1
|
Chen X, You M, Liao K, Zhang M, Wang L, Zhou K, Chen G, Li J. Quantitative Magnetic Resonance Imaging Had Greater Sensitivity in Diagnosing Chondral Lesions of the Knee: A Systematic Review and Meta-Analysis. Arthroscopy 2024:S0749-8063(24)00091-4. [PMID: 38336108 DOI: 10.1016/j.arthro.2024.01.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 01/21/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024]
Abstract
PURPOSE To investigate the accuracy and reliability of magnetic resonance imaging (MRI) in identifying and grading chondral lesions and explore the optimal imaging technique to image cartilage. METHOD A comprehensive search was conducted on Medline, Embase, and Cochrane Library. Eligible cohort studies published before August 2022 were included. The study reports used MRI to diagnose and grade cartilage lesions, with intraoperative findings as the reference standard. Summary estimates of diagnostic performance were obtained. The reliability of MRI interpretation was summarized. Subgroup analyses were performed based on assessed imaging techniques, field strength, and joint surface. RESULTS Forty-three trials and 3,706 patients were included in the systematic review. The overall area under curve for hierarchical summarized receiver operating characteristics was 0.91 (95% confidence interval [CI] 0.88-0.93). The pooled sensitivity for quantitative MRI, 3-dimensional MRI, and 2-dimensional MRI was 0.82 (95% CI 0.64-0.92), 0.79 (95% CI 0.74-0.83), and 0.63 (95% CI 0.51-0.73), respectively. The pooled sensitivity of 3 Tesla (3T), 1.5 Tesla (1.5T), and <1.5 Tesla MRI was 0.79 (95% CI 0.72-0.85), 0.67 (95% CI 0.60-0.74), and 0.55 (95% CI 0.39-0.71), respectively. There were differences in interobserver consistency across different studies. CONCLUSIONS In general, MRI had high specificity in discriminating normal cartilage, but its sensitivity for identifying chondral lesions is less optimal. Further analysis showed that quantitative MRI, 3D MRI, and 3T MRI demonstrate greater sensitivity compared with 2D MRI, 1.5T MRI, and <1.5 Tesla MRI. LEVEL OF EVIDENCE Level III, systematic review of Level II-III studies.
Collapse
Affiliation(s)
- Xi Chen
- Sports Medicine Center, West China Hospital, West Chian School of Medicine, Sichuan University, Chengdu, Sichuan, China; Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Mingke You
- Sports Medicine Center, West China Hospital, West Chian School of Medicine, Sichuan University, Chengdu, Sichuan, China; Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Kai Liao
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | | | - Lingcheng Wang
- Sports Medicine Center, West China Hospital, West Chian School of Medicine, Sichuan University, Chengdu, Sichuan, China; Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Kai Zhou
- Sports Medicine Center, West China Hospital, West Chian School of Medicine, Sichuan University, Chengdu, Sichuan, China; Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Gang Chen
- Sports Medicine Center, West China Hospital, West Chian School of Medicine, Sichuan University, Chengdu, Sichuan, China; Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jian Li
- Sports Medicine Center, West China Hospital, West Chian School of Medicine, Sichuan University, Chengdu, Sichuan, China; Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| |
Collapse
|
2
|
Magnetic resonance imaging is able to detect patellofemoral focal cartilage injuries: a systematic review with meta-analysis. Knee Surg Sports Traumatol Arthrosc 2022; 31:2469-2481. [PMID: 36266368 DOI: 10.1007/s00167-022-07203-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 10/10/2022] [Indexed: 02/14/2023]
Abstract
PURPOSE The purpose of this study was to analyze the diagnostic accuracy of magnetic resonance imaging (MRI) to detect and grade the severity of patellofemoral (PF) cartilage injuries. METHODS A systematic review was conducted on PubMed, EMBASE and Cochrane Library databases (up to July 1st 2022) to search for studies that reported the diagnostic accuracy of MRI to detect and grade PF cartilage injuries as compared to diagnostic arthroscopy. Risk of bias was judged using the QUADAS-2 tool. Quantitative syntheses were performed to calculate the diagnostic accuracy metric-sensitivity, specificity, positive likelihood (LR+) and negative likelihood (LR-) ratios, diagnostic odds ratio (DOR)-and presented as median with 25% and 75% percentiles. The summary receiver operating characteristic (SROC) curves were also calculated. Diagnostic accuracy metrics were calculated for all PF cartilage injuries and then sub-grouped by patellar and trochlear lesions. Diagnostic accuracy was also calculated according to the grading of cartilage injuries. RESULTS Forty-five studies were included for qualitative analyses and forty studies were included for quantitative synthesis. A total of 3534 participants with a weighted mean age of 38.1 years were included. Diagnostic accuracy was generally high: sensitivity (0.8, 0.6-1.0), specificity (0.9, 0.8-1.0), LR+ (6.4, 3.1-15.3), LR- (0.3, 0.2-0.4) and DOR (21.3, 9.9-121.1). The area under the curve (AUC) of the SROC was 0.9. The diagnostic accuracy was slightly higher for patellar (sensitivity 0.8, specificity 0.8, LR+ 5.3, LR- 0.2, DOR 28.8) than for trochlear lesions (sensitivity 0.7, specificity 0.9, LR+ 5.5, LR- 0.4, DOR 14.3). The sensitivity was generally higher when grading advanced (vs. early or intermediate) cartilage injuries of the patella. CONCLUSION The MRI is able to diagnose PF cartilage injuries with reasonably high diagnostic accuracy (as compared to arthroscopy). Clinicians can rely on MRI to reliably diagnose PF cartilage injuries (with some limitations) which will play an important role in deciding for surgical or non-operative treatment. LEVEL OF EVIDENCE Level III.
Collapse
|
3
|
Ikumi A, Kohyama S, Okuwaki S, Tatsumura M, Hara Y, Mammoto T, Ogawa T, Yoshii Y, Kawamura H, Yamazaki M. Effects of Magnetic Resonance Imaging With Axial Traction of the Thumb Carpometacarpal Joint on Articular Cartilage Visibility: A Feasibility Study. Cureus 2022; 14:e22421. [PMID: 35371756 PMCID: PMC8941330 DOI: 10.7759/cureus.22421] [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] [Accepted: 02/20/2022] [Indexed: 11/07/2022] Open
Abstract
Objectives The objective of this study was to verify the usefulness of magnetic resonance imaging (MRI) with axial traction of the thumb for observing articular cartilage. Materials and methods Eleven healthy adult volunteers (39.7 ± 7.4 years) without thumb carpometacarpal joint arthritis or trauma were included in this study. A 3-tesla (3T) MRI (Magnetom Skyra, Siemens Healthineers AG, Munich, Germany) of the right thumb with axial traction applied by a finger trap with three traction weights (0, 2, and 5 kg) was performed. A 3D T2* multiecho data imaging combination (MEDIC) was selected to visualize the articular cartilage. After multiplanar reconstruction, sagittal and coronal images of the thumb carpometacarpal joint were used to evaluate the articular cartilage visibility and joint space widths at five locations. Articular cartilage visibility was evaluated using our original classification method that used the percentage of the cartilage detectable area. The Friedman test was used to compare the differences between each traction weight and location. Results Articular cartilage visibility significantly improved with axial traction. The average joint space widths with the 5-kg application were 1.9 ± 0.8, 3.9 ± 0.6, 2.0 ± 0.9, 3.9 ± 1.1, and 2.5 ± 1.4 mm at the center, volar edge, dorsal edge, radial edge, and ulnar edge, respectively. The joint space widths significantly increased proportionally with the traction weight at all locations. The joint space widths at the volar and radial edges were significantly greater than those at other locations. Conclusion Applying axial traction to the thumb increased the joint space widths and improved the visibility of the articular cartilage in the carpometacarpal joint on MRI.
Collapse
|
4
|
He X, Ertürk MA, Grant A, Wu X, Lagore RL, DelaBarre L, Eryaman Y, Adriany G, Auerbach EJ, Van de Moortele PF, Uğurbil K, Metzger GJ. First in-vivo human imaging at 10.5T: Imaging the body at 447 MHz. Magn Reson Med 2019; 84:289-303. [PMID: 31846121 DOI: 10.1002/mrm.28131] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/25/2019] [Accepted: 11/26/2019] [Indexed: 01/31/2023]
Abstract
PURPOSE To investigate the feasibility of imaging the human torso and to evaluate the performance of several radiofrequency (RF) management strategies at 10.5T. METHODS Healthy volunteers were imaged on a 10.5T whole-body scanner in multiple target anatomies, including the prostate, hip, kidney, liver, and heart. Phase-only shimming and spoke pulses were used to demonstrate their performance in managing the B 1 + inhomogeneity present at 447 MHz. Imaging protocols included both qualitative and quantitative acquisitions to show the feasibility of imaging with different contrasts. RESULTS High-quality images were acquired and demonstrated excellent overall contrast and signal-to-noise ratio. The experimental results matched well with predictions and suggested good translational capabilities of the RF management strategies previously developed at 7T. Phase-only shimming provided increased efficiency, but showed pronounced limitations in homogeneity, demonstrating the need for the increased degrees of freedom made possible through single- and multispoke RF pulse design. CONCLUSION The first in-vivo human imaging was successfully performed at 10.5T using previously developed RF management strategies. Further improvement in RF coils, transmit chain, and full integration of parallel transmit functionality are needed to fully realize the benefits of 10.5T.
Collapse
Affiliation(s)
- Xiaoxuan He
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota
| | - M Arcan Ertürk
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota
| | - Andrea Grant
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota
| | - Xiaoping Wu
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota
| | - Russell L Lagore
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota
| | - Lance DelaBarre
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota
| | - Yiğitcan Eryaman
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota
| | - Gregor Adriany
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota
| | - Eddie J Auerbach
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota
| | | | - Kâmil Uğurbil
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota
| | - Gregory J Metzger
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota
| |
Collapse
|
5
|
Wuennemann F, Kintzelé L, Zeifang F, Maier MW, Burkholder I, Weber MA, Kauczor HU, Rehnitz C. Diagnostic performance of 3D-multi-Echo-data-image-combination (MEDIC) for evaluating SLAP lesions of the shoulder. BMC Musculoskelet Disord 2019; 20:598. [PMID: 31830984 PMCID: PMC6909556 DOI: 10.1186/s12891-019-2986-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 12/03/2019] [Indexed: 01/02/2023] Open
Abstract
Background Superior labral anterior to posterior (SLAP) lesions remain a clinical and diagnostic challenge in routine (non-arthrographic) MR examinations of the shoulder. This study prospectively evaluated the ability of 3D-Multi-Echo-Data-Image-Combination (MEDIC) compared to that of routine high resolution 2D-proton-density weighted fat-saturated (PD fs) sequence using 3 T-MRI to detect SLAP lesions using arthroscopy as gold standard. Methods Seventeen consecutive patients (mean age, 51.6 ± 14.8 years, 11 males) with shoulder pain underwent 3 T MRI including 3D-MEDIC and 2D-PD fs followed by arthroscopy. The presence or absence of SLAP lesions was evaluated using both sequences by two independent raters with 4 and 14 years of experience in musculoskeletal MRI, respectively. During arthroscopy, SLAP lesions were classified according to Snyder’s criteria by two certified orthopedic shoulder surgeons. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 3D-MEDIC and 2D-PD fs for detection of SLAP lesions were calculated with reference to arthroscopy as a gold standard. Interreader agreement and sequence correlation were analyzed using Cohen’s kappa coefficient. Figure 1 demonstrates the excellent visibility of a proven SLAP lesion using the 3D-MEDIC and Fig. 2 demonstrates a false-positive case. Results Arthroscopy revealed SLAP lesions in 11/17 patients. Using 3D-MEDIC, SLAP lesions were diagnosed in 14/17 patients by reader 1 and in 13/17 patients by reader 2. Using 2D-PD fs, SLAP lesions were diagnosed in 11/17 patients by reader 1 and 12/17 patients for reader 2. Sensitivity, specificity, PPV, and NPV of 3D-MEDIC were 100.0, 50.0, 78.6, and 100.0% for reader 1; and 100.0, 66.7, 84.6, and 100% for reader 2, respectively. Sensitivity, specificity, PPV, and NPV of 2D-PD fs were 90.9, 83.3, 90.9, and 83.3% for reader 1 and 100.0, 83.3, 91.7, and 100.0% for reader 2. The combination of 2D-PD fs and 3D-MEDIC increased specificity from 50.0 to 83.3% for reader 1 and from 66.7 to 100.0% for reader 2. Interreader agreement was almost perfect with a Cohen’s kappa of 0.82 for 3D-MEDIC and 0.87 for PD fs. Conclusions With its high sensitivity and NPV, 3D-MEDIC is a valuable tool for the evaluation of SLAP lesions. As the combination with routine 2D-PD fs further increases specificity, we recommend incorporation of 3D-MEDIC as an additional sequence in conventional shoulder protocols in patients with non-specific shoulder pain.
Collapse
Affiliation(s)
- Felix Wuennemann
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
| | - Laurent Kintzelé
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| | - Felix Zeifang
- Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, University Hospital Heidelberg, Schlierbacher Landstraße 200A, 69118, Heidelberg, Germany
| | - Michael W Maier
- Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, University Hospital Heidelberg, Schlierbacher Landstraße 200A, 69118, Heidelberg, Germany.,Swabian Joint Center Stuttgart, ATOS Clinic Stuttgart, Hohenheimer Straße 91, 70184, Stuttgart, Germany
| | - Iris Burkholder
- Department of Nursing and Health, University of Applied Sciences of the Saarland, Malstatter Straße 17, 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 110, 69120, Heidelberg, Germany
| | - Christoph Rehnitz
- Diagnostic and Interventional Radiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
| |
Collapse
|
6
|
Huber E, David G, Thompson AJ, Weiskopf N, Mohammadi S, Freund P. Dorsal and ventral horn atrophy is associated with clinical outcome after spinal cord injury. Neurology 2018; 90:e1510-e1522. [PMID: 29592888 PMCID: PMC5921039 DOI: 10.1212/wnl.0000000000005361] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 01/24/2018] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE To investigate whether gray matter pathology above the level of injury, alongside white matter changes, also contributes to sensorimotor impairments after spinal cord injury. METHODS A 3T MRI protocol was acquired in 17 tetraplegic patients and 21 controls. A sagittal T2-weighted sequence was used to characterize lesion severity. At the C2-3 level, a high-resolution T2*-weighted sequence was used to assess cross-sectional areas of gray and white matter, including their subcompartments; a diffusion-weighted sequence was used to compute voxel-based diffusion indices. Regression models determined associations between lesion severity and tissue-specific neurodegeneration and associations between the latter with neurophysiologic and clinical outcome. RESULTS Neurodegeneration was evident within the dorsal and ventral horns and white matter above the level of injury. Tract-specific neurodegeneration was associated with prolonged conduction of appropriate electrophysiologic recordings. Dorsal horn atrophy was associated with sensory outcome, while ventral horn atrophy was associated with motor outcome. White matter integrity of dorsal columns and corticospinal tracts was associated with daily-life independence. CONCLUSION Our results suggest that, next to anterograde and retrograde degeneration of white matter tracts, neuronal circuits within the spinal cord far above the level of injury undergo transsynaptic neurodegeneration, resulting in specific gray matter changes. Such improved understanding of tissue-specific cord pathology offers potential biomarkers with more efficient targeting and monitoring of neuroregenerative (i.e., white matter) and neuroprotective (i.e., gray matter) agents.
Collapse
Affiliation(s)
- Eveline Huber
- From the Spinal Cord Injury Center (E.H., G.D., P.F.), Balgrist University Hospital, Zurich, Switzerland; Department of Brain Repair and Rehabilitation (A.J.T., P.F.) and Wellcome Trust Centre for Neuroimaging (N.W., S.M., P.F.), UCL Institute of Neurology, University College London, UK; Department of Neurophysics (N.W., P.F.), Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; and Department of Systems Neuroscience (S.M.), University Medical Center Hamburg-Eppendorf, Germany
| | - Gergely David
- From the Spinal Cord Injury Center (E.H., G.D., P.F.), Balgrist University Hospital, Zurich, Switzerland; Department of Brain Repair and Rehabilitation (A.J.T., P.F.) and Wellcome Trust Centre for Neuroimaging (N.W., S.M., P.F.), UCL Institute of Neurology, University College London, UK; Department of Neurophysics (N.W., P.F.), Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; and Department of Systems Neuroscience (S.M.), University Medical Center Hamburg-Eppendorf, Germany
| | - Alan J Thompson
- From the Spinal Cord Injury Center (E.H., G.D., P.F.), Balgrist University Hospital, Zurich, Switzerland; Department of Brain Repair and Rehabilitation (A.J.T., P.F.) and Wellcome Trust Centre for Neuroimaging (N.W., S.M., P.F.), UCL Institute of Neurology, University College London, UK; Department of Neurophysics (N.W., P.F.), Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; and Department of Systems Neuroscience (S.M.), University Medical Center Hamburg-Eppendorf, Germany
| | - Nikolaus Weiskopf
- From the Spinal Cord Injury Center (E.H., G.D., P.F.), Balgrist University Hospital, Zurich, Switzerland; Department of Brain Repair and Rehabilitation (A.J.T., P.F.) and Wellcome Trust Centre for Neuroimaging (N.W., S.M., P.F.), UCL Institute of Neurology, University College London, UK; Department of Neurophysics (N.W., P.F.), Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; and Department of Systems Neuroscience (S.M.), University Medical Center Hamburg-Eppendorf, Germany
| | - Siawoosh Mohammadi
- From the Spinal Cord Injury Center (E.H., G.D., P.F.), Balgrist University Hospital, Zurich, Switzerland; Department of Brain Repair and Rehabilitation (A.J.T., P.F.) and Wellcome Trust Centre for Neuroimaging (N.W., S.M., P.F.), UCL Institute of Neurology, University College London, UK; Department of Neurophysics (N.W., P.F.), Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; and Department of Systems Neuroscience (S.M.), University Medical Center Hamburg-Eppendorf, Germany
| | - Patrick Freund
- From the Spinal Cord Injury Center (E.H., G.D., P.F.), Balgrist University Hospital, Zurich, Switzerland; Department of Brain Repair and Rehabilitation (A.J.T., P.F.) and Wellcome Trust Centre for Neuroimaging (N.W., S.M., P.F.), UCL Institute of Neurology, University College London, UK; Department of Neurophysics (N.W., P.F.), Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; and Department of Systems Neuroscience (S.M.), University Medical Center Hamburg-Eppendorf, Germany.
| |
Collapse
|
7
|
Bodelle B, Luboldt W, Wichmann JL, Fischer S, Vogl TJ, Beeres M. Chondral lesions in the patellofemoral joint in MRI: Intra-individual comparison of short-tau inversion recovery sequence (STIR) with 2D multiple-echo data image combination sequence (MEDIC). Eur J Radiol Open 2016; 3:259-263. [PMID: 27844041 PMCID: PMC5099322 DOI: 10.1016/j.ejro.2016.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 10/25/2016] [Accepted: 10/27/2016] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To determine the value of the 2D multiple-echo data image combination (MEDIC) sequence relative to the short-tau inversion recovery (STIR) sequence regarding the depiction of chondral lesions in the patellofemoral joint. MATERIALS AND METHODS During a period of 6 month patients with acute pain at the anterior aspect of the knee, joint effusion and suspected chondral lesion defect in the patellofemoral joint underwent MRI including axial MEDIC and STIR imaging. Patients with chondral lesions in the patellofemoral joint on at least one sequence were included. The MEDIC and STIR sequence were quantitatively compared regarding the patella cartilage-to-effusion contrast-to-noise ratio (CNR) and qualitatively regarding the depiction of chondral lesions independently scored by two radiologists on a 3-point scale (1 = not depicted; 2 = blurred depicted; 3 = clearly depicted) using the Wilcoxon-Mann-Whitney-Test. For the analysis of inter-observer agreement the Cohen's Weighted Kappa test was used. RESULTS 30 of 58 patients (male: female, 21:9; age: 44 ± 12 yrs) revealed cartilage lesions (fissures, n = 5 including fibrillation; gaps, n = 15; delamination, n = 7; osteoarthritis, n = 3) and were included in this study. The STIR-sequence was significantly (p < 0.001) superior to the MEDIC-sequence regarding both, the patella cartilage-to-effusion CNR (mean CNR: 232 ± 61 vs. 40 ± 16) as well as the depiction of chondral lesion (mean score: 2.83 ± 0.4 vs. 1.75 ± 0.7) with substantial inter-observer agreement in the rating of both sequences (κ = 0.76-0.89). CONCLUSION For the depiction of chondral lesions in the patellofemoral joint, the axial STIR-sequence should be chosen in preference to the axial MEDIC-sequence.
Collapse
Affiliation(s)
- Boris Bodelle
- Goethe University of Frankfurt, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Wolfgang Luboldt
- Goethe University of Frankfurt, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Julian L Wichmann
- Goethe University of Frankfurt, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Sebastian Fischer
- Goethe University of Frankfurt, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Thomas J Vogl
- Goethe University of Frankfurt, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Martin Beeres
- Goethe University of Frankfurt, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| |
Collapse
|
8
|
Voxel-based analysis of grey and white matter degeneration in cervical spondylotic myelopathy. Sci Rep 2016; 6:24636. [PMID: 27095134 PMCID: PMC4837346 DOI: 10.1038/srep24636] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 04/04/2016] [Indexed: 12/21/2022] Open
Abstract
In this prospective study, we made an unbiased voxel-based analysis to investigate above-stenosis spinal degeneration and its relation to impairment in patients with cervical spondylotic myelopathy (CSM). Twenty patients and 18 controls were assessed with high-resolution MRI protocols above the level of stenosis. Cross-sectional areas of grey matter (GM), white matter (WM), and posterior columns (PC) were measured to determine atrophy. Diffusion indices assessed tract-specific integrity of PC and lateral corticospinal tracts (CST). Regression analysis was used to reveal relationships between MRI measures and clinical impairment. Patients showed mainly sensory impairment. Atrophy was prominent within the cervical WM (13.9%, p = 0.004), GM (7.2%, p = 0.043), and PC (16.1%, p = 0.005). Fractional anisotropy (FA) was reduced in the PC (−11.98%, p = 0.006) and lateral CST (−12.96%, p = 0.014). In addition, radial (+28.47%, p = 0.014), axial (+14.72%, p = 0.005), and mean (+16.50%, p = 0.001) diffusivities were increased in the PC. Light-touch score was associated with atrophy (R2 = 0.3559, p = 0.020) and FA (z score 3.74, p = 0.003) in the PC, as was functional independence and FA in the lateral CST (z score 3.68, p = 0.020). This study demonstrates voxel-based degeneration far above the stenosis at a level not directly affected by the compression and provides unbiased readouts of tract-specific changes that relate to impairment.
Collapse
|
9
|
Swami VG, Cheng-Baron J, Hui C, Thompson RB, Jaremko JL. Reliability of 3D localisation of ACL attachments on MRI: comparison using multi-planar 2D versus high-resolution 3D base sequences. Knee Surg Sports Traumatol Arthrosc 2015; 23:1206-14. [PMID: 24651978 DOI: 10.1007/s00167-014-2948-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2013] [Accepted: 03/10/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE Anatomic placement of anterior cruciate ligament (ACL) grafts at arthroscopic reconstruction can be challenging. Localising ACL attachments on magnetic resonance imaging (MRI) sequences pre-operatively could aid with planning for anatomic graft placement. Though ACL attachments can be identified on two-dimensional (2D) MRI, slice thickness theoretically limits out-of-plane accuracy and a 3D MRI base sequence with smaller isotropic voxels may improve observer reliability in localising ACL attachment locations. The purpose of this study was to test whether a high-resolution 3D sequence improved inter- and intra-observer reliability of ACL attachment localisation compared with conventional 2D MRI for this application. METHODS Twenty paediatric knees were retrospectively scanned at 1.5 Tesla with multi-planar 2D proton density (slice thickness 3-4 mm) and T2-weighted 3D multiple-echo data image combination gradient echo (isotropic 0.8 mm voxels) sequences. Two observers blinded to each others' findings identified ACL attachments on MRI slices, and 3D reconstructions showing ACL attachments were produced. ACL attachment centre locations and areas were calculated, and reliability assessed. RESULTS Inter-observer variation of centre locations of ACL attachments identified on 3D versus 2D sequences was not significantly different (mean ± SD): 1.8 ± 0.6 versus 1.5 ± 0.7 mm at femoral attachments, 1.7 ± 0.7 versus 1.5 ± 0.8 mm at tibial attachments (p > 0.05). The 95 % confidence interval for centre locations was <4.0 mm in all cases. Inter-observer reliability of attachment areas was not higher for 3D sequences. CONCLUSIONS ACL attachment centres were localised with high and similar inter- and intra-observer reliability on a high-resolution 3D and multi-planar conventional 2D sequences. Using this technique, MRI could potentially be used for planning and intra-operative guidance of anatomic ACL reconstruction, whether from 2D or 3D base sequences. Surgeons in clinical practice need not order a lengthy dedicated 3D MRI to localise ligament attachments, but can confidently use a standard 2D MRI for this application. LEVEL OF EVIDENCE III.
Collapse
Affiliation(s)
- Vimarsha Gopal Swami
- Department of Radiology and Diagnostic Imaging, University of Alberta, 2A2.41 WC Mackenzie Health Sciences Centre, 8440-112 Street, Edmonton, AB, T6G 2B7, Canada,
| | | | | | | | | |
Collapse
|
10
|
Abstract
Excellent morphological imaging of cartilage is now possible and allows the detection of subtle cartilage pathologies. Besides the standard 2D sequences, a multitude of 3D sequences are available for high-resolution cartilage imaging. The first part therefore deals with modern possibilities of morphological imaging. The second part deals with functional cartilage imaging with which it is possible to detect changes in cartilage composition and thus early osteoarthritis as well as to monitor biochemical changes after therapeutic interventions. Validated techniques such as delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) and T2 mapping as well the latest techniques, such as the glycosaminoglycan chemical exchange-dependent saturation transfer (gagCEST) technique will be discussed.
Collapse
|
11
|
|
12
|
Schieda N, Avruch L, Shabana WM, Malone SC. Multi-echo gradient recalled echo imaging of the pelvis for improved depiction of brachytherapy seeds and fiducial markers facilitating radiotherapy planning and treatment of prostatic carcinoma. J Magn Reson Imaging 2014; 41:715-20. [DOI: 10.1002/jmri.24590] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Accepted: 01/09/2014] [Indexed: 11/08/2022] Open
Affiliation(s)
- Nicola Schieda
- The Ottawa Hospital, The University of Ottawa; Department of Radiology; Civic Campus C1 Ottawa Ontario Canada
| | - Leonard Avruch
- The Ottawa Hospital, The University of Ottawa; Department of Radiology; Civic Campus C1 Ottawa Ontario Canada
| | - Wael M. Shabana
- The Ottawa Hospital, The University of Ottawa; Department of Radiology; Civic Campus C1 Ottawa Ontario Canada
| | - Shawn Christopher Malone
- The Ottawa Hospital, The University of Ottawa; Department of Radiation Oncology; Ottawa Ontario Canada
| |
Collapse
|
13
|
Multiple-echo data image combination in infants with developmental dysplasia of the hip: comparison with conventional T1-weighted and T2-weighted imaging. J Pediatr Orthop B 2014; 23:37-43. [PMID: 24080773 DOI: 10.1097/bpb.0000000000000001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Two-dimensional multiple-echo data image combination (MEDIC) images, as well as conventional T1-weighted and T2-weighted images, were obtained for 38 infants with developmental dysplasia of the hip. We retrospectively reviewed these images to evaluate subjective image quality and femoral head-to-ischium contrast. MEDIC images were considered to be of high quality compared with the conventional T1-weighted (P<0.0001) and T2-weighted images (P<0.05), as well as have a higher contrast than conventional T1-weighted and T2-weighted images (P<0.001, respectively). In conclusion, MEDIC images provide diagnostic improvement in studies on developmental dysplasia of the hip.
Collapse
|
14
|
Fujinaga Y, Yoshioka H, Sakai T, Sakai Y, Souza F, Lang P. Quantitative measurement of femoral condyle cartilage in the knee by MRI: validation study by multireaders. J Magn Reson Imaging 2013; 39:972-7. [PMID: 24123712 DOI: 10.1002/jmri.24217] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 04/16/2013] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To determine reproducibility of the femoral condyle cartilage volume (CV) in cross-sectional and longitudinal studies using various 3D imaging techniques at 1.5 T and 3 T. MATERIALS AND METHODS In 21 subjects with osteoarthritis, magnetic resonance imaging (MRI) including four different sequences (sagittal 3D fat suppressed spoiled gradient-echo [SPGR] at 1.5 T, fat suppressed fast low angle shot [FLASH] at 3 T, water-excitation dual echo steady state [DESS] at 3 T, and water-excitation multiecho data image combination [MEDIC] at 3 T) were acquired at baseline and ∼1 year later. The CV measured using semiautomated segmentation software by three readers was analyzed. RESULTS The mean of the interclass correlation coefficient between each reader from SPGR, FLASH, DESS, and MEDIC was 0.899, 0.948, 0.943, and 0.954, respectively. The mean CV (×10(4) mm(3) ) measured by each reader from SPGR/FLASH/DESS/MEDIC sequences was the following in this order: 1.34/1.52/1.50/1.35, 1.21/1.43/1.40/1.27, 1.22/1.37/1.36/1.22, and 1.17/1.36/1.35/1.21 by readers 1, 2, 3 (first analysis), and 3 (second analysis), respectively. There was no statistically significant difference in CV between any readers in any sequences. The CV measured on FLASH and DESS tended to be greater than that on SPGR or MEDIC. CONCLUSION Inter- and intraobserver reproducibility of cartilage segmentation using semiautomated software was validated. Although there was no statistical significance, there was a tendency of under- or overestimating CV by each sequence.
Collapse
Affiliation(s)
- Yasunari Fujinaga
- Department of Radiological Sciences, University of California, Irvine, California, USA; Department of Radiology, Shinshu University School of Medicine, Matsumoto, Japan
| | | | | | | | | | | |
Collapse
|
15
|
Theysohn JM, Kraff O, Maderwald S, Kokulinsky PC, Ladd ME, Barkhausen J, Ladd SC. MRI of the ankle joint in healthy non-athletes and in marathon runners: image quality issues at 7.0 T compared to 1.5 T. Skeletal Radiol 2013; 42:261-7. [PMID: 22688975 DOI: 10.1007/s00256-012-1454-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Revised: 03/08/2012] [Accepted: 05/20/2012] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To present imaging characteristics of the ankle at 7.0 T and to investigate the appearance and image quality of presumed pathologies of ankles without physical strain as well as of ankles after a marathon run in comparison to 1.5 T. MATERIALS AND METHODS Appearance of presumed pathologic findings and image quality of TSE (PD, T2, and STIR) and GRE sequences (MEDIC, DESS, and/or CISS) at 7.0 T and 1.5 T MRI were compared by two senior radiologists in consensus in two healthy controls without strain and in six marathon runners after a full-length marathon (eight males, mean age 49.1 years). RESULTS Overall, 7.0 T MRI allowed for higher resolution images for most of the sequences while requiring comparable acquisition times and achieving high contrast images mainly in gradient echo sequences. Bursal or presumed peritendineal fluid and/or edematous tissue, which were found in seven of eight subjects, could be best appreciated with 7.0 T MEDIC. Other findings with sharper delineation at 7.0 T included cartilage defects (best: CISS), osseous avulsions, and osteophytes (best: DESS). Nevertheless, 1.5 T STIR imaging enabled assessment of a tibiotalar bone edema-like lesion in two runners, which was barely visible at 7.0 T using STIR, but not with any other sequence at 7.0 T including MEDIC (with frequency selective fat suppression). 7.0 T showed larger image quality variations with challenges especially in the TSE sequences. CONCLUSION Our initial results of ultra-high-field ankle joint imaging demonstrate the improved depiction of ankle anatomy, fluid depositions, and cartilage defects. However imaging of edema-like bone lesions remains challenging at ultra-high magnetic field strength, and TSE coverage in particular is limited by the specific absorption rate.
Collapse
Affiliation(s)
- J M Theysohn
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany.
| | | | | | | | | | | | | |
Collapse
|
16
|
Harris JD, Brophy RH, Jia G, Price B, Knopp M, Siston RA, Flanigan DC. Sensitivity of magnetic resonance imaging for detection of patellofemoral articular cartilage defects. Arthroscopy 2012; 28:1728-37. [PMID: 22749495 DOI: 10.1016/j.arthro.2012.03.018] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Revised: 03/12/2012] [Accepted: 03/13/2012] [Indexed: 02/02/2023]
Abstract
PURPOSE Chondral defects within the patellofemoral compartment are common and lack the ability to heal on their own. Early detection of these lesions with a noninvasive modality would be beneficial in delaying or preventing their possible progression to osteoarthritis. We hypothesized that magnetic resonance imaging (MRI) is a sensitive, specific, and accurate imaging modality for the detection of patellofemoral chondral defects with substantial interobserver reliability and that MRI has a higher sensitivity, specificity, and accuracy for detecting patellar defects than trochlear defects. METHODS A systematic review of multiple medical databases was performed by use of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol. Analysis of studies that reported diagnostic performance of MRI in the assessment of patellofemoral chondral defects (patella and trochlea), using arthroscopy as the reference gold standard, was performed. Sensitivity, specificity, accuracy, and interobserver reliability were reported. Significant heterogeneity across studies precluded meta-analysis. RESULTS MRI was more sensitive in detection of patellar (87%) versus trochlear (72%) defects. MRI was similarly specific for patellar (86%) and trochlear (89%) defects. MRI was similarly accurate for patellar (84%) and trochlear (83%) defects. Interobserver agreement was substantial to almost perfect for both patellar and trochlear defects. CONCLUSIONS MRI is a highly sensitive, specific, and accurate noninvasive diagnostic modality for the detection of chondral defects in the patellofemoral compartment of the knee, using arthroscopy as the reference gold standard. Although there was wide variability in the statistical parameters assessed, MRI was more sensitive for detection of patellar versus trochlear defects and similarly specific and accurate for patellar and trochlear defects. Interobserver reliability is substantial to near perfect in the assessment of these lesions, without a significant difference between patellar and trochlear defects. CLINICAL RELEVANCE Use of MRI may allow early detection of chondral defects within the patellofemoral compartment, enabling clinicians to adopt strategies to delay or prevent progression to osteoarthritis. LEVEL OF EVIDENCE Level III, systematic review of Level I, II, and III studies.
Collapse
Affiliation(s)
- Joshua D Harris
- Sports Medicine Center and Cartilage Restoration Program, The Ohio State University, Columbus, USA
| | | | | | | | | | | | | |
Collapse
|
17
|
Bao YF, Tang WJ, Zhu DQ, Li YX, Zee CS, Chen XJ, Geng DY. Sensory neuronopathy involves the spinal cord and brachial plexus: a quantitative study employing multiple-echo data image combination (MEDIC) and turbo inversion recovery magnitude (TIRM). Neuroradiology 2012; 55:41-8. [DOI: 10.1007/s00234-012-1085-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Accepted: 08/14/2012] [Indexed: 11/25/2022]
|
18
|
Freund P, Curt A, Friston K, Thompson A. Tracking changes following spinal cord injury: insights from neuroimaging. Neuroscientist 2012; 19:116-28. [PMID: 22730072 PMCID: PMC4107798 DOI: 10.1177/1073858412449192] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Traumatic spinal cord injury is often disabling and recovery of function is limited. As a
consequence of damage, both spinal cord and brain undergo anatomical and functional
changes. Besides clinical measures of recovery, biomarkers that can detect early
anatomical and functional changes might be useful in determining clinical outcome—during
the course of rehabilitation and recovery—as well as furnishing a tool to evaluate novel
treatment interventions and their mechanisms of action. Recent evidence suggests an
interesting three-way relationship between neurological deficit and changes in the spinal
cord and of the brain and that, importantly, noninvasive magnetic resonance imaging
techniques, both structural and functional, provide a sensitive tool to lay out these
interactions. This review describes recent findings from multimodal imaging studies of
remote anatomical changes (i.e., beyond the lesion site), cortical reorganization, and
their relationship to clinical disability. These developments in this field may improve
our understanding of effects on the nervous system that are attributable to the injury
itself and will allow their distinction from changes that result from rehabilitation
(i.e., functional retraining) and from interventions affecting the nervous system directly
(i.e., neuroprotection or regeneration).
Collapse
Affiliation(s)
- Patrick Freund
- Department of Brain Repair & Rehabilitation, UCL Institute of Neurology, UCL, London, UK.
| | | | | | | |
Collapse
|
19
|
Jang U, Hwang D. High-quality multiple T2(*) contrast MR images from low-quality multi-echo images using temporal-domain denoising methods. Med Phys 2011; 39:468-74. [DOI: 10.1118/1.3671934] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
20
|
Roemer FW, Hunter DJ, Winterstein A, Li L, Kim YJ, Cibere J, Mamisch TC, Guermazi A. Hip Osteoarthritis MRI Scoring System (HOAMS): reliability and associations with radiographic and clinical findings. Osteoarthritis Cartilage 2011; 19:946-62. [PMID: 21550411 DOI: 10.1016/j.joca.2011.04.003] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Revised: 03/01/2011] [Accepted: 04/03/2011] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To develop a semiquantitative MRI-based scoring system (HOAMS) of hip osteoarthritis (OA) and test its reliability and validity. DESIGN Fifty-two patients with chronic hip pain were included. 1.5T magnetic resonance imaging (MRI) was performed on all patients. Pelvic radiographs were scored according to the Kellgren-Lawrence (KL) system. Clinical outcomes were assessed by the hip osteoarthritis outcome score (HOOS). MRIs were analyzed using a novel whole-joint MRI score that incorporated 13 articular features. Reliability was determined on a random subset of 15 cases. Weighted-kappa statistics and overall agreement were used as a measure of intra- and inter-observer reliability. Associations between MRI features and radiographic OA severity were calculated using Cochran-Armitage test for trend. Ordinal logistic regression was used to assess associations between MRI features and severity of pain and functional limitation. RESULTS Distribution of radiographic grading was: KL 0=12 (27%), KL 1=11 (25%), KL 2=14 (32%), KL 3=5 (11%) and KL 4=2 (5%). Intra-reader reliability for the different features ranged from 0.18 (cysts) to 0.85 (cartilage). Inter-reader reliability ranged between 0.15 (cysts) and 0.85 (BMLs). Low kappas were due to low frequencies of some features as overall percent agreement was good to excellent (83.8% and 83.1%). There was a strong association between MRI-detected lesions and radiographic severity (P=0.002). Non-significant trends were observed between MRI features and clinical outcomes. CONCLUSION MRI-based semiquantitative assessment of the hip shows adequate reliability. Presence of more severe MRI-detected intraarticular pathology shows a strong association with radiographic OA. The results suggest possible associations between MRI-detected pathology and clinical symptoms.
Collapse
Affiliation(s)
- F W Roemer
- Quantitative Imaging Center, Department of Radiology, Boston University Medical Center, 820 Harrison Avenue, Boston, MA 02118, USA.
| | | | | | | | | | | | | | | |
Collapse
|
21
|
Quatman CE, Hettrich CM, Schmitt LC, Spindler KP. The clinical utility and diagnostic performance of magnetic resonance imaging for identification of early and advanced knee osteoarthritis: a systematic review. Am J Sports Med 2011; 39:1557-68. [PMID: 21730207 PMCID: PMC3782308 DOI: 10.1177/0363546511407612] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Current diagnostic strategies for detection of structural articular cartilage abnormalities, the earliest structural signs of osteoarthritis, often do not capture the condition until it is too far advanced for the most potential benefit of noninvasive interventions. PURPOSE To systematically review the literature relative to the following questions: (1) Is magnetic resonance imaging (MRI) a valid, sensitive, specific, accurate, and reliable instrument to identify knee articular cartilage abnormalities compared with arthroscopy? (2) Is MRI a sensitive tool that can be utilized to identify early cartilage degeneration? STUDY DESIGN Systematic review. METHODS A systematic search was performed in November 2010 using PubMed MEDLINE (from 1966), CINAHL (from 1982), SPORTDiscus (from 1985), SCOPUS (from 1996), and EMBASE (from 1974) databases. RESULTS Fourteen level I and 13 level II studies were identified that met inclusion criteria and provided information related to diagnostic performance of MRI compared with arthroscopic evaluation. The diagnostic performance of MRI demonstrated a large range of sensitivities, specificities, and accuracies. The sensitivity for identifying articular cartilage abnormalities in the knee joint was reported between 26% and 96%. Specificity and accuracy were reported between 50% and 100% and between 49% and 94%, respectively. The sensitivity, specificity, and accuracy for identifying early osteoarthritis were reported between 0% and 86%, 48% and 95%, and 5% and 94%, respectively. As a result of inconsistencies between imaging techniques and methodological shortcomings of many of the studies, a meta-analysis was not performed, and it was difficult to fully synthesize the information to state firm conclusions about the diagnostic performance of MRI. CONCLUSION There is evidence in some MRI protocols that MRI is a relatively valid, sensitive, specific, accurate, and reliable clinical tool for identifying articular cartilage degeneration. Because of heterogeneity of MRI sequences, it is not possible to make definitive conclusions regarding its global clinical utility for guiding diagnosis and treatment strategies. CLINICAL RELEVANCE Traumatic sports injuries to the knee may be significant precursor events to early onset of posttraumatic osteoarthritis. Magnetic resonance imaging may aid in early identification of structural injuries to articular cartilage as evidenced by articular cartilage degeneration grading.
Collapse
Affiliation(s)
- Carmen E. Quatman
- Cincinnati Children’s Hospital Medical Center Research Foundation Sports Medicine Biodynamics Center and Human Performance Laboratory, Cincinnati, OH
| | - Carolyn M. Hettrich
- Vanderbilt Sports Medicine, Department of Orthopaedics and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN
| | - Laura C. Schmitt
- Cincinnati Children’s Hospital Medical Center Research Foundation Sports Medicine Biodynamics Center and Human Performance Laboratory, Cincinnati, OH,The Ohio State University, School of Allied Medical Professions, Division of Physical Therapy, Columbus, OH
| | - Kurt P. Spindler
- Vanderbilt Sports Medicine, Department of Orthopaedics and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN
| |
Collapse
|
22
|
Abstract
CONTEXT Although disorders of the patellofemoral joint are common in the athlete, their management can be challenging and require a thorough physical examination and radiologic evaluation, including advanced magnetic resonance imaging techniques. EVIDENCE ACQUISITION Relevant articles were searched under OVID and MEDLINE (1968 to 2010) using the keywords patellofemoral joint, patellofemoral pain or patella and radiography, imaging, or magnetic resonance imaging, and the referenced sources were reviewed for additional articles. The quality and validity of the studies were assessed on the basis of careful analysis of the materials and methods before their inclusion in this article. RESULTS Physical examination and imaging evaluation including standard radiographs are crucial in identifying evidence of malalignment or instability. Magnetic resonance imaging provides valuable information about concomitant soft tissue injuries to the medial stabilizers as well as injuries to the articular cartilage, including chondral shears and osteochondral fractures. Quantitative magnetic resonance imaging assessing the ultrastructure of cartilage has shown high correlation with histology and may be useful for timing surgery. CONCLUSIONS Evaluation of patellofemoral disorders is complex and requires a comprehensive assessment. Recent advancements in imaging have made possible a more precise evaluation of the individual anatomy of the patient, addressing issues of malalignment, instability, and underlying cartilage damage.
Collapse
Affiliation(s)
| | - Beth E. Shubin Stein
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York
| | | |
Collapse
|
23
|
Diederichs G, Issever AS, Scheffler S. MR imaging of patellar instability: injury patterns and assessment of risk factors. Radiographics 2010; 30:961-81. [PMID: 20631363 DOI: 10.1148/rg.304095755] [Citation(s) in RCA: 182] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
First-time patellar dislocation typically occurs with twisting knee motions, during which the medial ligamentous stabilizers rupture, and the patella strikes against the lateral femoral condyle. The typical injury pattern is a tear of the medial patellofemoral ligament (MPFL) and bone bruises of the patella and the lateral femoral condyle. Additionally, complex injuries to bone, cartilage, and ligaments may occur. The ensuing loss of medial restraint favors future patellar dislocations, especially if additional risk factors are present. Recurrent patellar dislocations usually occur in individuals with anatomic variants of the patellar stabilizers, such as trochlear dysplasia, patella alta, and lateralization of the tibial tuberosity. Magnetic resonance (MR) imaging is reliable in identifying risk factors for chronic patellar instability and in assessing knee joint damage associated with patellar dislocation. MR imaging can thus provide important information for individually tailored treatment. Patients with primary patellar dislocation without severe internal derangement who lack major risk factors can be treated conservatively. Patients with pronounced ligamentous tears or large osteochondral lesions require prompt surgery. In addition, surgical correction of anatomic variants will help reduce the potential for chronic instability. The most common procedures, in addition to MPFL reconstruction, include trochleoplasty, medialization of the tibial tuberosity, and medial capsular plication. For comprehensive assessment of patellar dislocation, a radiologist should be able to identify typical injury patterns, know standard methods to assess risk factors for patellar instability, and be familiar with surgical options.
Collapse
Affiliation(s)
- Gerd Diederichs
- Department of Radiology, Charité-Universitätsmedizin Berlin, Campus Charité Mitte, Charitéplatz 1, 10117 Berlin, Germany.
| | | | | |
Collapse
|
24
|
Choi JS, Kim MJ, Kim JH, Choi JY, Chung YE, Park MS, Kim KW. Comparison of multi-echo and single-echo gradient-recalled echo sequences for SPIO-enhanced liver MRI at 3 T. Clin Radiol 2010; 65:916-23. [PMID: 20933647 DOI: 10.1016/j.crad.2010.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2010] [Revised: 07/02/2010] [Accepted: 07/14/2010] [Indexed: 01/04/2023]
Abstract
AIM To assess the utility of a T2*-weighted, multi-echo data imaging combination sequenced on superparamagnetic iron oxide (SPIO)-enhanced liver magnetic resonance imaging (MRI) using a 3 T system. MATERIALS AND METHODS Fifty patients underwent SPIO-enhanced MRI at 3 T using T2*-weighted, single-echo, gradient-recalled echo (GRE) sequences [fast imaging with steady precession; repetition time (TR)/echo time (TE), 126 ms/9 ms; flip angle, 30°] and multi-echo GRE (multi-echo data image combination) sequences (TR/TE, 186 ms/9 ms; flip angle, 30°). Three radiologists independently reviewed the images in a random order. The sensitivity and accuracy for the detection of focal hepatic lesions (a total of 76 lesions in 33 patients; 48 solid lesions, 28 non-solid lesions) were compared by analysing the area under the receiver operating characteristic curves. Image artefacts (flow artefacts, susceptibility artefacts, dielectric artefacts, and motion artefacts), lesion conspicuity, and overall image quality were evaluated according to a four-point scale: 1, poor; 2, fair; 3, good; 4, excellent. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the lesions were compared. RESULTS Image artefacts were more frequent with single-echo GRE (p<0.05). The mean scale of image quality assessment for flow, susceptibility, dielectric, and motion artefacts were 2.76, 3.13, 3.42, and 2.89 with single-echo, respectively, compared with 3.47, 3.43, 3.47, and 3.39, respectively, with multi-echo GRE. There was no significant difference in lesion conspicuity between single-echo (3.15) and multi-echo (3.30) GRE sequences. The overall image quality was significantly (p<0.05) better with multi-echo (3.37) than with single-echo GRE (2.89). The mean SNR and CNR of the lesions were significantly (p<0.05) higher on multi-echo (79±23 and 128±59, respectively) images than on single-echo (38±11 and 102±44, respectively) images. Lesion detection accuracy and sensitivity were not significantly different between the two sequences. Mean accuracies and sensitivities were 0.864 and 0.785 for single-echo and 0.847 and 0.785 for multi-echo GRE, respectively. CONCLUSION At 3 T, the T2*-weighted, multi-echo data image combination sequence performs comparably to the T2*-weighted, single-echo GRE sequence for SPIO-enhanced MRI with good overall image quality and a decrease in undesired artefacts.
Collapse
Affiliation(s)
- J S Choi
- Department of Radiology, Research Institute of Radiological Science, Yonsei University Health System, Seodaemun-gu, Seoul, South Korea
| | | | | | | | | | | | | |
Collapse
|
25
|
OLIVE JULIEN. DISTAL INTERPHALANGEAL ARTICULAR CARTILAGE ASSESSMENT USING LOW-FIELD MAGNETIC RESONANCE IMAGING. Vet Radiol Ultrasound 2010; 51:259-66. [DOI: 10.1111/j.1740-8261.2009.01663.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
26
|
O'Keeffe SA, Hogan BA, Eustace SJ, Kavanagh EC. Overuse injuries of the knee. Magn Reson Imaging Clin N Am 2010; 17:725-39, vii. [PMID: 19887299 DOI: 10.1016/j.mric.2009.06.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Overuse injuries are a common cause of morbidity in athletes. They occur after repetitive microtrauma, abnormal joint alignment, and poor training technique without appropriate time to heal. Overuse injuries are frequent in the knee joint because of the numerous attachment sites for lower limb musculature and tendons surrounding the joint. MR imaging is regarded as the noninvasive technique of choice for detection of internal derangements of the knee. This article describes the characteristic findings on MR of the common overuse injuries in the knee, including patellar tendinopathy, iliotibial band syndrome, cartilage disorders, medial plica syndrome, and bursitis.
Collapse
Affiliation(s)
- Sylvia A O'Keeffe
- Department of Radiology, Mater Misericordiae University Hospital, Eccles Street, Dublin 8, Ireland.
| | | | | | | |
Collapse
|
27
|
Andreisek G, White LM, Theodoropoulos JS, Naraghi A, Young N, Zhao CY, Mamisch TC, Sussman MS. Synthetic–Echo Time Postprocessing Technique for Generating Images with Variable T2-weighted Contrast: Diagnosis of Meniscal and Cartilage Abnormalities of the Knee. Radiology 2010; 254:188-99. [DOI: 10.1148/radiol.2541090314] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
|
28
|
Lee IS, Song JW. High field strength magnetic resonance imaging of musculoskeletal diseases. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2010. [DOI: 10.5124/jkma.2010.53.12.1074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- In Sook Lee
- Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Jong Woon Song
- Department of Radiology, Inje University Haeundae Paik Hospital, Busan, Korea
| |
Collapse
|
29
|
Fripp J, Crozier S, Warfield SK, Ourselin S. Automatic segmentation and quantitative analysis of the articular cartilages from magnetic resonance images of the knee. IEEE TRANSACTIONS ON MEDICAL IMAGING 2010; 29:55-64. [PMID: 19520633 PMCID: PMC3717377 DOI: 10.1109/tmi.2009.2024743] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
In this paper, we present a segmentation scheme that automatically and accurately segments all the cartilages from magnetic resonance (MR) images of nonpathological knees. Our scheme involves the automatic segmentation of the bones using a three-dimensional active shape model, the extraction of the expected bone-cartilage interface (BCI), and cartilage segmentation from the BCI using a deformable model that utilizes localization, patient specific tissue estimation and a model of the thickness variation. The accuracy of this scheme was experimentally validated using leave one out experiments on a database of fat suppressed spoiled gradient recall MR images. The scheme was compared to three state of the art approaches, tissue classification, a modified semi-automatic watershed algorithm and nonrigid registration (B-spline based free form deformation). Our scheme obtained an average Dice similarity coefficient (DSC) of (0.83, 0.83, 0.85) for the (patellar, tibial, femoral) cartilages, while (0.82, 0.81, 0.86) was obtained with a tissue classifier and (0.73, 0.79, 0.76) was obtained with nonrigid registration. The average DSC obtained for all the cartilages using a semi-automatic watershed algorithm (0.90) was slightly higher than our approach (0.89), however unlike this approach we segment each cartilage as a separate object. The effectiveness of our approach for quantitative analysis was evaluated using volume and thickness measures with a median volume difference error of (5.92, 4.65, 5.69) and absolute Laplacian thickness difference of (0.13, 0.24, 0.12) mm.
Collapse
Affiliation(s)
- Jurgen Fripp
- CSIRO, ICTC, The Australian e-Health Research Centre-BioMedIA, Royal Brisbane and Women's Hospital, 4029 Herston, Qld., Australia.
| | | | | | | |
Collapse
|
30
|
Chevrefils C, Cheriet F, Aubin CE, Grimard G. Texture Analysis for Automatic Segmentation of Intervertebral Disks of Scoliotic Spines From MR Images. ACTA ACUST UNITED AC 2009; 13:608-20. [PMID: 19369169 DOI: 10.1109/titb.2009.2018286] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Claudia Chevrefils
- Institute of Biomedical Engineering, Ecole Polytechnique de Montreal, Montreal, QC H3C 3A7, Canada.
| | | | | | | |
Collapse
|
31
|
Li W, Abram F, Beaudoin G, Berthiaume MJ, Pelletier JP, Martel-Pelletier J. Human hip joint cartilage: MRI quantitative thickness and volume measurements discriminating acetabulum and femoral head. IEEE Trans Biomed Eng 2009; 55:2731-40. [PMID: 19126452 DOI: 10.1109/tbme.2008.925679] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This paper aims at developing a quantitative system for measuring human hip cartilage thickness and volume using magnetic resonance imaging (MRI). A new MRI-acquisition technique, named axial rotation, where the acquisition planes are organized around a virtual axis, was used. The MRI protocol consists of a 2-D multiple-echo data image combination (MEDIC) using water excitation. Inner and outer interface contours of acetabulum and femoral head cartilage are obtained using a semiautomated 3-D segmentation method and combined to form 3-D surfaces. A local spherical coordinate system computed from the original contours enables cartilage thickness and volume computation. An anatomical labeling is performed automatically for thickness and volume measurements in predefined subregions: inferior, anterior, superior, and posterior. A registration module is introduced allowing the assessment of cartilage changes over time. Validation of the system was conducted with three protocols each involving data obtained from nine subjects: 1) registration process accuracy; 2) intrareader reproducibility; and 3) intervisit coefficient of variation. Data showed excellent correlation coefficients for either the intrareader (r>or=0.0942, p<0.0001 ) or intervisit (r>or=0.0837, p<0.005) protocols. This noninvasive system, which enables the quantification of cartilage thickness and volume in the human hip joint using MRI, is the first to discriminate the acetabular and femoral head cartilage throughout the entire hip without the use of an external device, and to implement hip registration for follow-up studies on the same subject.
Collapse
Affiliation(s)
- Wei Li
- ArthroVision, Montreal, QC H2K 1B6, Canada.
| | | | | | | | | | | |
Collapse
|
32
|
Advantages of using multiple-echo image combination and asymmetric triangular phase masking in magnetic resonance venography at 3 T. Magn Reson Imaging 2009; 27:23-37. [DOI: 10.1016/j.mri.2008.05.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2007] [Revised: 05/06/2008] [Accepted: 05/06/2008] [Indexed: 01/02/2023]
|
33
|
Andreisek G, Froehlich JM, Hodler J, Weishaupt D, Beutler V, Pfirrmann CWA, Boesch C, Nanz D. Direct MR arthrography at 1.5 and 3.0 T: signal dependence on gadolinium and iodine concentrations--phantom study. Radiology 2008; 247:706-16. [PMID: 18403628 DOI: 10.1148/radiol.2473071013] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To prospectively quantify in vitro the influence of gadopentetate dimeglumine and ioversol on the magnetic resonance (MR) imaging signal observed with a variety of musculoskeletal pulse sequences to predict optimum gadolinium concentrations for direct MR arthrography at 1.5 and 3.0 T. MATERIALS AND METHODS In an in vitro study, T1 and T2 relaxation times of three dilution series of gadopentetate dimeglumine (concentration, 0-20.0 mmol gadolinium per liter) at ioversol concentrations with iodine concentration of 0, 236.4, and 1182 mmol iodine per liter (corresponding to 0, 30, and 150 mg of iodine per milliliter) were measured at 1.5 and 3.0 T. The relaxation rate dependence on concentrations of gadolinium and iodine was analytically modeled, and continuous profiles of signal versus gadolinium concentration were calculated for 10 pulse sequences used in current musculoskeletal imaging. After fitting to experimental discrete profiles, maximum signal-to-noise ratio (SNR), gadolinium concentration with maximum SNR, and range of gadolinium concentration with 90% of maximum SNR were derived. The overall influence of field strength and iodine concentration on these parameters was assessed by using t tests. The deviation of simulated from experimental signal-response profiles was assessed with the autocorrelation of the residuals. RESULTS The model reproduced relaxation rates of 0.37-38.24 sec(-1), with a mean error of 4.5%. Calculated SNR profiles matched the discrete experimental profiles, with autocorrelation of the residuals divided by the mean of less than 5.0. Admixture of ioversol consistently reduced T1 and T2, narrowed optimum gadolinium concentration ranges (P = .004-.006), and reduced maximum SNR (P < .001 to not significant). Optimum gadolinium concentration was 0.7-3.4 mmol/L at both field strengths. At 3.0 T, maximum SNR was up to 75% higher than at 1.5 T. CONCLUSION Admixture of ioversol to gadopentetate dimeglumine solutions results in a consistent additional relaxation enhancement, which can be analytically modeled to allow a near-quantitative a priori optimized match of contrast media concentrations and imaging protocol for a broad variety of pulse sequences.
Collapse
Affiliation(s)
- Gustav Andreisek
- Institute for Diagnostic Radiology and Department of Medical Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland.
| | | | | | | | | | | | | | | |
Collapse
|
34
|
Duc SR, Pfirrmann CWA, Schmid MR, Zanetti M, Koch PP, Kalberer F, Hodler J. Articular Cartilage Defects Detected with 3D Water-Excitation True FISP: Prospective Comparison with Sequences Commonly Used for Knee Imaging. Radiology 2007; 245:216-23. [PMID: 17717327 DOI: 10.1148/radiol.2451060990] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To prospectively compare the accuracy of three-dimensional (3D) water-excitation (WE) true fast imaging with steady-state precession (FISP) in the diagnosis of articular cartilage defects with that of sequences commonly used to image the knee, with arthroscopy or surgery as the reference standard. MATERIALS AND METHODS This study protocol was institutional review board approved. Written informed consent was obtained from all patients. Thirty knees in 29 patients (mean age, 56 years; range, 18-86 years) were prospectively evaluated by using sagittal 3D WE true FISP with two section thicknesses (1.7 mm [true FISPthin] and 3.0 mm [true FISPthick]), two-dimensional (2D) intermediate-weighted spin-echo with fat saturation, 2D fast short inversion time inversion-recovery, 3D WE double-echo steady-state, and 3D fat-saturated fast low-angle shot sequences. Cartilage defects were graded on magnetic resonance images and during surgery with a modified Noyes scoring system. Contrast-to-noise ratio (CNR) and CNR efficiency were calculated. Sensitivity, specificity, and accuracy were assessed. Interobserver agreement was determined with kappa statistics, and quantitative results were evaluated with the Wilcoxon signed rank test. RESULTS The performance of 3D WE true FISPthick (sensitivity, specificity, and accuracy, respectively, were 52%, 93%, and 71% for reader 1 and 65%, 88%, and 76% for reader 2) and 3D WE true FISPthin (sensitivity, specificity, and accuracy, respectively, were 58%, 94%, and 75% for reader 1 and 63%, 80%, and 71% for reader 2) sequences was no different than that of other sequences in the detection of circumscribed defects. Three-dimensional WE true FISP sequences had a significantly (P<.0033) higher CNR and CNR efficiency between cartilage and fluid than the corresponding sequences with the same section thickness. CONCLUSION Three-dimensional WE true FISP enables high contrast between joint fluid and articular cartilage and a diagnostic performance that is comparable with that of standard sequences.
Collapse
Affiliation(s)
- Sylvain R Duc
- Department of Radiology, University Hospital, Balgrist, Forchstrasse 340, CH-8008 Zurich, Switzerland.
| | | | | | | | | | | | | |
Collapse
|
35
|
Duc SR, Koch P, Schmid MR, Horger W, Hodler J, Pfirrmann CWA. Diagnosis of articular cartilage abnormalities of the knee: prospective clinical evaluation of a 3D water-excitation true FISP sequence. Radiology 2007; 243:475-82. [PMID: 17400759 DOI: 10.1148/radiol.2432060274] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE To prospectively evaluate the accuracy of three-dimensional (3D) water-excitation true fast imaging with steady-state precession (FISP) in the assessment of cartilage abnormalities of the knee, by using surgery as the reference standard. MATERIALS AND METHODS The study was approved by the hospital institutional review board. Written informed consent was obtained from all patients. Twenty-nine patients (30 knees) with a mean age of 56 years (range, 18-86 years) were prospectively evaluated with a sagittal 3D true FISP magnetic resonance (MR) sequence. The mean interval between MR imaging and surgery was 1 day (range, 0-9 days). During surgery, the articular surfaces of the knee were evaluated by using a modified Noyes score. The MR images were evaluated by two blinded readers on two separate occasions. Diagnostic performance was evaluated by setting the cutoff for abnormality between grade 1 (intact cartilage surface) and grade 2 (cartilage defects). Statistical methods used included calculation of sensitivity, specificity, and accuracy, with 95% confidence intervals (Wilson score method) and calculation of kappa values with standard errors. RESULTS Overall sensitivity, specificity, and accuracy for the two readers and the two evaluations ranged from 56% to 66%, 78% to 93%, and 71% to 75%, respectively. Interobserver agreement was substantial for both the first (kappa = 0.73) and the second (kappa = 0.65) evaluation. Intraobserver agreement was almost perfect (kappa = 0.84) for reader 1 and moderate (kappa = 0.60) for reader 2. CONCLUSION The 3D water-excitation true FISP MR sequence allows assessment of the articular cartilage of the knee with moderate-to-high specificity and low-to-moderate sensitivity.
Collapse
Affiliation(s)
- Sylvain R Duc
- Department of Radiology, University Hospital, Balgrist, Forchstrasse 340, CH-8008 Zurich, Switzerland
| | | | | | | | | | | |
Collapse
|
36
|
Affiliation(s)
- Timothy J Mosher
- Department of Radiology, MC H066, Pennsylvania State University Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033, USA.
| |
Collapse
|
37
|
Leow AD, Klunder AD, Jack CR, Toga AW, Dale AM, Bernstein MA, Britson PJ, Gunter JL, Ward CP, Whitwell JL, Borowski BJ, Fleisher AS, Fox NC, Harvey D, Kornak J, Schuff N, Studholme C, Alexander GE, Weiner MW, Thompson PM. Longitudinal stability of MRI for mapping brain change using tensor-based morphometry. Neuroimage 2006; 31:627-40. [PMID: 16480900 PMCID: PMC1941663 DOI: 10.1016/j.neuroimage.2005.12.013] [Citation(s) in RCA: 179] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2005] [Revised: 10/31/2005] [Accepted: 12/09/2005] [Indexed: 11/21/2022] Open
Abstract
Measures of brain change can be computed from sequential MRI scans, providing valuable information on disease progression, e.g., for patient monitoring and drug trials. Tensor-based morphometry (TBM) creates maps of these brain changes, visualizing the 3D profile and rates of tissue growth or atrophy, but its sensitivity depends on the contrast and geometric stability of the images. As part of the Alzheimer's Disease Neuroimaging Initiative (ADNI), 17 normal elderly subjects were scanned twice (at a 2-week interval) with several 3D 1.5 T MRI pulse sequences: high and low flip angle SPGR/FLASH (from which Synthetic T1 images were generated), MP-RAGE, IR-SPGR (N = 10) and MEDIC (N = 7) scans. For each subject and scan type, a 3D deformation map aligned baseline and follow-up scans, computed with a nonlinear, inverse-consistent elastic registration algorithm. Voxelwise statistics, in ICBM stereotaxic space, visualized the profile of mean absolute change and its cross-subject variance; these maps were then compared using permutation testing. Image stability depended on: (1) the pulse sequence; (2) the transmit/receive coil type (birdcage versus phased array); (3) spatial distortion corrections (using MEDIC sequence information); (4) B1-field intensity inhomogeneity correction (using N3). SPGR/FLASH images acquired using a birdcage coil had least overall deviation. N3 correction reduced coil type and pulse sequence differences and improved scan reproducibility, except for Synthetic T1 images (which were intrinsically corrected for B1-inhomogeneity). No strong evidence favored B0 correction. Although SPGR/FLASH images showed least deviation here, pulse sequence selection for the ADNI project was based on multiple additional image analyses, to be reported elsewhere.
Collapse
Affiliation(s)
- Alex D. Leow
- Laboratory of Neuro Imaging, Brain Mapping Division, Department of Neurology and Semel Institute of Neuroscience, UCLA School of Medicine, 635 Charles E. Young Drive South, Suite 225E, Los Angeles, CA 90095-7332, USA
| | - Andrea D. Klunder
- Laboratory of Neuro Imaging, Brain Mapping Division, Department of Neurology and Semel Institute of Neuroscience, UCLA School of Medicine, 635 Charles E. Young Drive South, Suite 225E, Los Angeles, CA 90095-7332, USA
| | | | - Arthur W. Toga
- Laboratory of Neuro Imaging, Brain Mapping Division, Department of Neurology and Semel Institute of Neuroscience, UCLA School of Medicine, 635 Charles E. Young Drive South, Suite 225E, Los Angeles, CA 90095-7332, USA
| | - Anders M. Dale
- Department of Neurosciences, U C San Diego, La Jolla, CA 92093, USA
- Department Psychiatry and Radiology, U C San Diego, La Jolla, CA 92093, USA
| | | | | | | | | | | | | | - Adam S. Fleisher
- Department of Neurosciences, U C San Diego, La Jolla, CA 92093, USA
| | - Nick C. Fox
- Institute of Neurology, University College London, UK
| | - Danielle Harvey
- Department of Public Health Sciences, UC Davis School of Medicine, Davis, CA 95616, USA
| | - John Kornak
- Department of Radiology and Department of Epidemiology and Biostatistics, UC San Francisco, San Francisco, C A 94143, USA
| | - Norbert Schuff
- Department of Radiology, U C San Francisco, San Francisco, C A 94143, USA
| | - Colin Studholme
- Department of Radiology, U C San Francisco, San Francisco, C A 94143, USA
| | - Gene E. Alexander
- Department of Psychology, Arizona State University, Tempe, AZ 85287, USA
| | - Michael W. Weiner
- Department of Radiology, U C San Francisco, San Francisco, C A 94143, USA
- Department Medicine and Psychiatry, U C San Francisco, San Francisco, C A 94143, USA
| | - Paul M. Thompson
- Laboratory of Neuro Imaging, Brain Mapping Division, Department of Neurology and Semel Institute of Neuroscience, UCLA School of Medicine, 635 Charles E. Young Drive South, Suite 225E, Los Angeles, CA 90095-7332, USA
| |
Collapse
|
38
|
Mosher TJ. Musculoskeletal Imaging at 3T: Current Techniques and Future Applications. Magn Reson Imaging Clin N Am 2006; 14:63-76. [PMID: 16530635 DOI: 10.1016/j.mric.2005.12.002] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
MSK MR imaging applications are making the transition rapidly from 1.5T to 3T. Initial experience in the knee suggests that the higher SNR provides technical improvement in routine clinical imaging with the potential for greater accuracy in the diagnosis of articular cartilage injury. Similarly, initial experience with 3T MR imaging in the evaluation of the hip and small joints of the hand and wrist has been positive. In other joints, clinical development has been limited by the lack of availability of dedicated surface coils, and sensitivity of 3TMR imaging to artifact. The clinical impact of this technology remains uncertain because no published controlled clinical trial has evaluated the impact of 3T MR imaging on diagnostic outcomes. In addition to clinical application, 3T MR imaging has an important role for furthering translational research in MSK diseases through the development of new molecular and functional MR imaging techniques.
Collapse
Affiliation(s)
- Timothy J Mosher
- Department of Radiology, Penn State Milton S. Hershey Medical Center, Hershey, PA 17033, USA.
| |
Collapse
|