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Xie Y, Li H, Chen Y, Cai J, Tao H, Chen S. More severe supraspinatus tendon degeneration on the contralateral shoulders in patients treated for symptomatic rotator cuff tears compared to healthy controls: a quantitative MRI-based study. Acta Radiol 2024; 65:616-624. [PMID: 38232947 DOI: 10.1177/02841851231222812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
BACKGROUND Patients treated for symptomatic rotator cuff tear (RCT) on one shoulder seem to have a higher prevalence of RCT on the contralateral shoulder. PURPOSE To compare the supraspinatus (SSP) tendon and RC muscle properties on the contralateral shoulder in patients after repair surgery to those healthy individuals using quantitative magnetic resonance imaging (MRI). MATERIAL AND METHODS A total of 23 patients treated for RCT (group A) and 23 healthy controls (group B) were recruited. Constant score, visual analog scale score (VAS), and MRI examinations were conducted. The SSP tendon structural status was graded based on the Zlatkin classification and quantified on ultrashort echo time (UTE)-T2* mapping images. Fatty degeneration of RC muscles was classified according to the Goutallier classification and quantified on T2 mapping. RESULTS The Constant and VAS scores were comparable between groups A and B (all P >0.05). No significant differences were observed in tendon structural status between the two groups (P >0.05). However, significant differences were established in UTE-T2* values of the SSP tendon on the distal subregion between groups A and B (16.4 ± 2.4 ms vs. 14.8 ± 1.2 ms; P = 0.01). Regarding muscle degeneration, no significant differences were displayed in T2 values and Goutallier classification of RC muscles (all P >0.05). CONCLUSION Patients with a treated RCT demonstrated inferior SSP tendon in the distal subregion on the contralateral shoulders one year postoperatively compared to that of healthy controls based on quantitative MRI data.
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Affiliation(s)
- Yuxue Xie
- Department of Radiology & Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, PR China
| | - Haoxiong Li
- Department of Radiology & Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, PR China
| | - Ye Chen
- Department of Radiology & Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, PR China
| | - Jiajie Cai
- Department of Radiology & Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, PR China
| | - Hongyue Tao
- Department of Radiology & Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, PR China
| | - Shuang Chen
- Department of Radiology & Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, PR China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, PR China
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McNish R, Lohse K, Pruthi S, Hastings MK, Zheng J, Zellers JA. Achilles tendon assessment on quantitative MRI: Sources of variability and relationships to tendinopathy. Scand J Med Sci Sports 2024; 34:e14650. [PMID: 38712745 PMCID: PMC11081531 DOI: 10.1111/sms.14650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 04/24/2024] [Accepted: 04/25/2024] [Indexed: 05/08/2024]
Abstract
Quantitative MRI (qMRI) measures are useful in assessing musculoskeletal tissues, but application to tendon has been limited. The purposes of this study were to optimize, identify sources of variability, and establish reproducibility of qMRI to assess Achilles tendon. Additionally, preliminarily estimates of effect of tendon pathology on qMRI metrics and structure-function relationships between qMRI measures and ankle performance were examined. T1, T1ρ, T2, and T2* maps of the Achilles tendon were obtained using a 3T MRI scanner. In participants with asymptomatic tendons (n = 21), MRI procedures were repeated twice, and region of interest selection was performed by three raters. Variance decomposition and reproducibility statistics were completed. To estimate the effect of pathology, qMRI measures from individuals with asymptomatic tendons were compared to qMRI measures from a pilot group of individuals with Achilles tendinopathy (n = 7). Relationships between qMRI and ankle performance measures were assessed. Between-participant variation accounted for the majority of variability (46.7%-64.0%) in all qMRI measures except T2*. ICCs met or exceeded 0.7 for all qMRI measures when averaged across raters or scans. Relaxation times were significantly longer in tendinopathic tendons (mean (SD) T1: 977.8 (208.6) ms, T1ρ: 35.4 (7.1) ms, T2: 42.8 (7.9) ms, T2*: 14.1 (7.6) ms, n = 7) compared to asymptomatic control tendons (T1: 691.7 (32.4) ms, T1ρ: 24.0 (3.6) ms, T2: 24.4 (7.5) ms, T2*: 9.5 (3.4) ms, n = 21) (p < 0.011 for all comparisons). T1 related to functional performance measures in symptomatic and asymptomatic groups. Study findings suggest that qMRI is reliable to assess the Achilles tendon. qMRI quantitatively assesses the presence of tendon pathology and relates to functional performance outcomes, supporting the utility of incorporating qMRI in research and clinic.
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Affiliation(s)
- Reika McNish
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Keith Lohse
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Neurology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Saksham Pruthi
- School of Medicine, Saint Louis University, St. Louis, Missouri, USA
| | - Mary K Hastings
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Jie Zheng
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Jennifer A Zellers
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, Missouri, USA
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Anz AW, Jordan SE, Ostrander RV, Branch EA, Denney TS, Cohen A, Andrews JR. Augmentation of ACL Autograft Reconstruction With an Amnion Collagen Matrix Wrap and Bone Marrow Aspirate Concentrate: A Pilot Randomized Controlled Trial With 2-Year Follow-up. Orthop J Sports Med 2023; 11:23259671231210035. [PMID: 38021297 PMCID: PMC10656805 DOI: 10.1177/23259671231210035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 06/06/2023] [Indexed: 12/01/2023] Open
Abstract
Background It is theorized that the lack of a synovial lining after anterior cruciate ligament (ACL) injury and ACL reconstruction (ACLR) contributes to slow ligamentization and possible graft failure. Whether graft maturation and incorporation can be improved with the use of a scaffold requires investigation. Purpose To evaluate the safety and efficacy of wrapping an ACL autograft with an amnion collagen matrix and injecting bone marrow aspirate concentrate (BMAC), quantify the cellular content of the BMAC samples, and assess 2-year postoperative patient-reported outcomes. Study Design Randomized controlled trial; Level of evidence, 2. Methods A total of 40 patients aged 18 to 35 years who were scheduled to undergo ACLR were enrolled in a prospective single-blinded randomized controlled trial with 2 arms based on graft type: bone-patellar tendon-bone (BTB; n = 20) or hamstring (HS; n = 20). Participants in each arm were randomized into a control group who underwent standard ACLR or an intervention group who had their grafts wrapped with an amnion collagen matrix during graft preparation, after which BMAC was injected under the wrap layers after implantation. Postoperative magnetic resonance imaging (MRI) mapping/processing yielded mean T2* relaxation time and graft volume values at 3, 6, 9, and 12 months. Participants completed the Single Assessment Numeric Evaluation Score, Knee injury and Osteoarthritis Outcome Score, and pain visual analog scale. Statistical linear mixed-effects models were used to quantify the effects over time and the differences between the control and intervention groups. Adverse events were also recorded. Results No significant differences were found at any time point between the intervention and control groups for BTB T2* (95% CI, -1.89 to 0.63; P = .31), BTB graft volume (95% CI, -606 to 876.1; P = .71), HS T2* (95% CI, -2.17 to 0.39; P = .162), or HS graft volume (95% CI, -11,141.1 to 351.5; P = .28). No significant differences were observed between the intervention and control groups of either graft type on any patient-reported outcome measure. No adverse events were reported after a 2-year follow-up. Conclusion In this pilot study, wrapping a graft with an amnion collagen matrix and injecting BMAC appeared safe. MRI T2* values and graft volume of the augmented ACL graft were not significantly different from that of controls, suggesting that the intervention did not result in improved graft maturation. Registration NCT03294759 (ClinicalTrials.gov identifier).
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Affiliation(s)
- Adam W. Anz
- Department of Research, Andrews Institute Center for Regenerative Medicine, Andrews Research & Education Foundation, Gulf Breeze, Florida, USA
| | - Steve E. Jordan
- Department of Research, Andrews Institute Center for Regenerative Medicine, Andrews Research & Education Foundation, Gulf Breeze, Florida, USA
| | - Roger V. Ostrander
- Department of Research, Andrews Institute Center for Regenerative Medicine, Andrews Research & Education Foundation, Gulf Breeze, Florida, USA
| | - Eric A. Branch
- Department of Research, Andrews Institute Center for Regenerative Medicine, Andrews Research & Education Foundation, Gulf Breeze, Florida, USA
| | - Thomas S. Denney
- Department of Electrical and Computer Engineering, Auburn University, Auburn, Alabama, USA
| | - Achraf Cohen
- Department of Mathematics and Statistics, University of West Florida, Pensacola, Florida, USA
| | - James R. Andrews
- Department of Research, Andrews Institute Center for Regenerative Medicine, Andrews Research & Education Foundation, Gulf Breeze, Florida, USA
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Zellers JA, Edalati M, Eekhoff JD, McNish R, Tang SY, Lake SP, Mueller MJ, Hastings MK, Zheng J. Quantative MRI predicts tendon mechanical behavior, collagen composition, and organization. J Orthop Res 2023; 41:2329-2338. [PMID: 36324161 PMCID: PMC10151441 DOI: 10.1002/jor.25471] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/06/2022] [Accepted: 10/08/2022] [Indexed: 11/05/2022]
Abstract
Quantitative magnetic resonance imaging (qMRI) measures have provided insights into the composition, quality, and structure-function of musculoskeletal tissues. Low signal-to-noise ratio has limited application to tendon. Advances in scanning sequences and sample positioning have improved signal from tendon allowing for evaluation of structure and function. The purpose of this study was to elucidate relationships between tendon qMRI metrics (T1, T2, T1ρ and diffusion tensor imaging [DTI] metrics) with tendon tissue mechanics, collagen concentration and organization. Sixteen human Achilles tendon specimens were collected, imaged with qMRI, and subjected to mechanical testing with quantitative polarized light imaging. T2 values were related to tendon mechanics [peak stress (rsp = 0.51, p = 0.044), equilibrium stress (rsp = 0.54, p = 0.033), percent relaxation (rsp = -0.55, p = 0.027), hysteresis (rsp = -0.64, p = 0.007), linear modulus (rsp = 0.67, p = 0.009)]. T1ρ had a statistically significant relationship with percent relaxation (r = 0.50, p = 0.048). Collagen content was significantly related to DTI measures (range of r = 0.56-0.62). T2 values from a single slice of the midportion of human Achilles tendons were strongest predictors of tendon tensile mechanical metrics. DTI diffusivity indices (mean diffusivity, axial diffusivity, radial diffusivity) were strongly correlated with collagen content. These findings build on a growing body of literature supporting the feasibility of qMRI to characterize tendon tissue and noninvasively measure tendon structure and function. Statement of Clinical Significance: Quantitative MRI can be applied to characterize tendon tissue and is a noninvasive measure that relates to tendon composition and mechanical behavior.
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Affiliation(s)
- Jennifer A. Zellers
- Program in Physical Therapy; Washington University School of Medicine in St. Louis
- Department of Orthopaedic Surgery; Washington University School of Medicine in St. Louis
| | - Masoud Edalati
- Mallinckrodt Institute of Radiology; Washington University School of Medicine in St. Louis
| | - Jeremy D. Eekhoff
- Department of Biomedical Engineering; Washington University in St. Louis
| | - Reika McNish
- Program in Physical Therapy; Washington University School of Medicine in St. Louis
| | - Simon Y. Tang
- Department of Orthopaedic Surgery; Washington University School of Medicine in St. Louis
| | - Spencer P. Lake
- Department of Orthopaedic Surgery; Washington University School of Medicine in St. Louis
- Department of Mechanical Engineering & Materials Science; Washington University in St. Louis
| | - Michael J. Mueller
- Program in Physical Therapy; Washington University School of Medicine in St. Louis
- Mallinckrodt Institute of Radiology; Washington University School of Medicine in St. Louis
| | - Mary K. Hastings
- Program in Physical Therapy; Washington University School of Medicine in St. Louis
- Department of Orthopaedic Surgery; Washington University School of Medicine in St. Louis
| | - Jie Zheng
- Mallinckrodt Institute of Radiology; Washington University School of Medicine in St. Louis
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Stein P, Wuennemann F, Schneider T, Zeifang F, Burkholder I, Weber MA, Kauczor HU, Rehnitz C. Detection and Quantitative Assessment of Arthroscopically Proven Long Biceps Tendon Pathologies Using T2 Mapping. Tomography 2023; 9:1577-1591. [PMID: 37736979 PMCID: PMC10514832 DOI: 10.3390/tomography9050126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 09/23/2023] Open
Abstract
This study evaluates how far T2 mapping can identify arthroscopically confirmed pathologies in the long biceps tendon (LBT) and quantify the T2 values in healthy and pathological tendon substance. This study comprised eighteen patients experiencing serious shoulder discomfort, all of whom underwent magnetic resonance imaging, including T2 mapping sequences, followed by shoulder joint arthroscopy. Regions of interest were meticulously positioned on their respective T2 maps, capturing the sulcal portion of the LBT and allowing for the quantification of the average T2 values. Subsequent analyses included the calculation of diagnostic cut-off values, sensitivities, and specificities for the detection of tendon pathologies, and the calculation of inter-reader correlation coefficients (ICCs) involving two independent radiologists. The average T2 value for healthy subjects was measured at 23.3 ± 4.6 ms, while patients with tendinopathy displayed a markedly higher value, at 47.9 ± 7.8 ms. Of note, the maximum T2 value identified in healthy tendons (29.6 ms) proved to be lower than the minimal value measured in pathological tendons (33.8 ms), resulting in a sensitivity and specificity of 100% (95% confidence interval 63.1-100) across all cut-off values ranging from 29.6 to 33.8 ms. The ICCs were found to range from 0.93 to 0.99. In conclusion, T2 mapping is able to assess and quantify healthy LBTs and can distinguish them from tendon pathology. T2 mapping may provide information on the (ultra-)structural integrity of tendinous tissue, facilitating early diagnosis, prompt therapeutic intervention, and quantitative monitoring after conservative or surgical treatments of LBT.
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Affiliation(s)
- Patrick Stein
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany
| | - Felix Wuennemann
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany
- Institute of Diagnostic and Interventional Radiology & Neuroradiology, Helios Dr. Horst Schmidt Clinics Wiesbaden, Ludwig-Erhard-Straße 100, 65199 Wiesbaden, Germany
| | - Thomas Schneider
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany
| | - Felix Zeifang
- Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, University Hospital Heidelberg, Schlierbacher Landstraße 200A, 69118 Heidelberg, Germany
- Ethianum Clinic Heidelberg, Voßstraße 6, 69115 Heidelberg, Germany
| | - Iris Burkholder
- Department of Nursing and Health, University of Applied Sciences of the Saarland, 66117 Saarbruecken, Germany
| | - Marc-André Weber
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Ernst-Heydemann-Straße 6, 18057 Rostock, Germany
| | - Hans-Ulrich Kauczor
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany
| | - Christoph Rehnitz
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany
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Ece B, Yigit H, Ergun E, Koseoglu EN, Karavas E, Aydin S, Kosar PN. Quantitative Analysis of Supraspinatus Tendon Pathologies via T2/T2* Mapping Techniques with 1.5 T MRI. Diagnostics (Basel) 2023; 13:2534. [PMID: 37568898 PMCID: PMC10417426 DOI: 10.3390/diagnostics13152534] [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: 06/02/2023] [Revised: 07/21/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
The aim of this study was to quantitatively assess supraspinatus tendon pathologies with T2/T2* mapping techniques, which are sensitive to biochemical changes. Conventional magnetic resonance imaging (MRI) and T2/T2* mapping techniques were applied to 41 patients with shoulder pathology, and there were also 20 asymptomatic cases included. The patients were divided into two groups: tendinosis and rupture. The supraspinatus tendon was divided into medial, middle, and lateral sub-regions, and the T2/T2* values were measured in both the coronal and sagittal planes for intergroup comparison. Intra-class and inter-class correlation coefficients (ICCs) were calculated to assess test reproducibility. Receiver operating characteristic (ROC) analysis was used to determine the cut-off value in each group. A total of 61 patients (27 males and 34 females)-including 20 asymptomatic individuals, 20 with tendinosis, and 21 with rupture-were evaluated using T2/T2* mapping techniques. In the rupture group, there were significant differences in the values of the lateral region (p < 0.001), as well as in the middle and medial regions (p < 0.05) of the supraspinatus tendon compared to the tendinosis and asymptomatic groups. These were determined using both T2* and T2 mapping in both the coronal and sagittal plane measurements. In the tendinosis group, there were significant differences in the values of the lateral region with T2* mapping (p < 0.001) in both the coronal and sagittal planes, and also with the T2 mapping in the coronal plane (p < 0.05) compared to the asymptomatic groups. The cut-off values for identifying supraspinatus pathology ranged from 85% to 90% for T2 measurements and above 90% for T2* measurements in both planes of the lateral section. The ICC values showed excellent reliability (ICC > 0.75) for all groups. In conclusion, T2 and T2* mapping techniques with 1.5 T MRI can be used to assess tendon rupture and tendinosis pathologies in the supraspinatus tendon. For an accurate evaluation, measurements from the lateral region in both the coronal and sagittal planes are more decisive.
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Affiliation(s)
- Bunyamin Ece
- Department of Radiology, Kastamonu University, 37150 Kastamonu, Turkey
| | - Hasan Yigit
- Department of Radiology, Health Sciences University, Ankara Education and Research Hospital, 06100 Ankara, Turkey; (H.Y.); (E.E.); (E.N.K.); (P.N.K.)
| | - Elif Ergun
- Department of Radiology, Health Sciences University, Ankara Education and Research Hospital, 06100 Ankara, Turkey; (H.Y.); (E.E.); (E.N.K.); (P.N.K.)
| | - Enver Necip Koseoglu
- Department of Radiology, Health Sciences University, Ankara Education and Research Hospital, 06100 Ankara, Turkey; (H.Y.); (E.E.); (E.N.K.); (P.N.K.)
| | - Erdal Karavas
- Department of Radiology, Bandırma Onyedi Eylül University, 10200 Bandırma, Turkey;
| | - Sonay Aydin
- Department of Radiology, Erzincan University, 24100 Erzincan, Turkey;
| | - Pinar Nercis Kosar
- Department of Radiology, Health Sciences University, Ankara Education and Research Hospital, 06100 Ankara, Turkey; (H.Y.); (E.E.); (E.N.K.); (P.N.K.)
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Xie Y, Li X, Liu S, Hu Y, Chen Y, Liu S, Wu P, Tao H, Chen S. Quantitative Magnetic Resonance Imaging-Based Tendon Healing of Different Regions of the Shoulder: Comparison Between the Suture-Bridge and Single-Row Techniques. Orthop J Sports Med 2023; 11:23259671221137835. [PMID: 36655017 PMCID: PMC9841867 DOI: 10.1177/23259671221137835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 08/30/2022] [Indexed: 01/12/2023] Open
Abstract
Background Rotator cuff retears occur more often at the proximal region with the suture-bridge (SB) technique than at the typical footprint region with the single-row (SR) technique. Few longitudinal clinical trials have focused on the postoperative tendon quality of the repaired rotator cuff at different regions between the 2 techniques. Purpose To compare tendon healing of the proximal and distal regions between the SB and SR techniques. Study Design Cohort study; Level of evidence, 3. Methods Included were consecutive patients who underwent arthroscopic rotator cuff repair and undertook clinical and magnetic resonance imaging (MRI) examinations at 3, 6, and 12 months postoperatively between 2016 and 2017. These patients were divided into the SB and SR groups according to the technique used. The repaired tendon was segmented into distal and proximal regions on ultrashort echo time-T2* mapping images. Clinical outcomes (Constant score, American Shoulder and Elbow Surgeons score, Fudan University Shoulder Score, and visual analog scale for pain) and MRI-based tendon healing (T2* values) of different regions were compared between the 2 groups. The differences in T2* values and clinical scores were determined by 1-way analysis of variance for repeated measurements. Results A total of 31 patients (17 in SB group and 14 in SR group) were included. At 12-month follow-up, significant improvements from preoperatively were achieved for all patients in all clinical scores (P < .001 for all). No significant between-group differences were found in T2* values of the distal region at any time point; however, the mean T2* value of the proximal region at 3 months was significantly higher in the SB group compared with the SR group (P = .03). This difference became nonsignificant at subsequent follow-up time points. Conclusion Significant clinical improvements over time can be expected in the first year after arthroscopic rotator cuff repair. In the early postoperative period, higher T2* values in the proximal region of the repaired tendon (representing inferior tendon quality) were seen with the SB technique compared with the SR technique; however, this phenomenon was resolved over time.
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Affiliation(s)
- Yuxue Xie
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiangwen Li
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China
| | - Shaohua Liu
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yiwen Hu
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China
| | - Ye Chen
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China
| | - Shiyin Liu
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China
| | - Puye Wu
- GE Healthcare, Shanghai, China
| | - Hongyue Tao
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China.,Hongyue Tao, MD, Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqizhong Road, Shanghai, China (); and Shuang Chen, PhD, Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqizhong Road, Shanghai, China ()
| | - Shuang Chen
- Department of Radiology and Institute of Medical Functional and Molecular Imaging, Huashan Hospital, Fudan University, Shanghai, China.,Hongyue Tao, MD, Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqizhong Road, Shanghai, China (); and Shuang Chen, PhD, Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqizhong Road, Shanghai, China ()
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8
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Regulski PA, Zielinski J, Borucki B, Nowinski K. A Weighted Stochastic Conjugate Direction Algorithm for Quantitative Magnetic Resonance Images—A Pattern in Ruptured Achilles Tendon T2-Mapping Assessment. Healthcare (Basel) 2022; 10:healthcare10050784. [PMID: 35627921 PMCID: PMC9141354 DOI: 10.3390/healthcare10050784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/09/2022] [Accepted: 04/20/2022] [Indexed: 11/16/2022] Open
Abstract
This study presents an accurate biexponential weighted stochastic conjugate direction (WSCD) method for the quantitative T2-mapping reconstruction of magnetic resonance images (MRIs), and this approach was compared with the non-negative-least-squares Gauss–Newton (GN) numerical optimization method in terms of accuracy and goodness of fit of the reconstructed images from simulated data and ruptured Achilles tendon (AT) MRIs. Reconstructions with WSCD and GN were obtained from data simulating the signal intensity from biexponential decay and from 58 MR studies of postrupture, surgically repaired ATs. Both methods were assessed in terms of accuracy (closeness of the means of calculated and true simulated T2 values) and goodness of fit (magnitude of mean squared error (MSE)). The lack of significant deviation in correct T2 values for the WSCD method was demonstrated for SNR ≥ 20 and for GN–SNR ≥ 380. The MSEs for WSCD and GN were 287.52 ± 224.11 and 2553.91 ± 1932.31, respectively. The WSCD reconstruction method was better than the GN method in terms of accuracy and goodness of fit.
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Affiliation(s)
- Piotr A. Regulski
- Department of Dental and Maxillofacial Radiology, Faculty of Medicine and Dentistry, Medical University of Warsaw, 02-091 Warsaw, Poland
- Correspondence: ; Tel.: +48-22-561-90-42
| | - Jakub Zielinski
- Interdisciplinary Centre for Mathematical and Computational Modelling, University of Warsaw, 00-927 Warsaw, Poland; (J.Z.); (B.B.); (K.N.)
| | - Bartosz Borucki
- Interdisciplinary Centre for Mathematical and Computational Modelling, University of Warsaw, 00-927 Warsaw, Poland; (J.Z.); (B.B.); (K.N.)
| | - Krzysztof Nowinski
- Interdisciplinary Centre for Mathematical and Computational Modelling, University of Warsaw, 00-927 Warsaw, Poland; (J.Z.); (B.B.); (K.N.)
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Trudel G, Duchesne-Bélanger S, Thomas J, Melkus G, Cron GO, Larson PEZ, Schweitzer M, Sheikh A, Louati H, Laneuville O. Quantitative analysis of repaired rabbit supraspinatus tendons (± channeling) using magnetic resonance imaging at 7 Tesla. Quant Imaging Med Surg 2021; 11:3460-3471. [PMID: 34341723 DOI: 10.21037/qims-20-1343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 03/26/2021] [Indexed: 01/08/2023]
Abstract
Background The quantitative assessment of supraspinatus tendons by conventional magnetic resonance is limited by low contrast-to-noise ratio (CNR). Magnetic resonance imaging (MRI) scanners operating at 7 Tesla offer high signal-to noise ratio (SNR), low CNR and high spatial resolution that are well-suited for rapidly relaxing tissues like tendons. Few studies have applied T2 and T2* mapping to musculoskeletal imaging and to the rotator cuff tendons. Our objective was to analyze the T2 and T2* relaxation times from surgically repaired supraspinatus tendons and the effect of bone channeling. Methods One supraspinatus tendon of 112 adult female New Zealand white rabbits was surgically detached and repaired one week later. Rabbits were randomly assigned to channeling (n=64) or control (n=48) groups and harvested at 0, 1, 2, and 4 weeks. A 7T magnet was used for signal acquisition. For T2 mapping, a sagittal multi slice 2D multi-echo spin-echo (MESE) CPMG sequence with fat saturation was applied and T2* mapping was performed using a 3D UTE sequence. Magnetic resonance images from supraspinatus tendons were analyzed by two raters. Three regions of interest were manually drawn on the first T2-weighted dataset. For T2 and T2*, different ROI masks were generated to obtain relaxation times. Results T2-weighted maps but not T2*-weighted maps generated reliable signals for relaxation time measurement. Torn supraspinatus tendons had lower T2 than controls at the time of repair (20.0±3.4 vs. 25.6±3.9 ms; P<0.05). T2 increased at 1, 2 and 4 postoperative weeks: 22.7±3.1, 23.3±3.9 and 24.0±5.1 ms, respectively, and values were significantly different from contralateral supraspinatus tendons (24.8±3.1; 26.8±4.3 and 26.5±3.6 ms; all P<0.05). Bone channeling did not affect T2 (P>0.05). Conclusions Supraspinatus tendons detached for 1 week had shorter T2 relaxation time compared to contralateral as measured with 7T MRI.
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Affiliation(s)
- Guy Trudel
- Bone and Joint Research Laboratory, Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Department of Medicine, Division of Physiatry, University of Ottawa, Ottawa, ON, Canada.,Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada
| | - Samuel Duchesne-Bélanger
- Bone and Joint Research Laboratory, Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Department of Biology, University of Ottawa, Ottawa, ON, Canada
| | - Justin Thomas
- Bone and Joint Research Laboratory, Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Department of Biology, University of Ottawa, Ottawa, ON, Canada
| | - Gerd Melkus
- Department of Medical Imaging, The Ottawa Hospital, Ottawa, ON, Canada.,Department of Radiology, University of Ottawa, Ottawa, ON, Canada
| | - Greg O Cron
- Department of Medical Imaging, The Ottawa Hospital, Ottawa, ON, Canada.,Department of Radiology, University of Ottawa, Ottawa, ON, Canada
| | - Peder E Z Larson
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, CA, USA
| | - Mark Schweitzer
- Department of Radiology, Stony Brook University NY, New York, NY, USA
| | - Adnan Sheikh
- Department of Medical Imaging, The Ottawa Hospital, Ottawa, ON, Canada.,Department of Radiology, University of Ottawa, Ottawa, ON, Canada
| | - Hakim Louati
- Bone and Joint Research Laboratory, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Odette Laneuville
- Bone and Joint Research Laboratory, Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Department of Biology, University of Ottawa, Ottawa, ON, Canada
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10
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Lockard CA, Nolte PC, Gawronski KMB, Elrick BP, Goldenberg BT, Horan MP, Dornan GJ, Ho CP, Millett PJ. Quantitative T2 mapping of the glenohumeral joint cartilage in asymptomatic shoulders and shoulders with increasing severity of rotator cuff pathology. Eur J Radiol Open 2021; 8:100329. [PMID: 33644264 PMCID: PMC7895706 DOI: 10.1016/j.ejro.2021.100329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/01/2021] [Accepted: 02/03/2021] [Indexed: 02/02/2023] Open
Abstract
Glenohumeral cartilage T2 values were correlated to increasing rotator cuff pathology severity. Massive tear versus lesser injury differences were most evident in superior humeral cartilage. Sagittal T2 mapping best captures superior humeral head cartilage change in massive tear patients.
Purpose To examine the relationship between glenohumeral cartilage T2 mapping values and rotator cuff pathology. Method Fifty-nine subjects (age 48.2 ± 13.5 years, 15 asymptomatic volunteers and 10 tendinosis, 13 partial-thickness tear, 8 full-thickness tear, and 13 massive tear patients) underwent glenohumeral cartilage T2 mapping. The humeral head cartilage was segmented in the sagittal and coronal planes. The glenoid cartilage was segmented in the coronal plane. Group means for each region were calculated and compared between the groups. Results Massive tear group T2 values were significantly higher than the asymptomatic group values for the humeral head cartilage included in the sagittal (45 ± 7 versus 32 ± 4 ms, p < .001) and coronal (44 ± 6 versus 38 ± 1 ms, p = 0.01) plane images. Mean T2 was also significantly higher for massive than full-thickness tears (45 ± 7 versus 38 ± 5 ms, p = 0.02), massive than partial-thickness tears (45 ± 7 versus 34 ± 4 ms, p < 0.001), and massive tears than tendinosis (45 ± 7 versus 35 ± 4 ms, p = 0.001) in the sagittal-images humeral head region and significantly higher for massive tears than asymptomatic shoulders (44 ± 6 versus 38 ± 1 ms, p = 0.01) in the coronal-images humeral head region. Conclusion Humeral head cartilage T2 values were significantly positively correlated with rotator cuff pathology severity. Massive rotator cuff tear patients demonstrated significantly higher superior humeral head cartilage T2 mapping values relative to subjects with no/lesser degrees of rotator cuff pathology.
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Key Words
- Cartilage
- Cuff tear arthropathy
- FS, fat suppressed
- GCor, glenoid, coronal plane
- HH, humeral head
- HHCor, humeral head, coronal plane
- HHSag, humeral head, sagittal plane
- MRI, magnetic resonance imaging
- Magnetic resonance imaging
- PD, proton density
- RC, rotator cuff
- ROI, region of interest
- Rotator cuff
- SPACE, sampling perfection with application-optimized contrasts using different flip angle evolution
- Shoulder
- T2, transverse relaxation time
- TSE, turbo spin echo
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Affiliation(s)
- Carly A Lockard
- Steadman Philippon Research Institute, 181 W Meadow Dr, Ste 1000, Vail, CO 81657, USA
| | - Philip-C Nolte
- Steadman Philippon Research Institute, 181 W Meadow Dr, Ste 1000, Vail, CO 81657, USA
| | - Karissa M B Gawronski
- Steadman Philippon Research Institute, 181 W Meadow Dr, Ste 1000, Vail, CO 81657, USA
| | - Bryant P Elrick
- Steadman Philippon Research Institute, 181 W Meadow Dr, Ste 1000, Vail, CO 81657, USA
| | - Brandon T Goldenberg
- Steadman Philippon Research Institute, 181 W Meadow Dr, Ste 1000, Vail, CO 81657, USA
| | - Marilee P Horan
- Steadman Philippon Research Institute, 181 W Meadow Dr, Ste 1000, Vail, CO 81657, USA
| | - Grant J Dornan
- Steadman Philippon Research Institute, 181 W Meadow Dr, Ste 1000, Vail, CO 81657, USA
| | - Charles P Ho
- Steadman Philippon Research Institute, 181 W Meadow Dr, Ste 1000, Vail, CO 81657, USA
| | - Peter J Millett
- Steadman Philippon Research Institute, 181 W Meadow Dr, Ste 1000, Vail, CO 81657, USA.,The Steadman Clinic, 181 W Meadow Dr, Ste 400, Vail, CO 81657, USA
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11
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Wang N, Badar F, Xia Y. Resolution-dependent influences of compressed sensing in quantitative T2 mapping of articular cartilage. NMR IN BIOMEDICINE 2020; 33:e4260. [PMID: 32040226 PMCID: PMC7415577 DOI: 10.1002/nbm.4260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 12/18/2019] [Accepted: 12/29/2019] [Indexed: 06/10/2023]
Abstract
This study evaluates the resolution-dependent influences of compressed sensing (CS) in MRI quantification of T2 mapping in articular cartilage with osteoarthritis (OA). T2-weighed 2D experiments of healthy and OA cartilage were fully sampled in k-space with five echo times at both 17.6 μm and 195.3 μm in-plane resolutions; termed as microscopic MRI (μMRI) and macroscopic MRI (mMRI) respectively. These fully sampled k-space data were under-sampled at various 2D CS accelerating factors (AF = 4-32). The under-sampled data were reconstructed individually into 2D images using nonlinear reconstruction, which were used to calculate the T2 maps. The bulk and zonal variations of T2 values in cartilage were evaluated at different AFs. The study finds that the T2 images at AFs up to 8 preserved major visual information and produced negligible artifacts for μMRI. The T2 values remained accurate for different sub-tissue zones at various AFs. The absolute difference between the CS (AF up to 32) and the Ground Truth (i.e., using 100% of the k-space data) of the mean T2 values through the whole tissue depth was higher in mMRI versus μMRI. For mMRI (where the resolution mimics the clinical MRI of human cartilage), the quantitative T2 mapping at AFs up to 4 showed negligible variations. This study demonstrates that both clinical MRI and μMRI can benefit from the use of CS in image acquisition, and μMRI benefits more from the use of CS by acquiring much less data, without losing significant accuracy in the quantification of T2 maps in osteoarthritic cartilage.
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Affiliation(s)
- Nian Wang
- Center for In Vivo Microscopy, Duke University School of Medicine, Durham, North Carolina, USA
- Department of Radiology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Farid Badar
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, MI 48309
| | - Yang Xia
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, MI 48309
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12
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Bruno F, Palumbo P, Arrigoni F, Mariani S, Aringhieri G, Carotti M, Natella R, Zappia M, Cipriani P, Giacomelli R, Di Cesare E, Splendiani A, Masciocchi C, Barile A. Advanced diagnostic imaging and intervention in tendon diseases. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:98-106. [PMID: 32945284 PMCID: PMC7944667 DOI: 10.23750/abm.v91i8-s.10007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 06/08/2020] [Indexed: 12/11/2022]
Abstract
Degenerative tendon pathology represents one of the most frequent and disabling musculoskeletal disorders. Diagnostic radiology plays a fundamental role in the clinical evaluation of tendon pathologies. Moreover, several minimally invasive treatments can be performed under imaging guidance to treat tendon disorders, maximizing the efficacy and reducing procedural complications. In this review article we describe the most relevant diagnostic features of conventional and advanced US and MRI imaging in tendon disorders, along with the main options for image-guided intervention. (www.actabiomedica.it)
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Affiliation(s)
- Federico Bruno
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Pierpaolo Palumbo
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | | | - Silvia Mariani
- Emergency Radiology, San Salvatore Hospital, L'Aquila, Italy.
| | - Giacomo Aringhieri
- Diagnostic and Interventional Radiology, Department of Translational Research and of New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
| | - Marina Carotti
- Dipartimento di Scienze Radiologiche S. O. D. Radiologia Pediatrica e Specialistica, Azienda Ospedaliera Universitaria, Ospedali Riuniti "Umberto I-G.M. Lancisi-Salesi", and Dipartimento di Scienze Cliniche Specialistiche e Odontostomatologiche, University Politecnica delle Marche, Ancona, Italy.
| | - Raffaele Natella
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy.
| | - Marcello Zappia
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.
| | - Paola Cipriani
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Roberto Giacomelli
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Ernesto Di Cesare
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Alessandra Splendiani
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Carlo Masciocchi
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Antonio Barile
- Department of Applied Clinical Science and Biotechnology, University of L'Aquila, L'Aquila, Italy.
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13
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Alaia EF, Subhas N. Shoulder MR Imaging and MR Arthrography Techniques: New Advances. Magn Reson Imaging Clin N Am 2020; 28:153-163. [PMID: 32241655 DOI: 10.1016/j.mric.2019.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
MR imaging is the standard diagnostic modality that provides a comprehensive and accurate assessment for both osseous and soft-tissue pathologic conditions of the shoulder. This article discusses standard MR imaging and arthrography protocols used routinely in clinical practice, as well as more innovative sequences and reconstruction techniques, facilitated by the increasing availability of high-field-strength magnets and multichannel phased array surface coils and incorporation of artificial intelligence. These exciting innovations allow for a more detailed and diagnostic imaging assessment, improvements in image quality, and more rapid image acquisition.
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Affiliation(s)
- Erin F Alaia
- Department of Radiology, Musculoskeletal Division, NYU Langone Health, NYU Langone Orthopedic Hospital, 301 East 17th Street, 6th Floor, New York, NY 10003, USA.
| | - Naveen Subhas
- Department of Radiology, Musculoskeletal Division, Imaging Institute, Cleveland Clinic, 9500 Euclid Avenue, A21, Cleveland, OH 44195, USA
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14
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Ashir A, Ma Y, Jerban S, Jang H, Wei Z, Le N, Du J, Chang EY. Rotator Cuff Tendon Assessment in Symptomatic and Control Groups Using Quantitative MRI. J Magn Reson Imaging 2020; 52:864-872. [PMID: 32129560 DOI: 10.1002/jmri.27115] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 02/14/2020] [Accepted: 02/18/2020] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Relatively weak correlations between patient symptoms and rotator cuff tendon (RCT) tearing have been reported; however, the relationship between symptoms and tendinosis has been less well-studied. PURPOSE/HYPOTHESIS To use quantitative MRI to assess the bilateral RCTs in shoulders of both patients with unilateral symptomatic tendinopathy and control subjects. We hypothesized that quantitative MRI measures would differ between symptomatic patients and controls. STUDY TYPE Prospective imaging study. POPULATION/SUBJECTS In all, 48 shoulders from 24 subjects (mean age, 32.8 years), including 14 patients with unilateral symptomatic tendinopathy and 10 asymptomatic controls. FIELD STRENGTH/SEQUENCE 3T/3D ultrashort echo time Cones sequence with magnetization transfer preparation (UTE-Cones-MT) and Carr-Purcell-Meiboom-Gill. ASSESSMENT Macromolecular fraction (MMF) and T2 relaxation were measured in four regions of the superior RCT, including all-segments, and lateral-third, bursal-sided, and articular-sided segments. The Western Ontario Rotator Cuff (WORC) index and visual analog scale were assessed. STATISTICAL TESTS Three shoulder groups were evaluated, including symptomatic shoulders, contralateral asymptomatic shoulders in patients, and asymptomatic controls. MMF and T2 values were compared between groups using a bootstrap-based comparison of means. RESULTS Significant differences were found in both MMF and T2 values between symptomatic and control RCTs when analyzing all-segments (P = 0.027 and P = 0.006, respectively) and articular-sided segments (both P = 0.001). Significant differences between asymptomatic RCTs in patients and control RCTs were also found, including MMF in all four anatomic regions analyzed (P = 0.024-0.044), as well as T2 in all-segments (P = 0.003), bursal-sided segments (P = 0.021), and articular-sided segments (P = 0.002). No significant differences in MMF (P = 0.420-0.950) or T2 (P = 0.380-0.910) were seen between ipsilateral symptomatic and contralateral asymptomatic RCTs in patients. DATA CONCLUSION Symptomatic RCTs showed significantly lower MMF values and higher T2 values compared with control RCTs. In patients with unilateral symptomatic tendinopathy, the contralateral shoulder can demonstrate asymptomatic tendinopathy, which can be quantified using MMF or T2 . EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 2. J. Magn. Reson. Imaging 2020;52:864-872.
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Affiliation(s)
- Aria Ashir
- Department of Radiology, University of California, San Diego, California, USA.,Research Service, VA San Diego Healthcare System, San Diego, California, USA.,College of Medicine, Drexel University, Philadelphia, Pennsylvania, USA
| | - Yajun Ma
- Department of Radiology, University of California, San Diego, California, USA
| | - Saeed Jerban
- Department of Radiology, University of California, San Diego, California, USA
| | - Hyungseok Jang
- Department of Radiology, University of California, San Diego, California, USA
| | - Zhao Wei
- Department of Radiology, University of California, San Diego, California, USA
| | - Nicole Le
- Research Service, VA San Diego Healthcare System, San Diego, California, USA
| | - Jiang Du
- Department of Radiology, University of California, San Diego, California, USA
| | - Eric Y Chang
- Department of Radiology, University of California, San Diego, California, USA.,Research Service, VA San Diego Healthcare System, San Diego, California, USA
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15
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Anz AW, Edison J, Denney TS, Branch EA, Walz CR, Brock KV, Goodlett MD. 3-T MRI mapping is a valid in vivo method of quantitatively evaluating the anterior cruciate ligament: rater reliability and comparison across age. Skeletal Radiol 2020; 49:443-452. [PMID: 31482257 DOI: 10.1007/s00256-019-03301-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 08/13/2019] [Accepted: 08/15/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE As biologic augmentation methods emerge, objective measures of soft tissues are necessary for developmental study. The purpose of this study was to develop a quantitative MRI mapping protocol for the ACL. The objectives were (1) to provide age-based T2 relaxation, T2* relaxation, and volume values in healthy individuals, (2) to establish the intra-rater and inter-rater reliability of ACL mapping, and (3) to determine whether 3-T or 7-T MRI is more appropriate for future clinical trials. MATERIALS AND METHODS Thirty healthy participants, aged 18-62, asymptomatic for knee pathology and without history of knee injury underwent both a 3-T and 7-T MRI. Manual image mapping of the anterior cruciate ligament was performed by two observers and processed to obtain T2, T2*, and volume values. Analysis of variance and two-way random effects model were used to calculate statistical significance and intraclass correlation coefficients. RESULTS Across all participants, 3-T and 7-T mean T2, T2* and volume values were 37.1 ± 7.9 and 39.7 ± 6.2 ms (p = 0.124), 10.9 ± 1.3 and 10.9 ± 0.9 ms (p = 0.981), and 2380 ± 602 and 2484 ± 736 mm3 (p = 0.551), respectively. The T2, T2*, and volume did not vary between age cohorts (p > 0.05). Excellent inter-rater and intra-rater reliability regarding T2 and T2* values was found. While ACL volume exhibited good inter-rater reliability and excellent intra-rater reliability. CONCLUSIONS T2 relaxation values and ACL volume do not vary with age and therefore can be used as a quantifiable, non-invasive method to assess ACL graft maturation. 7-T MRI analysis was not superior to 3-T MRI analysis, suggesting that 3-T MRI is practical and capable for future comparative studies.
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Affiliation(s)
- Adam W Anz
- Andrews Institute for Orthopaedics & Sports Medicine, 1040 Gulf Breeze Parkway, Gulf Breeze, FL, 32561, USA.
| | - Jos Edison
- Edward Via College of Osteopathic Medicine, 910 South Donahue Drive, Auburn, AL, 36832, USA
| | - Thomas S Denney
- Department of Electrical and Computer Engineering, Auburn University, 200 Broun Hall, Auburn, AL, 36849, USA
| | - Eric A Branch
- Andrews Institute for Orthopaedics & Sports Medicine, 1040 Gulf Breeze Parkway, Gulf Breeze, FL, 32561, USA
| | - Christopher R Walz
- Department of Electrical and Computer Engineering, Auburn University, 200 Broun Hall, Auburn, AL, 36849, USA
| | - Kenny V Brock
- Edward Via College of Osteopathic Medicine, 910 South Donahue Drive, Auburn, AL, 36832, USA
| | - Michael D Goodlett
- Auburn University Athletics, Auburn Athletics Complex, 392 S Donahue Drive, Auburn, AL, 36849, USA
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16
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Guo T, Ma YJ, High RA, Tang Q, Wong JH, Byra M, Searleman AC, To SC, Wan L, Le N, Du J, Chang EY. Assessment of an in vitro model of rotator cuff degeneration using quantitative magnetic resonance and ultrasound imaging with biochemical and histological correlation. Eur J Radiol 2019; 121:108706. [PMID: 31655315 DOI: 10.1016/j.ejrad.2019.108706] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 09/10/2019] [Accepted: 10/09/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE Quantitative imaging methods could improve diagnosis of rotator cuff degeneration, but the capability of quantitative MR and US imaging parameters to detect alterations in collagen is unknown. The goal of this study was to assess quantitative MR and US imaging measures for detecting abnormalities in collagen using an in vitro model of tendinosis with biochemical and histological correlation. METHOD 36 pieces of supraspinatus tendons from 6 cadaveric donors were equally distributed into 3 groups (2 subjected to different concentrations of collagenase and a control group). Ultrashort echo time MR and US imaging measures were performed to assess changes at baseline and after 24 h of enzymatic digestion. Biochemical and histological measures, including brightfield, fluorescence, and polarized microscopy, were used to verify the validity of the model and were compared with quantitative imaging parameters. Correlations between the imaging parameters and biochemically measured digestion were analyzed. RESULTS Among the imaging parameters, macromolecular fraction (MMF), adiabatic T1ρ, T2*, and backscatter coefficient (BSC) were useful in differentiating between the extent of degeneration among the 3 groups. MMF strongly correlated with collagen loss (r=-0.81; 95% confidence interval [CI]: -0.90,-0.66), while the adiabatic T1ρ (r = 0.66; CI: 0.42,0.81), T2* (r = 0.58; CI: 0.31,0.76), and BSC (r = 0.51; CI: 0.22,0.72) moderately correlated with collagen loss. CONCLUSIONS MMF, adiabatic T1ρ, and T2* measured and US BSC can detect alterations in collagen. Of the quantitative MR and US imaging measures evaluated, MMF showed the highest correlation with collagen loss and can be used to assess rotator cuff degeneration.
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Affiliation(s)
- Tan Guo
- Department of Radiology, Beijing Hospital, Beijing, China; Department of Radiology, University of California, San Diego, CA, United States.
| | - Ya-Jun Ma
- Department of Radiology, University of California, San Diego, CA, United States.
| | - Rachel A High
- Department of Radiology, University of California, San Diego, CA, United States; Research Service, VA San Diego Healthcare System, San Diego, CA, United States.
| | - Qingbo Tang
- Department of Radiology, University of California, San Diego, CA, United States; Research Service, VA San Diego Healthcare System, San Diego, CA, United States.
| | - Jonathan H Wong
- Department of Radiology, University of California, San Diego, CA, United States; Research Service, VA San Diego Healthcare System, San Diego, CA, United States.
| | - Michal Byra
- Department of Radiology, University of California, San Diego, CA, United States; Department of Ultrasound, Institute of Fundamental Technological Research, Polish Academy of Sciences, Warsaw, Poland.
| | - Adam C Searleman
- Department of Radiology, University of California, San Diego, CA, United States.
| | - Sarah C To
- Department of Radiology, University of California, San Diego, CA, United States; Research Service, VA San Diego Healthcare System, San Diego, CA, United States.
| | - Lidi Wan
- Department of Radiology, University of California, San Diego, CA, United States.
| | - Nicole Le
- Department of Radiology, University of California, San Diego, CA, United States; Research Service, VA San Diego Healthcare System, San Diego, CA, United States.
| | - Jiang Du
- Department of Radiology, University of California, San Diego, CA, United States; Research Service, VA San Diego Healthcare System, San Diego, CA, United States.
| | - Eric Y Chang
- Department of Radiology, University of California, San Diego, CA, United States; Research Service, VA San Diego Healthcare System, San Diego, CA, United States.
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17
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Lockard CA, Chang A, Clanton TO, Ho CP. T2* mapping and subregion analysis of the tibialis posterior tendon using 3 Tesla magnetic resonance imaging. Br J Radiol 2019; 92:20190221. [PMID: 31596118 DOI: 10.1259/bjr.20190221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE Early detection of tibialis posterior tendon changes and appropriate intervention is necessary to prevent disease progression to flat-foot deformity and foot/ankle dysfunction, and the need for operative treatment. Currently, differentiating between early-stage tibialis posterior tendon deficiency patients who will benefit from conservative vs more aggressive treatment is challenging. The objective of this work was to establish a quantitative MRI T2* mapping method and subregion baseline values in the tibialis posterior tendon in asymptomatic ankles for future clinical application in detecting tendon degeneration. METHODS 26 asymptomatic volunteers underwent T2* mapping. The tendon was divided axially into seven subregions. Summary statistics for T2* within each subregion were calculated and compared using Tukey post-hoc pairwise comparisons. RESULTS Results are reported for 24 subjects. The mean tibialis posterior tendon T2* was 7 ± 1 ms. Subregion values ranged from 6 ± 1 to 9 ± 2 ms with significant between-region differences in T2*. Inter- and intrarater absolute agreement intraclass correlation coefficient (ICC) values were all "excellent" (0.75 < ICC=1.00) except for regions 5 through 7, which had "fair to good" interrater and/or and intrarater ICC values (0.4 < ICC=0.75). CONCLUSION A tibialis posterior tendon T2* mapping protocol, subregion division method, and baseline T2* values for clinically relevant regions were established. Significant differences in T2* were observed along the tendon length. ADVANCES IN KNOWLEDGE This work demonstrates that regional variation exists and should be considered for future T2*-based research on posterior tibias tendon degeneration and when using T2* mapping to evaluate for potential tibialis posterior tendon degeneration.
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Affiliation(s)
- Carly Anne Lockard
- Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 1000 Vail, Colorado 81657, United States
| | - Angela Chang
- Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 1000 Vail, Colorado 81657, United States
| | - Thomas O Clanton
- The Steadman Clinic, 181 West Meadow Drive, Suite 400 Vail, Colorado 81657, United States
| | - Charles P Ho
- Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 1000 Vail, Colorado 81657, United States
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18
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7.1 T MRI and T2 mapping of the human and porcine vitreous body post mortem. Eur J Pharm Biopharm 2018; 131:82-91. [DOI: 10.1016/j.ejpb.2018.07.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 07/24/2018] [Accepted: 07/25/2018] [Indexed: 12/30/2022]
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Kumar NM, Fritz B, Stern SE, Warntjes JBM, Lisa Chuah YM, Fritz J. Synthetic MRI of the Knee: Phantom Validation and Comparison with Conventional MRI. Radiology 2018; 289:465-477. [PMID: 30152739 DOI: 10.1148/radiol.2018173007] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Purpose To test the hypothesis that synthetic MRI of the knee generates accurate and repeatable quantitative maps and produces morphologic MR images with similar quality and detection rates of structural abnormalities than does conventional MRI. Materials and Methods Data were collected prospectively between January 2017 and April 2018 and were retrospectively analyzed. An International Society for Magnetic Resonance in Medicine-National Institute of Standards and Technology phantom was used to determine the accuracy of T1, T2, and proton density (PD) quantification. Statistical models were applied for correction. Fifty-four participants (24 men, 30 women; mean age, 40 years; range, 18-62 years) underwent synthetic and conventional 3-T MRI twice on the same day. Fifteen of 54 participants (28%) repeated the protocol within 9 days. The intra- and interday agreements of quantitative cartilage measurements were assessed. Contrast-to-noise (CNR) ratios, image quality, and structural abnormalities were assessed on corresponding synthetic and conventional images. Statistical analyses included the Wilcoxon test, χ2 test, and Cohen Kappa. P values less than or equal to .01 were considered to indicate a statistically significant difference. Results Synthetic MRI quantification of T1, T2, and PD values had an overall model-corrected error margin of 0.8%. The synthetic MRI interday repeatability of articular cartilage quantification had native and model-corrected error margins of 3.3% and 3.5%, respectively. The cartilage-to-fluid CNR and menisci-to-fluid CNR was higher on synthetic than conventional MR images (P ≤ .001, respectively). Synthetic MRI improved short-tau inversion recovery fat suppression (P ˂ .01). Intermethod agreements of structural abnormalities were good (kappa, 0.621-0.739). Conclusion Synthetic MRI of the knee is accurate for T1, T2, and proton density quantification, and simultaneously generated morphologic MR images have detection rates of structural abnormalities similar to those of conventional MR images, with similar acquisition time. © RSNA, 2018.
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Affiliation(s)
- Neil M Kumar
- From the Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, Baltimore, MD 21287 (N.M.K., J.F.); Department of Radiology, Balgrist University Hospital, Zurich, Switzerland (B.F.); Faculty of Medicine, University of Zurich, Zurich, Switzerland (B.F.); Bond Business School, Bond University, Gold Coast, Australia (S.E.S.); Center for Medical Imaging Science and Visualization, Linköping University, Linköping, Sweden (J.B.M.W.); Division of Clinical Physiology, Department of Medicine and Health, University Hospital, Linköping, Sweden (J.B.M.W.); SyntheticMR AB, Linköping, Sweden (J.B.M.W.); and Siemens Healthcare GmbH, Erlangen, Germany (Y.M.L.C.)
| | - Benjamin Fritz
- From the Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, Baltimore, MD 21287 (N.M.K., J.F.); Department of Radiology, Balgrist University Hospital, Zurich, Switzerland (B.F.); Faculty of Medicine, University of Zurich, Zurich, Switzerland (B.F.); Bond Business School, Bond University, Gold Coast, Australia (S.E.S.); Center for Medical Imaging Science and Visualization, Linköping University, Linköping, Sweden (J.B.M.W.); Division of Clinical Physiology, Department of Medicine and Health, University Hospital, Linköping, Sweden (J.B.M.W.); SyntheticMR AB, Linköping, Sweden (J.B.M.W.); and Siemens Healthcare GmbH, Erlangen, Germany (Y.M.L.C.)
| | - Steven E Stern
- From the Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, Baltimore, MD 21287 (N.M.K., J.F.); Department of Radiology, Balgrist University Hospital, Zurich, Switzerland (B.F.); Faculty of Medicine, University of Zurich, Zurich, Switzerland (B.F.); Bond Business School, Bond University, Gold Coast, Australia (S.E.S.); Center for Medical Imaging Science and Visualization, Linköping University, Linköping, Sweden (J.B.M.W.); Division of Clinical Physiology, Department of Medicine and Health, University Hospital, Linköping, Sweden (J.B.M.W.); SyntheticMR AB, Linköping, Sweden (J.B.M.W.); and Siemens Healthcare GmbH, Erlangen, Germany (Y.M.L.C.)
| | - J B Marcel Warntjes
- From the Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, Baltimore, MD 21287 (N.M.K., J.F.); Department of Radiology, Balgrist University Hospital, Zurich, Switzerland (B.F.); Faculty of Medicine, University of Zurich, Zurich, Switzerland (B.F.); Bond Business School, Bond University, Gold Coast, Australia (S.E.S.); Center for Medical Imaging Science and Visualization, Linköping University, Linköping, Sweden (J.B.M.W.); Division of Clinical Physiology, Department of Medicine and Health, University Hospital, Linköping, Sweden (J.B.M.W.); SyntheticMR AB, Linköping, Sweden (J.B.M.W.); and Siemens Healthcare GmbH, Erlangen, Germany (Y.M.L.C.)
| | - Yen Mei Lisa Chuah
- From the Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, Baltimore, MD 21287 (N.M.K., J.F.); Department of Radiology, Balgrist University Hospital, Zurich, Switzerland (B.F.); Faculty of Medicine, University of Zurich, Zurich, Switzerland (B.F.); Bond Business School, Bond University, Gold Coast, Australia (S.E.S.); Center for Medical Imaging Science and Visualization, Linköping University, Linköping, Sweden (J.B.M.W.); Division of Clinical Physiology, Department of Medicine and Health, University Hospital, Linköping, Sweden (J.B.M.W.); SyntheticMR AB, Linköping, Sweden (J.B.M.W.); and Siemens Healthcare GmbH, Erlangen, Germany (Y.M.L.C.)
| | - Jan Fritz
- From the Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N Caroline St, Baltimore, MD 21287 (N.M.K., J.F.); Department of Radiology, Balgrist University Hospital, Zurich, Switzerland (B.F.); Faculty of Medicine, University of Zurich, Zurich, Switzerland (B.F.); Bond Business School, Bond University, Gold Coast, Australia (S.E.S.); Center for Medical Imaging Science and Visualization, Linköping University, Linköping, Sweden (J.B.M.W.); Division of Clinical Physiology, Department of Medicine and Health, University Hospital, Linköping, Sweden (J.B.M.W.); SyntheticMR AB, Linköping, Sweden (J.B.M.W.); and Siemens Healthcare GmbH, Erlangen, Germany (Y.M.L.C.)
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Lockard CA, Wilson KJ, Ho CP, Shin RC, Katthagen JC, Millett PJ. Quantitative mapping of glenohumeral cartilage in asymptomatic subjects using 3 T magnetic resonance imaging. Skeletal Radiol 2018; 47:671-682. [PMID: 29196823 DOI: 10.1007/s00256-017-2829-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 10/17/2017] [Accepted: 11/14/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of this study was to develop quantitative T2 mapping methodology in asymptomatic shoulders for the entire mappable region of the glenohumeral cartilage in the coronal and sagittal planes, to assess the feasibility and limitations of the development of a diagnostic tool for future application in symptomatic patients. MATERIALS AND METHODS Twenty-one asymptomatic volunteers underwent sagittal and coronal glenohumeral T2 mapping, as the spherical geometry of the humeral head obviates the need to evaluate the entire glenohumeral cartilage in a single plane. The humeral head cartilage orthogonal to the mapping plane was manually segmented in the sagittal and coronal planes, whereas the glenoid cartilage was segmented in the coronal plane. Cartilage T2 summary statistics were calculated and coverage in each mapping plane was qualitatively assessed. RESULTS The mean ± standard deviation of the glenoid cartilage T2 was 38 ± 2 ms. The coronal and sagittal mapping planes captured different regions of the humeral head with some overlap: inferior-medial to superior-lateral versus superior/superior-lateral to anterior-lateral and posterior-lateral respectively. The mean humeral head cartilage T2 in the coronal plane was 41 ± 3 ms, which was significantly different (p < 0.05) from the sagittal plane mean of 34 ± 2 ms. CONCLUSION This study measured characteristic glenoid and humeral head cartilage T2 values over the area mappable with two planes. Importantly, this study demonstrated that two-dimensional mapping in a single plane or two combined planes cannot capture the entirety of the semi-spherical humeral head cartilage. This highlights the need for three-dimensional T2 mapping techniques in the shoulder.
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Affiliation(s)
- Carly A Lockard
- Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 1000, Vail, CO, 81657, USA
| | - Katharine J Wilson
- Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 1000, Vail, CO, 81657, USA
| | - Charles P Ho
- Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 1000, Vail, CO, 81657, USA.
| | - Richard C Shin
- Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 1000, Vail, CO, 81657, USA
| | - J Christoph Katthagen
- Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 1000, Vail, CO, 81657, USA
| | - Peter J Millett
- Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 1000, Vail, CO, 81657, USA.,The Steadman Clinic, 181 West Meadow Drive, Suite 400, Vail, CO, 81657, USA
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Zhu Y, Cheng X, Ma Y, Wong JH, Xie Y, Du J, Chang EY. Rotator cuff tendon assessment using magic-angle insensitive 3D ultrashort echo time cones magnetization transfer (UTE-Cones-MT) imaging and modeling with histological correlation. J Magn Reson Imaging 2017; 48:160-168. [PMID: 29219218 DOI: 10.1002/jmri.25914] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 11/16/2017] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Rotator cuff tendons (RCTs) are challenging to image due to the "magic angle effect" and their short T2 . PURPOSE To assess the degree of magic angle sensitivity of human RCTs and to utilize a 3D ultrashort echo time Cones sequence with magnetization transfer preparation (UTE-Cones-MT) and two-pool quantitative MT modeling with histological correlation. We hypothesized that MT parameters would be less sensitive to the magic angle compared with conventional T2 measurements. STUDY TYPE Prospective imaging pathologic correlation. SPECIMEN Twenty cadaveric rotator cuff tendons were imaged at five sample orientations ranging from 0-90° relative to the B0 field. FIELD STRENGTH/SEQUENCE 3T/3D UTE-Cones-MT and Carr-Purcell-Meiboom-Gill (CPMG). ASSESSMENT Two-pool quantitative MT modeling parameters and T2 values were calculated in regions of interest drawn by a medical physicist. Histopathological analysis was performed and mild and severe tendinopathy groups were assigned by a histopathologist and histotechnician. STATISTICAL TESTS Coefficients of variations (CVs) were calculated for measures between the different orientations and group means were compared for each measure. RESULTS CVs of T2 and macromolecular fractions between orientations were 26.14 ± 16.82% and 6.18 ± 2.77% (mean ± SD), respectively. T2 measurements at 0°, 27°, 70°, and 90° showed significant differences between the two histological groups (P = 0.004, 0.008, 0.003, and 0.015, respectively), but not at 55° (P = 0.611). Mean T2 value ranges between orientations for the mild and severe tendinopathy groups were 15.27-30.32 msec and 20.81-35.85 msec, respectively, showing overlap despite statistically significant differences (P = 0.003). Macromolecular fractions at all angles showed significant differences between the two groups (P < 0.0001). Mean fraction ranges between orientations for the mild and severe tendinopathy groups were 14.32-17.17% and 10.00-13.75% respectively (P < 0.0001) with no overlap. DATA CONCLUSION Compared with T2 , macromolecular fraction obtained with the 3D UTE-Cones-MT technique is resistant to the magic angle effect and is more sensitive to RCT degeneration. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2017.
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Affiliation(s)
- Yanchun Zhu
- Department of Radiology, University of California, San Diego Medical Center, San Diego, California, USA.,Shenzhen Institute of Advanced Technology, Chinese Academic of Science, Shenzhen, China
| | - Xin Cheng
- Department of Radiology, University of California, San Diego Medical Center, San Diego, California, USA.,Department of Histology and Embryology, Jinan University School of Medicine, Guangzhou, China
| | - Yajun Ma
- Department of Radiology, University of California, San Diego Medical Center, San Diego, California, USA.,Radiology Service, VA San Diego Healthcare System, San Diego, California, USA
| | - Jonathan H Wong
- Department of Radiology, University of California, San Diego Medical Center, San Diego, California, USA.,Radiology Service, VA San Diego Healthcare System, San Diego, California, USA
| | - Yaoqin Xie
- Shenzhen Institute of Advanced Technology, Chinese Academic of Science, Shenzhen, China
| | - Jiang Du
- Department of Radiology, University of California, San Diego Medical Center, San Diego, California, USA
| | - Eric Y Chang
- Radiology Service, VA San Diego Healthcare System, San Diego, California, USA
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Wilson KJ, Surowiec RK, Johnson NS, Lockard CA, Clanton TO, Ho CP. T2* Mapping of Peroneal Tendons Using Clinically Relevant Subregions in an Asymptomatic Population. Foot Ankle Int 2017; 38:677-683. [PMID: 28552042 DOI: 10.1177/1071100717693208] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Peroneal tendon evaluation is particularly demanding using current magnetic resonance imaging (MRI) techniques because of their curving path around the lateral malleolus. Quantifiable, objective data on the health of the peroneal tendons could be useful for improving diagnosis of tendon pathology and tracking post-treatment responses. The purpose of this study was to establish a method and normative T2-star (T2*) values for the peroneal tendons in a screened asymptomatic cohort using clinically reproducible subregions, providing a baseline for comparison with peroneal tendon pathology. METHODS Unilateral ankle scans were acquired for 26 asymptomatic volunteers with a 3-Tesla MRI system using a T2* mapping sequence in the axial and sagittal planes. The peroneus brevis and peroneus longus tendons were manually segmented and subregions were isolated in the proximity of the lateral malleolus. Summary statistics for T2* values were calculated. RESULTS The peroneus brevis tendon exhibited a mean T2* value of 12 ms and the peroneus longus tendon was 11 ms. Subregions distal to the lateral malleolus had significantly higher T2* values ( P < .05) than the subregions proximal in both tendons, in both the axial and sagittal planes. CONCLUSION Peroneal tendon regions distal to the inferior tip of the lateral malleolus had significantly higher T2* values than those regions proximal, which could be related to anatomical differences along the tendon. CLINICAL RELEVANCE This study provides a quantitative method and normative baseline T2* mapping values for comparison with symptomatic clinically compromised peroneal tendon patients.
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Affiliation(s)
| | | | | | | | | | - Charles P Ho
- 1 Steadman Philippon Research Institute, Vail, CO, USA
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Krepkin K, Bruno M, Raya JG, Adler RS, Gyftopoulos S. Quantitative assessment of the supraspinatus tendon on MRI using T2/T2* mapping and shear-wave ultrasound elastography: a pilot study. Skeletal Radiol 2017; 46:191-199. [PMID: 27896400 DOI: 10.1007/s00256-016-2534-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 10/05/2016] [Accepted: 11/10/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine whether there is an association between T2/T2* mapping and supraspinatus tendon mechanical properties as assessed by shear-wave ultrasound elastography (SWE). MATERIALS AND METHODS This HIPAA-compliant prospective pilot study received approval from our hospital's institutional review board. Eight patients (3 males/5 females; age range 44-72 years) and nine shoulders underwent conventional shoulder MRI, T2/T2* mapping on a 3-T scanner, and SWE. Two musculoskeletal radiologists reviewed the MRI examinations in consensus for evidence of supraspinatus tendon pathology, with tear size measured for full-thickness tears. T2/T2* values and ultrasound shear-wave velocities (SWV) were calculated in three corresponding equidistant regions of interest (ROIs) within the insertional 1-2 cm of the supraspinatus tendon (medial, middle, lateral). Pearson correlation coefficients between T2/T2* values and SWV, as well as among T2, T2*, SWV and tear size, were calculated. RESULTS There was a significant negative correlation between T2* and SWV in the lateral ROI (r = -0.86, p = 0.013) and overall mean ROI (r = -0.90, p = 0.006). There was significant positive correlation between T2 and measures of tear size in the lateral and mean ROIs (r range 0.71-0.77, p range 0.016-0.034). There was significant negative correlation between SWV and tear size in the middle and mean ROIs (r range -0.79--0.68, p range 0.011-0.046). CONCLUSION Our pilot study demonstrated a potential relationship between T2* values and shear wave velocity values in the supraspinatus tendon, a finding that could lead to an improved, more quantitative evaluation of the rotator cuff tendons.
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Affiliation(s)
- Konstantin Krepkin
- Department of Radiology, NYU Langone Medical Center/Hospital for Joint Diseases, 301 E 17th Street, New York, NY, 10003, USA
| | - Mary Bruno
- Department of Radiology, NYU Langone Medical Center, Center for Biomedical Imaging, 660 First Avenue, New York, NY, 10016, USA
| | - José G Raya
- Department of Radiology, NYU Langone Medical Center, Center for Biomedical Imaging, 660 First Avenue, New York, NY, 10016, USA
| | - Ronald S Adler
- Department of Radiology, NYU Langone Medical Center/Hospital for Joint Diseases, 301 E 17th Street, New York, NY, 10003, USA
| | - Soterios Gyftopoulos
- Department of Radiology, NYU Langone Medical Center/Hospital for Joint Diseases, 301 E 17th Street, New York, NY, 10003, USA.
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Fouré A. New Imaging Methods for Non-invasive Assessment of Mechanical, Structural, and Biochemical Properties of Human Achilles Tendon: A Mini Review. Front Physiol 2016; 7:324. [PMID: 27512376 PMCID: PMC4961896 DOI: 10.3389/fphys.2016.00324] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 07/14/2016] [Indexed: 12/30/2022] Open
Abstract
The mechanical properties of tendon play a fundamental role to passively transmit forces from muscle to bone, withstand sudden stretches, and act as a mechanical buffer allowing the muscle to work more efficiently. The use of non-invasive imaging methods for the assessment of human tendon's mechanical, structural, and biochemical properties in vivo is relatively young in sports medicine, clinical practice, and basic science. Non-invasive assessment of the tendon properties may enhance the diagnosis of tendon injury and the characterization of recovery treatments. While ultrasonographic imaging is the most popular tool to assess the tendon's structural and indirectly, mechanical properties, ultrasonographic elastography, and ultra-high field magnetic resonance imaging (UHF MRI) have recently emerged as potentially powerful techniques to explore tendon tissues. This paper highlights some methodological cautions associated with conventional ultrasonography and perspectives for in vivo human Achilles tendon assessment using ultrasonographic elastography and UHF MRI.
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Affiliation(s)
- Alexandre Fouré
- Aix-Marseille Université, Centre National de la Recherche Scientifique, Centre de Résonance Magnétique Biologique et Médicale CRMBM UMR 7339 Marseille, France
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25
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Ganal E, Ho CP, Wilson KJ, Surowiec RK, Smith WS, Dornan GJ, Millett PJ. Quantitative MRI characterization of arthroscopically verified supraspinatus pathology: comparison of tendon tears, tendinosis and asymptomatic supraspinatus tendons with T2 mapping. Knee Surg Sports Traumatol Arthrosc 2016; 24:2216-24. [PMID: 25739912 DOI: 10.1007/s00167-015-3547-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 02/18/2015] [Indexed: 12/01/2022]
Abstract
PURPOSE Quantitative MRI T2 mapping is a non-invasive imaging technique sensitive to biochemical changes, but no studies have evaluated T2 mapping in pathologic rotator cuff tendons. It was sought to evaluate the efficacy of T2 mapping in detecting differences in the supraspinatus tendon (SST) among patients with tendinosis, partial tears and minimally retracted full-thickness tears, relative to asymptomatic volunteers. METHODS The pathologic cohort consisted of two arthroscopically verified groups: tendinosis and a tear group of partial tears or minimally retracted full-thickness tears, and was compared to an asymptomatic cohort with no prior history of shoulder pathology. The SST was manually segmented from the footprint to the medial humeral head in the coronal and sagittal planes and divided into six clinically relevant subregions. Mean T2 values and inter- and intra-rater reliability were assessed. RESULTS In the anterolateral subregion, the tear group exhibited significantly higher mean T2 values (43.9 ± 12.7 ms) than the tendinosis (34.9 ± 3.9 ms; p = 0.006) and asymptomatic (33.6 ± 5.3 ms; p = 0.015) groups. In the posterolateral subregion, the tear group had higher mean T2 values (45.2 ± 13.7) than the asymptomatic group (34.7 ± 6.7; p = 0.012). Inter- and intra-rater reliability was mostly excellent (ICC > 0.75). CONCLUSION T2 mapping is an accurate non-invasive method to identify quantitatively early rotator cuff pathology. The lateral region in the coronal plane in particular may differentiate partial and small minimally retracted full-thickness tears from tendinosis and asymptomatic tendons. Understanding and being able to measure quantitatively the process of tendon degeneration and subsequent tearing may help clinicians to better predict at-risk groups and to stratify treatment options. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Edmund Ganal
- The Steadman Clinic, 181 W Meadow Dr, Suite 400, Vail, CO, 81657, USA
| | - Charles P Ho
- Steadman Philippon Research Institute, 181 W Meadow Dr, Vail, CO, 81657, USA
| | - Katharine J Wilson
- Steadman Philippon Research Institute, 181 W Meadow Dr, Vail, CO, 81657, USA
| | - Rachel K Surowiec
- Steadman Philippon Research Institute, 181 W Meadow Dr, Vail, CO, 81657, USA
| | - W Sean Smith
- Steadman Philippon Research Institute, 181 W Meadow Dr, Vail, CO, 81657, USA
| | - Grant J Dornan
- Steadman Philippon Research Institute, 181 W Meadow Dr, Vail, CO, 81657, USA
| | - Peter J Millett
- The Steadman Clinic, 181 W Meadow Dr, Suite 400, Vail, CO, 81657, USA.
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Fukawa T, Yamaguchi S, Watanabe A, Sasho T, Akagi R, Muramatsu Y, Akatsu Y, Katsuragi J, Endo J, Osone F, Sato Y, Okubo T, Takahashi K. Quantitative Assessment of Tendon Healing by Using MR T2 Mapping in a Rabbit Achilles Tendon Transection Model Treated with Platelet-rich Plasma. Radiology 2015; 276:748-55. [DOI: 10.1148/radiol.2015141544] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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