106-113. [PMID: 30556613 DOI: 10.1002/jmri.26552] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 10/08/2018] [Accepted: 10/08/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Legg-Calvé-Perthes disease (LCPD) is a childhood hip disorder thought to be caused by disruption of blood supply to the developing femoral head. There is potential for imaging to help assess revascularization of the femoral head. PURPOSE To investigate whether quantitative susceptibility mapping (QSM) can detect neovascularization in the epiphyseal cartilage following ischemic injury to the developing femoral head. STUDY TYPE Prospective. ANIMAL MODEL Right femoral head ischemia was surgically induced in 6-week-old male piglets. The animals were sacrificed 48 hours (n = 3) or 4 weeks (n = 7) following surgery, and the operated and contralateral control femoral heads were harvested for ex vivo MRI. FIELD STRENGTH/SEQUENCE Preclinical 9.4T MRI to acquire susceptibility-weighted 3D gradient echo (GRE) images with 0.1 mm isotropic spatial resolution. ASSESSMENT The 3D GRE images were used to manually segment the cartilage overlying the femoral head and were subsequently postprocessed using QSM. Vessel volume, cartilage volume, and vessel density were measured and compared between operated and control femoral heads at each timepoint. Maximum intensity projections of the QSM images were subjectively assessed to identity differences in cartilage canal appearance, location, and density. STATISTICAL TESTS Paired t-tests with Bonferroni correction were used (P < 0.008 considered significant). RESULTS Increased vascularity of the epiphyseal cartilage following ischemic injury was clearly identified using QSM. No changes were detected 48 hours after surgery. Vessel volume, cartilage volume, and vessel density were all increased in the operated vs. control femoral heads 4 weeks after surgery (P = 0.001, 0.002, and 0.001, respectively). Qualitatively, the increase in vessel density at 4 weeks was due to the formation of new vessels that were organized in a brush-like orientation in the epiphyseal cartilage, consistent with the histological appearance of neovascularization. DATA CONCLUSION QSM can detect neovascularization in the epiphyseal cartilage following ischemic injury to the femoral head. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;50:106-113.
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Affiliation(s)
- Casey P Johnson
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Luning Wang
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ferenc Tóth
- Department of Veterinary Population Medicine, University of Minnesota, St. Paul, Minnesota, USA
| | - Olumide Aruwajoye
- Center for Excellence in Hip Disorders, Texas Scottish Rite Hospital, Dallas, Texas, USA
| | - Brooke Kirkham
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA
| | - Cathy S Carlson
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, Minnesota, USA
| | - Harry K W Kim
- Center for Excellence in Hip Disorders, Texas Scottish Rite Hospital, Dallas, Texas, USA.,Department of Orthopaedic Surgery, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Jutta M Ellermann
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
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14
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Wang D, Wang Z, Zhang L, Li Z, Tian X, Fang J, Lu Q, Zhang X. Cellular ATP levels are affected by moderate and strong static magnetic fields. Bioelectromagnetics 2018; 39:352-360. [PMID: 29709058 DOI: 10.1002/bem.22122] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Accepted: 03/23/2018] [Indexed: 12/21/2022]
Abstract
Mitochondrion is the major cellular energy producing organelle that is at the boundary between chemical reactions and physical processes. Although mitochondria have been shown to be affected by physical methods such as nonthermal plasma, whether static magnetic field (SMF) could also affect them is still unclear. Here we used rat adrenal PC12 cells to compare SMFs of different intensities for their effects on ATP (adenosine-5'-triphosphate), the major energy source produced by mitochondria, which is essential for various cellular processes. Our results show that although 0.26 or 0.50 T SMFs did not affect ATP, 1 T and 9 T SMFs affected ATP level differently and time-dependently. Moreover, SMF-induced ATP level fluctuations are correlated with mitochondrial membrane potential changes. Our study provides insights not only into understanding various cellular effects of SMFs, but also the potential clinical applications of SMFs. Bioelectromagnetics. 39:352-360, 2018. © 2018 Wiley Periodicals, Inc.
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Affiliation(s)
- Dongmei Wang
- High Magnetic Field Laboratory, Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China.,University of Science and Technology of China, Hefei, China
| | - Ze Wang
- High Magnetic Field Laboratory, Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China.,University of Science and Technology of China, Hefei, China
| | - Lei Zhang
- High Magnetic Field Laboratory, Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China.,University of Science and Technology of China, Hefei, China
| | - Zhiyuan Li
- High Magnetic Field Laboratory, Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China
| | - XiaoFei Tian
- High Magnetic Field Laboratory, Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China.,University of Science and Technology of China, Hefei, China
| | - Jun Fang
- High Magnetic Field Laboratory, Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China.,Anhui Province Key Laboratory of Condensed Matter Physics at Extreme Conditions, Hefei, China
| | - Qingyou Lu
- High Magnetic Field Laboratory, Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China.,University of Science and Technology of China, Hefei, China.,Anhui Province Key Laboratory of Condensed Matter Physics at Extreme Conditions, Hefei, China
| | - Xin Zhang
- High Magnetic Field Laboratory, Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China.,Institute of Physical Science and Information Technology, Anhui University, Hefei, China
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15
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Kolb A, Robinson S, Stelzeneder D, Schreiner M, Chiari C, Windhager R, Trattnig S, Bohndorf K. Vessel architecture in human knee cartilage in children: an in vivo susceptibility-weighted imaging study at 7 T. Eur Radiol 2018; 28:3384-3392. [PMID: 29484458 PMCID: PMC6028839 DOI: 10.1007/s00330-017-5290-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 12/04/2017] [Accepted: 12/27/2017] [Indexed: 12/16/2022]
Abstract
Objectives To evaluate the clinical feasibility of ultrahigh field 7-T SWI to visualize vessels and assess their density in the immature epiphyseal cartilage of human knee joints. Methods 7-T SWI of 12 knees (six healthy volunteers, six patients with osteochondral abnormalities; mean age 10.7 years; 3 female, 9 male) were analysed by two readers, classifying intracartilaginous vessel densities (IVD) in three grades (no vessels, low IVD and high IVD) in defined femoral, tibial and patellar zones. Differences between patients and volunteers, IVDs in different anatomic locations, differences between cartilage overlying osteochondral abnormalities and corresponding normal zones, and differences in age groups were analysed. Results Interrater reliability showed moderate agreement between the two readers (κ = 0.58, p < 0.001). The comparison of IVDs between patients and volunteers revealed no significant difference (p = 0.706). The difference between zones in the cartilage overlying osteochondral abnormalities to corresponding normal zones showed no significant difference (p = 0.564). IVDs were related to anatomic location, with decreased IVDs in loading areas (p = 0.003). IVD was age dependent, with more vessels present in the younger participants (p = 0.001). Conclusions The use of SWI in conjunction with ultrahigh field MRI makes the in vivo visualization of vessels in the growing cartilage of humans feasible, providing insights into the role of the vessel network in acquired disturbances. Key Points • SWI facilitates in vivo visualization of vessels in the growing human cartilage. • Interrater reliability of the intracartilaginous vessel grading was moderate. • Intracartilaginous vessel densities are dependent on anatomical location and age. Electronic supplementary material The online version of this article (10.1007/s00330-017-5290-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alexander Kolb
- Department of Orthopaedic Surgery, Medical University Vienna, Vienna, Austria.
| | - Simon Robinson
- High Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Vienna, Austria
| | - David Stelzeneder
- Department of Orthopaedic Surgery, Medical University Vienna, Vienna, Austria
| | - Markus Schreiner
- Department of Orthopaedic Surgery, Medical University Vienna, Vienna, Austria
| | - Catharina Chiari
- Department of Orthopaedic Surgery, Medical University Vienna, Vienna, Austria
| | - Reinhard Windhager
- Department of Orthopaedic Surgery, Medical University Vienna, Vienna, Austria
| | - Siegfried Trattnig
- High Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Vienna, Austria
| | - Klaus Bohndorf
- High Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Vienna, Austria
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16
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Contribution of 3-T Susceptibility-Weighted MRI to Detection of Intraarticular Hemosiderin Accumulation in Patients With Hemophilia. AJR Am J Roentgenol 2018; 210:1141-1147. [PMID: 29470160 DOI: 10.2214/ajr.17.18594] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to assess the feasibility of 3-T susceptibility-weighted imaging (SWI) for detecting intraarticular hemosiderin accumulation in patients with hemophilia. SUBJECTS AND METHODS Forty-one joints in 24 patients with hemophilia were imaged with conventional MRI and SWI sequences. Two experienced musculoskeletal radiologists and one general radiologist (reader 3) interpreted the images for hemosiderin accumulation. The final decision was determined in consensus by readers 1 and 2 using both conventional MRI and SWI sequences. The diagnostic consistencies of each MRI sequence with the reference and pairwise agreements between interpreters were assessed. RESULTS For conventional MRI sequences, the diagnostic consistencies of the two experienced musculoskeletal radiologists with the reference were substantial (κ = 0.63 and 0.62), whereas the consistency of the general radiologist with the reference was moderate (κ = 0.47). The SWI interpretations of all readers had almost perfect agreement with the reference (κ = 1, κ = 1, κ = 0.97). Interobserver agreement also improved at SWI interpretations. CONCLUSION SWI contributes to more accurate grading of intraarticular hemosiderin accumulation than is achieved with conventional MRI sequences.
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17
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Martel G, Crowley D, Olive J, Halley J, Laverty S. Ultrasonographic screening for subclinical osteochondrosis of the femoral trochlea in foals (28-166 days old): a prospective farm study. Equine Vet J 2017; 50:312-320. [DOI: 10.1111/evj.12772] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 10/11/2017] [Indexed: 11/25/2022]
Affiliation(s)
- G. Martel
- Comparative Orthopedic Research Laboratory; Department of Clinical Sciences; Faculty of Veterinary Medicine; University of Montreal; Saint-Hyacinthe Quebec Canada
| | - D. Crowley
- Fethard Equine Hospital; Fethard Ireland
| | - J. Olive
- Radiology, Department of Clinical Sciences; Faculty of Veterinary Medicine; University of Montreal; Saint-Hyacinthe Quebec Canada
| | - J. Halley
- Fethard Equine Hospital; Fethard Ireland
| | - S. Laverty
- Comparative Orthopedic Research Laboratory; Department of Clinical Sciences; Faculty of Veterinary Medicine; University of Montreal; Saint-Hyacinthe Quebec Canada
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18
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Dymerska B, Bohndorf K, Schennach P, Rauscher A, Trattnig S, Robinson SD. In vivo phase imaging of human epiphyseal cartilage at 7 T. Magn Reson Med 2017; 79:2149-2155. [PMID: 28758241 DOI: 10.1002/mrm.26858] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 07/10/2017] [Accepted: 07/11/2017] [Indexed: 12/23/2022]
Abstract
PURPOSE To assess the potential clinical utility of in vivo susceptibility-weighted imaging and quantitative susceptibility mapping of growth cartilage in the juvenile human knee at 7 T. METHODS High-resolution gradient-echo images of the knees of six healthy children and adolescents aged 6 to 15 were acquired with a 28-channel coil at 7 T. Phase images from the coils were combined using a short echo-time reference scan method (COMPOSER). RESULTS Veins oriented perpendicular to the static B0 field appeared doubled in susceptibility-weighted imaging, but not quantitative susceptibility mapping. Veins and layers in the cartilage were visible in all children up to the age of 13. CONCLUSIONS Phase imaging using susceptibility-weighted imaging and quantitative susceptibility mapping allows the in vivo visualization of veins and layers in human growth cartilage. Magn Reson Med 79:2149-2155, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Barbara Dymerska
- High Field Magnetic Resonance Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Austria
| | - Klaus Bohndorf
- High Field Magnetic Resonance Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Austria
| | - Paul Schennach
- High Field Magnetic Resonance Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Austria
| | - Alexander Rauscher
- UBC MRI Research Centre, University of British Columbia, Vancouver, British Columbia, Canada
| | - Siegfried Trattnig
- High Field Magnetic Resonance Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Austria
| | - Simon D Robinson
- High Field Magnetic Resonance Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Austria
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19
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Martel G, Forget C, Gilbert G, Richard H, Moser T, Olive J, Laverty S. Validation of the ultrasonographic assessment of the femoral trochlea epiphyseal cartilage in foals at osteochondrosis predilected sites with magnetic resonance imaging and histology. Equine Vet J 2017; 49:821-828. [DOI: 10.1111/evj.12698] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Accepted: 04/21/2017] [Indexed: 11/30/2022]
Affiliation(s)
- G. Martel
- Département des Sciences Cliniques; Faculté de Médecine Vétérinaire; Université de Montréal; St-Hyacinthe Quebec Canada
| | - C. Forget
- Service vétérinaire Dr Claude Forget; St-Jérôme Quebec Canada
| | - G. Gilbert
- Philips Healthcare; MR Clinical Science; Markham Ontario Canada
| | - H. Richard
- Département des Sciences Cliniques; Faculté de Médecine Vétérinaire; Université de Montréal; St-Hyacinthe Quebec Canada
| | - T. Moser
- Centre Hospitalier de l'Université de Montréal; Hôpital Notre-Dame; Montréal Quebec Canada
| | - J. Olive
- Animal Oncology and Imaging Center; Rotkreuz Switzerland
| | - S. Laverty
- Département des Sciences Cliniques; Faculté de Médecine Vétérinaire; Université de Montréal; St-Hyacinthe Quebec Canada
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20
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Tóth F, David FH, LaFond E, Wang L, Ellermann JM, Carlson CS. In vivo visualization using MRI T 2 mapping of induced osteochondrosis and osteochondritis dissecans lesions in goats undergoing controlled exercise. J Orthop Res 2017; 35:868-875. [PMID: 27283998 PMCID: PMC5458739 DOI: 10.1002/jor.23332] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 06/05/2016] [Indexed: 02/04/2023]
Abstract
In vivo visualization of subclinical osteochondrosis (OC) lesions, characterized by necrosis of epiphyseal growth cartilage, is necessary to clarify the pathogenesis of this disease. Hence, our objectives were to demonstrate induced necrosis of the epiphyseal cartilage in vivo using MRI and to monitor progression or resolution of resulting lesions. We also aimed to improve the goat model of OC by introducing controlled exercise. Vascular supply to the epiphyseal cartilage was surgically interrupted in four 5-day-old goats to induce ischemic cartilage necrosis in a medial femoral condyle. Starting 3 weeks postoperatively, goats underwent daily controlled exercise until euthanasia at 6, 10, 11 (n = 2) weeks postoperatively. T2 maps of operated and control femora were obtained in vivo at 3 (n = 4), 6 (n = 4), 9 (n = 3), and 11 (n = 2) weeks postoperatively using a 3 T MR scanner. In vivo MRI findings were validated against MRI results obtained ex vivo at 9.4 T in three goats and compared to histological results in all goats. Surgical interruption of the vascular supply caused ischemic cartilage necrosis in three out of four goats. T2 maps obtained in vivo at 3 T identified regions of increased relaxation time consistent with discrete areas of cartilage necrosis 3-11 weeks postoperatively and demonstrated delayed progression of the ossification front at 9 (n = 1) and 11 (n = 2) weeks postoperatively. In vivo MRI findings were confirmed by ex vivo MRI at 9.4 T and by histology. Identification of cartilage necrosis in clinical patients in the early stages of OC using T2 maps may provide valuable insight into the pathogenesis of this condition. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:868-875, 2017.
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Affiliation(s)
- Ferenc Tóth
- Veterinary Population Medicine Department, University of Minnesota, St. Paul, MN, USA
| | - Frédéric H. David
- Veterinary Clinical Sciences Department, University of Minnesota, St. Paul, MN, USA
| | - Elizabeth LaFond
- Veterinary Clinical Sciences Department, University of Minnesota, St. Paul, MN, USA
| | - Luning Wang
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | - Jutta M. Ellermann
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | - Cathy S. Carlson
- Veterinary Population Medicine Department, University of Minnesota, St. Paul, MN, USA
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Ellermann J, Johnson CP, Wang L, Macalena JA, Nelson BJ, LaPrade RF. Insights into the Epiphyseal Cartilage Origin and Subsequent Osseous Manifestation of Juvenile Osteochondritis Dissecans with a Modified Clinical MR Imaging Protocol: A Pilot Study. Radiology 2016; 282:798-806. [PMID: 27631413 DOI: 10.1148/radiol.2016160071] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To retrospectively determine if a modified clinical magnetic resonance (MR) imaging protocol provides information on the origin of juvenile osteochondritis dissecans (JOCD) lesions and allows for staging on the basis of the proposed natural history of JOCD to better guide clinical management of the disease. Materials and Methods This institutional review board-approved, HIPAA-compliant, retrospective study was performed in 13 consecutive patients (mean age, 14.9 years; age range, 10-22 years; nine male and four female patients) and one additional comparative patient (a 44-year-old man), in which 19 knees with 20 JOCD lesions were imaged. Seventeen lesions occurred in the medial femoral condyle, two occurred in the lateral femoral condyle, and one occurred in the medial trochlea. The clinical 3-T MR imaging protocol was supplemented with a routinely available multiecho gradient-recalled-echo sequence with the shortest attainable echo time of approximately 4 msec (T2* mapping). Results At the earliest manifestation, the lesion was entirely cartilaginous (n = 1). Subsequently, primary cartilaginous lesions within the epiphyseal cartilage developed a rim calcification that originated from normal subjacent bone, which defined a clear cleft between the lesion progeny and the parent bone (n = 9). Secondarily, progeny lesions became ossified (n = 7) while at the same time forming varying degrees of osseous bridging and/or clefting with the parent bone. Two healed lesions with a linear bony scar and one detached lesion were identified. Conclusion The modified MR imaging protocol allowed for identification of the epiphyseal cartilage origin and subsequent stages of ossification in JOCD. The approach allows further elucidation of the natural history of the disease and may better guide clinical management. © RSNA, 2016.
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Affiliation(s)
- Jutta Ellermann
- From the Department of Radiology and Center for Magnetic Resonance Research (J.E., C.P.J., L.W.) and Department of Orthopaedic Surgery (J.A.M., B.J.N.), University of Minnesota Medical Center, 2021 6th St SE, Minneapolis, MN 55455; and Complex Knee and Sports Medicine Surgery, The Steadman Clinic and Steadman Philippon Research Institute, Vail, Colo (R.F.L.)
| | - Casey P Johnson
- From the Department of Radiology and Center for Magnetic Resonance Research (J.E., C.P.J., L.W.) and Department of Orthopaedic Surgery (J.A.M., B.J.N.), University of Minnesota Medical Center, 2021 6th St SE, Minneapolis, MN 55455; and Complex Knee and Sports Medicine Surgery, The Steadman Clinic and Steadman Philippon Research Institute, Vail, Colo (R.F.L.)
| | - Luning Wang
- From the Department of Radiology and Center for Magnetic Resonance Research (J.E., C.P.J., L.W.) and Department of Orthopaedic Surgery (J.A.M., B.J.N.), University of Minnesota Medical Center, 2021 6th St SE, Minneapolis, MN 55455; and Complex Knee and Sports Medicine Surgery, The Steadman Clinic and Steadman Philippon Research Institute, Vail, Colo (R.F.L.)
| | - Jeffrey A Macalena
- From the Department of Radiology and Center for Magnetic Resonance Research (J.E., C.P.J., L.W.) and Department of Orthopaedic Surgery (J.A.M., B.J.N.), University of Minnesota Medical Center, 2021 6th St SE, Minneapolis, MN 55455; and Complex Knee and Sports Medicine Surgery, The Steadman Clinic and Steadman Philippon Research Institute, Vail, Colo (R.F.L.)
| | - Bradley J Nelson
- From the Department of Radiology and Center for Magnetic Resonance Research (J.E., C.P.J., L.W.) and Department of Orthopaedic Surgery (J.A.M., B.J.N.), University of Minnesota Medical Center, 2021 6th St SE, Minneapolis, MN 55455; and Complex Knee and Sports Medicine Surgery, The Steadman Clinic and Steadman Philippon Research Institute, Vail, Colo (R.F.L.)
| | - Robert F LaPrade
- From the Department of Radiology and Center for Magnetic Resonance Research (J.E., C.P.J., L.W.) and Department of Orthopaedic Surgery (J.A.M., B.J.N.), University of Minnesota Medical Center, 2021 6th St SE, Minneapolis, MN 55455; and Complex Knee and Sports Medicine Surgery, The Steadman Clinic and Steadman Philippon Research Institute, Vail, Colo (R.F.L.)
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22
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Martel G, Kiss S, Gilbert G, Anne-Archard N, Richard H, Moser T, Laverty S. Differences in the vascular tree of the femoral trochlear growth cartilage at osteochondrosis-susceptible sites in foals revealed by SWI 3T MRI. J Orthop Res 2016; 34:1539-46. [PMID: 26740060 DOI: 10.1002/jor.23149] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 01/04/2016] [Indexed: 02/04/2023]
Abstract
Focal ischemic chondronecrosis of epiphyseal growth cartilage (EGC) during endochondral ossification is believed to be a key early event on the pathway to osteochondrosis (OC) in both animals and humans. The lateral ridge of the equine trochlea is a site where severe osteochondritis dissecans lesions frequently arise and is a model for the study of naturally occurring disease. Non-invasive imaging to investigate EGC vascularity may help elucidate why focal ischemia occurs. 3T MRI susceptibility-weighted imaging (SWI) of femoral trochlea of OC predisposed (n = 10) and control (n = 6) day-old foals, with minimal joint loading after birth, was performed. SWI and 3D images revealed the EGC vascular architecture without a contrast agent, and matched histologic observations. No vascular lesions were identified. There was no difference in the vascular density and architecture between control and OC specimens, but a striking difference in vascular pattern was seen at the OC-predilected site in the lateral ridge of the trochlea in all specimens, when compared to the medial ridge of the trochlea, where OC lesions are rarely observed. This site was less ossified with more perichondrial vessels not yet bridging with the subchondral bone. Furthermore, the mean vascular density of all specimens was significantly higher at this site. We speculate that joint morphology and focal internal trauma on this site with a unique vascular architecture may trigger ischemic events at this site. SWI permitted visualization of EGC in young foals with a clinical 3T MRI and paves the way for non-destructive longitudinal studies to improve understanding of OC in all species. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1539-1546, 2016.
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Affiliation(s)
- Gabrielle Martel
- Comparative Orthopaedic Research Laboratory, Faculté de médecine vétérinaire, Université de Montréal, Montréal, Quebec, Canada
| | - Sabrina Kiss
- Department of Radiology, Centre Hospitalier de l'Université de Montréal, Hôpital Notre-Dame, Montréal, Quebec, Canada
| | | | - Nicolas Anne-Archard
- Comparative Orthopaedic Research Laboratory, Faculté de médecine vétérinaire, Université de Montréal, Montréal, Quebec, Canada
| | - Hélène Richard
- Comparative Orthopaedic Research Laboratory, Faculté de médecine vétérinaire, Université de Montréal, Montréal, Quebec, Canada
| | - Thomas Moser
- Department of Radiology, Centre Hospitalier de l'Université de Montréal, Hôpital Notre-Dame, Montréal, Quebec, Canada
| | - Sheila Laverty
- Comparative Orthopaedic Research Laboratory, Faculté de médecine vétérinaire, Université de Montréal, Montréal, Quebec, Canada
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23
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Yuen J, Hung J, Wiggermann V, Robinson SD, McCormack R, d'Entremont AG, Rauscher A. Multi-echo GRE imaging of knee cartilage. J Magn Reson Imaging 2016; 45:1502-1513. [PMID: 27564991 DOI: 10.1002/jmri.25438] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 08/08/2016] [Indexed: 12/24/2022] Open
Abstract
PURPOSE To visualize healthy and abnormal articular cartilage, we investigated the potential of using the 3D multi-echo gradient echo (GRE) signal's magnitude and frequency and maps of T2* relaxation. MATERIALS AND METHODS After optimizing imaging parameters in five healthy volunteers, 3D multi-echo GRE magnetic resonance (MR) images were acquired at 3T in four patients with chondral damage prior to their arthroscopic surgery. Average magnitude and frequency information was extracted from the GRE images, and T2* maps were generated. Cartilage abnormalities were confirmed after arthroscopy and were graded using the Outerbridge classification scheme. Regions of interest were identified on average magnitude GRE images and compared to arthroscopy. RESULTS All four patients presented with regions of Outerbridge Grade I and II cartilage damage on arthroscopy. One patient had Grade III changes. Grade I, II, and III changes were detectable on average magnitude and T2* maps, while Grade II and higher changes were also observable on MR frequency maps. For average magnitude images of healthy volunteers, the signal-to-noise ratio of the magnitude image averaged over three echoes was 4.26 ± 0.32, 12.26 ± 1.09, 14.31 ± 1.93, and 13.36 ± 1.13 in bone, femoral, tibial, and patellar cartilage, respectively. CONCLUSION This proof-of-principle study demonstrates the feasibility of using different imaging contrasts from the 3D multi-echo GRE scan to visualize abnormalities of the articular cartilage. © 2016 International Society for Magnetic Resonance in Medicine Level of Evidence: 1 J. MAGN. RESON. IMAGING 2017;45:1502-1513.
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Affiliation(s)
- Joanna Yuen
- UBC MRI Research Centre, University of British Columbia, Vancouver, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, Canada.,Department of Physics and Astronomy, University of British Columbia, Vancouver, Canada
| | - Jachin Hung
- Department of Physics and Astronomy, University of British Columbia, Vancouver, Canada
| | - Vanessa Wiggermann
- UBC MRI Research Centre, University of British Columbia, Vancouver, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, Canada.,Department of Physics and Astronomy, University of British Columbia, Vancouver, Canada
| | - Simon D Robinson
- High Field Magnetic Resonance Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Robert McCormack
- Department of Orthopaedics, University of British Columbia, Vancouver, Canada
| | - Agnes G d'Entremont
- Department of Mechanical Engineering, University of British Columbia, Vancouver, Canada.,Centre for Hip Health and Mobility, University of British Columbia, Vancouver, Canada.,Child and Family Research Institute, University of British Columbia, Vancouver, Canada
| | - Alexander Rauscher
- UBC MRI Research Centre, University of British Columbia, Vancouver, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, Canada.,Child and Family Research Institute, University of British Columbia, Vancouver, Canada
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24
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Wang L, Nissi MJ, Toth F, Johnson CP, Garwood M, Carlson CS, Ellermann J. Quantitative susceptibility mapping detects abnormalities in cartilage canals in a goat model of preclinical osteochondritis dissecans. Magn Reson Med 2016; 77:1276-1283. [PMID: 27018370 DOI: 10.1002/mrm.26214] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 02/18/2016] [Accepted: 02/19/2016] [Indexed: 12/31/2022]
Abstract
PURPOSE To use quantitative susceptibility mapping (QSM) to investigate changes in cartilage canals in the distal femur of juvenile goats after their surgical transection. METHODS Chondronecrosis was surgically induced in the right medial femoral condyles of four 4-day-old goats. Both the operated and control knees were harvested at 2, 3, 5, and 10 weeks after the surgeries. Ex vivo MRI scans were conducted at 9.4 Tesla using TRAFF (relaxation time along a fictitious field)-weighted fast spin echo imaging and QSM to detect areas of chondronecrosis and investigate cartilage canal abnormalities. Histological sections from these same areas stained with hematoxylin and eosin and safranin O were evaluated to assess the affected tissues. RESULTS Both the histological sections and the TRAFF -weighted images of the femoral condyles demonstrated focal areas of chondronecrosis, evidenced by pyknotic chondrocyte nuclei, loss of matrix staining, and altered MR image contrast. At increasing time points after surgery, progressive changes and eventual disappearance of abnormal cartilage canals were observed in areas of chondronecrosis by using QSM. CONCLUSION Abnormal cartilage canals were directly visualized in areas of surgically induced chondronecrosis. Quantitative susceptibility mapping enabled investigation of the vascular changes accompanying chondronecrosis in juvenile goats. Magn Reson Med 77:1276-1283, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Luning Wang
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Mikko J Nissi
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Ferenc Toth
- Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, Saint Paul, Minnesota, USA
| | - Casey P Johnson
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Michael Garwood
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Cathy S Carlson
- Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, Saint Paul, Minnesota, USA
| | - Jutta Ellermann
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
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25
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Tóth F, Nissi MJ, Ellermann JM, Wang L, Shea KG, Polousky J, Carlson CS. Novel Application of Magnetic Resonance Imaging Demonstrates Characteristic Differences in Vasculature at Predilection Sites of Osteochondritis Dissecans. Am J Sports Med 2015; 43:2522-7. [PMID: 26286878 PMCID: PMC4766866 DOI: 10.1177/0363546515596410] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Understanding the pathogenesis of osteochondrosis/osteochondritis dissecans and other developmental orthopaedic diseases that are thought to occur secondary to defects in vascular supply to growth/epiphyseal cartilage has been hampered by the inability to image the vasculature in this tissue. This is particularly true in human beings due to limitations of current imaging techniques and the lack of availability of appropriate cadaveric samples for histological studies. HYPOTHESIS Susceptibility-weighted imaging, an MRI sequence, allows identification of characteristic differences in the vascular architecture in species that are affected by osteochondrosis/osteochondritis dissecans on the femoral condyle (humans and pigs) versus a species that is free of the disease (goat). STUDY DESIGN Controlled laboratory study. MATERIALS Distal femora from cadavers of juvenile humans (n = 5), pigs (n = 3), and goats (n = 3) were scanned in a 9.4-T MRI scanner using susceptibility-weighted imaging. Three-dimensional reconstructions were created, and minimum intensity projections were calculated in 3 planes to enhance visualization of the vascular architecture. RESULTS Susceptibility-weighted imaging allowed clear visualization of the epiphyseal vasculature in all species. Vascular architecture, with vessels primarily arising from the perichondrium, was similar in humans and pigs, which are predisposed to osteochondrosis/osteochondritis dissecans, and was starkly different from that present in goats, a species in which there are no reports of osteochondrosis/osteochondritis dissecans. Furthermore, vessels in the distal femoral predilection site disappeared with age in humans in a pattern similar to that reported previously in pigs. CONCLUSION Nearly identical vascular architecture at the shared primary predilection site of osteochondrosis/osteochondritis dissecans in the femoral condyles in human beings and pigs suggests that vascular failure, which is known to be central to the pathogenesis of this disease in pigs, may also play a role in humans. CLINICAL RELEVANCE This assumption of a shared pathogenesis is supported by the pattern of disappearance of vessels with age at the primary predilection site of osteochondritis dissecans in humans, which is essentially identical to that which has been reported in pigs. Susceptibility-weighted imaging will likely help further elucidate this potential relationship in the future.
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Affiliation(s)
- Ferenc Tóth
- Department of Veterinary Population Medicine, University of Minnesota, St. Paul, MN, USA,Correspondence to: Ferenc Toth, 435H AnSci/VetMed, 1988 Fitch Avenue, St. Paul, MN 55108, USA; Tel.: 1-612-624-7727;
| | - Mikko J. Nissi
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA,Department of Radiology, Institute of Diagnostics, University of Oulu, Oulu, Finland,Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Jutta M. Ellermann
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Luning Wang
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Kevin G. Shea
- St Lukes Health System, Boise, ID,Department of Orthopedics, University of Utah, Salt Lake City, UT
| | - John Polousky
- The Rocky Mountain Hospital for Children, Denver, CO
| | - Cathy S. Carlson
- Department of Veterinary Population Medicine, University of Minnesota, St. Paul, MN, USA
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26
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Nissi MJ, Tóth F, Wang L, Carlson CS, Ellermann JM. Improved Visualization of Cartilage Canals Using Quantitative Susceptibility Mapping. PLoS One 2015; 10:e0132167. [PMID: 26168296 PMCID: PMC4500468 DOI: 10.1371/journal.pone.0132167] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 06/10/2015] [Indexed: 11/18/2022] Open
Abstract
Purpose Cartilage canal vessels are critical to the normal function of epiphyseal (growth) cartilage and damage to these vessels is demonstrated or suspected in several important developmental orthopaedic diseases. High-resolution, three-dimensional (3-D) visualization of cartilage canals has recently been demonstrated using susceptibility weighted imaging (SWI). In the present study, a quantitative susceptibility mapping (QSM) approach is evaluated for 3-D visualization of the cartilage canals. It is hypothesized that QSM post-processing improves visualization of the cartilage canals by resolving artifacts present in the standard SWI post-processing while retaining sensitivity to the cartilage canals. Methods Ex vivo distal femoral specimens from 3- and 8-week-old piglets and a 1-month-old human cadaver were scanned at 9.4 T with a 3-D gradient recalled echo sequence suitable for SWI and QSM post-processing. The human specimen and the stifle joint of a live, 3-week-old piglet also were scanned at 7.0 T. Datasets were processed using the standard SWI method and truncated k-space division QSM approach. To compare the post-processing methods, minimum/maximum intensity projections and 3-D reconstructions of the processed datasets were generated and evaluated. Results Cartilage canals were successfully visualized using both SWI and QSM approaches. The artifactual splitting of the cartilage canals that occurs due to the dipolar phase, which was present in the SWI post-processed data, was eliminated by the QSM approach. Thus, orientation-independent visualization and better localization of the cartilage canals was achieved with the QSM approach. Combination of GRE with a mask based on QSM data further improved visualization. Conclusions Improved and artifact-free 3-D visualization of the cartilage canals was demonstrated by QSM processing of the data, especially by utilizing susceptibility data as an enhancing mask. Utilizing tissue-inherent contrast, this method allows noninvasive assessment of the vasculature in the epiphyseal cartilage in the developing skeleton and potentially increases the opportunity to diagnose disease of this tissue in the preclinical stages, when treatment likely will have increased efficacy.
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Affiliation(s)
- Mikko J. Nissi
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN, United States of America
- Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, United States of America
- Research Group of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
- * E-mail:
| | - Ferenc Tóth
- Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, United States of America
| | - Luning Wang
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN, United States of America
- Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, United States of America
| | - Cathy S. Carlson
- Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, United States of America
| | - Jutta M. Ellermann
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN, United States of America
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Abstract
Osteochondrosis is defined as a focal disturbance in endochondral ossification. The cartilage superficial to an osteochondrosis lesion can fracture, giving rise to fragments in joints known as osteochondrosis dissecans (OCD). In pigs and horses, it has been confirmed that the disturbance in ossification is the result of failure of the blood supply to epiphyseal growth cartilage and associated ischemic chondronecrosis. The earliest lesion following vascular failure is an area of ischemic chondronecrosis at an intermediate depth of the growth cartilage (osteochondrosis latens) that is detectable ex vivo, indirectly using contrast-enhanced micro- and conventional computed tomography (CT) or directly using adiabatic T1ρ magnetic resonance imaging. More chronic lesions of ischemic chondronecrosis within the ossification front (osteochondrosis manifesta) are detectable by the same techniques and have also been followed longitudinally in pigs using plain CT. The results confirm that lesions sometimes undergo spontaneous resolution, and in combination, CT and histology observations indicate that this occurs by filling of radiolucent defects with bone from separate centers of endochondral ossification that form superficial to lesions and by phagocytosis and intramembranous ossification of granulation tissue that forms deep to lesions. Research is currently aimed at discovering the cause of the vascular failure in osteochondrosis, and studies of spontaneous lesions suggest that failure is associated with the process of incorporating blood vessels into the advancing ossification front during growth. Experimental studies also show that bacteremia can lead to vascular occlusion. Future challenges are to differentiate between causes of vascular failure and to discover the nature of the heritable predisposition for osteochondrosis.
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Affiliation(s)
- K. Olstad
- Faculty of Veterinary Medicine and Biosciences, Institute of Companion Animal Clinical Sciences, Norwegian University of Life Sciences, Oslo, Norway
| | - S. Ekman
- Swedish University of Agricultural Sciences, Uppsala, Sweden
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Surgical induction, histological evaluation, and MRI identification of cartilage necrosis in the distal femur in goats to model early lesions of osteochondrosis. Osteoarthritis Cartilage 2015; 23:300-7. [PMID: 25463443 PMCID: PMC4305013 DOI: 10.1016/j.joca.2014.11.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 09/25/2014] [Accepted: 11/06/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Identify and interrupt the vascular supply to portions of the distal femoral articular-epiphyseal cartilage complex (AECC) in goat kids to induce cartilage necrosis, characteristic of early lesions of osteochondrosis (OC); then utilize magnetic resonance imaging (MRI) to identify necrotic areas of cartilage. DESIGN Distal femora were perfused and cleared in goat kids of various ages to visualize the vascular supply to the distal femoral AECC. Vessels located on the axial aspect of the medial femoral condyle (MFC) and on the abaxial side of the lateral trochlear ridge were transected in eight 4- to 5-day-old goats to induce cartilage necrosis. Goats were euthanized 1, 2, 3, 4, 5, 6, 9, and 10 weeks post operatively and operated stifles were harvested. Adiabatic T1ρ relaxation time maps of the harvested distal femora were generated using a 9.4 T MR scanner, after which samples were evaluated histologically. RESULTS Interruption of the vascular supply to the MFC caused lesions of cartilage necrosis in 6/8 goat kids that were demonstrated histologically. Adiabatic T1ρ relaxation time mapping identified these areas of cartilage necrosis in 5/6 cases. No significant findings were detected after transection of perichondrial vessels supplying the lateral trochlear ridge. CONCLUSIONS Cartilage necrosis, characteristic of early OC, can be induced by interrupting the vascular supply to the distal femoral AECC in goat kids. The ability of high field MRI to identify these areas of cartilage necrosis in the AECC using the adiabatic T1ρ sequence suggests that this technique may be useful in the future for the early diagnosis of OC.
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