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Zhang L, Mai W, Mo X, Zhang R, Zhang D, Zhong X, Zhao S, Shi C. Quantitative evaluation of meniscus injury using synthetic magnetic resonance imaging. BMC Musculoskelet Disord 2024; 25:292. [PMID: 38622682 PMCID: PMC11020173 DOI: 10.1186/s12891-024-07375-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 03/21/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Magnetic resonance imaging (MRI) can diagnose meniscal lesions anatomically, while quantitative MRI can reflect the changes of meniscal histology and biochemical structure. Our study aims to explore the association between the measurement values obtained from synthetic magnetic resonance imaging (SyMRI) and Stoller grades. Additionally, we aim to assess the diagnostic accuracy of SyMRI in determining the extent of meniscus injury. This potential accuracy could contribute to minimizing unnecessary invasive examinations and providing guidance for clinical treatment. METHODS Total of 60 (n=60) patients requiring knee arthroscopic surgery and 20 (n=20) healthy subjects were collected from July 2022 to November 2022. All subjects underwent conventional MRI and SyMRI. Manual measurements of the T1, T2 and proton density (PD) values were conducted for both normal menisci and the most severely affected position of injured menisci. These measurements corresponded to the Stoller grade of meniscus injuries observed in the conventional MRI. All patients and healthy subjects were divided into normal group, degeneration group and torn group according to the Stoller grade on conventional MRI. One-way analysis of variance (ANOVA) was employed to compare the T1, T2 and PD values of the meniscus among 3 groups. The accuracy of SyMRI in diagnosing meniscus injury was assessed by comparing the findings with arthroscopic observations. The diagnostic efficiency of meniscus degeneration and tear between conventional MRI and SyMRI were analyzed using McNemar test. Furthermore, a receiver operating characteristic curve (ROC curve) was constructed and the area under the curve (AUC) was utilized for evaluation. RESULTS According to the measurements of SyMRI, there was no statistical difference of T1 value or PD value measured by SyMRI among the normal group, degeneration group and torn group, while the difference of T2 value was statistically significant among 3 groups (P=0.001). The arthroscopic findings showed that 11 patients were meniscal degeneration and 49 patients were meniscal tears. The arthroscopic findings were used as the gold standard, and the difference of T1 and PD values among the 3 groups was not statistically significant, while the difference of T2 values (32.81±2.51 of normal group, 44.85±3.98 of degeneration group and 54.42±3.82 of torn group) was statistically significant (P=0.001). When the threshold of T2 value was 51.67 (ms), the maximum Yoden index was 0.787 and the AUC value was 0.934. CONCLUSIONS The measurement values derived from SyMRI could reflect the Stoller grade, illustrating that SyMRI has good consistency with conventional MRI. Moreover, the notable consistency observed between SyMRI and arthroscopy suggests a potential role for SyMRI in guiding clinical diagnoses.
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Affiliation(s)
- Lingtao Zhang
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, No. 613 West Huangpu Avenue, Tianhe District, Guangzhou, 510630, China
| | - Wenfeng Mai
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, No. 613 West Huangpu Avenue, Tianhe District, Guangzhou, 510630, China
| | - Xukai Mo
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, No. 613 West Huangpu Avenue, Tianhe District, Guangzhou, 510630, China
| | - Ruifen Zhang
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, No. 613 West Huangpu Avenue, Tianhe District, Guangzhou, 510630, China
| | - Dong Zhang
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, No. 613 West Huangpu Avenue, Tianhe District, Guangzhou, 510630, China
| | - Xing Zhong
- UItrasonic Department, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Shuangquan Zhao
- Medical Imaging Center, The Second Affiliated Hospital of Shenzhen University, No. 118 Longjing 2nd Road, Bao'an District, Shenzhen, 518101, China.
| | - Changzheng Shi
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, No. 613 West Huangpu Avenue, Tianhe District, Guangzhou, 510630, China.
- Subingtian center for speed research and training, Guangdong Key Laboratory of speed capability research, School of physical education, Jinan University, Shenzhen, China.
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Kamishima T. Editorial for "Effects of T 1p Characteristics of Load-Bearing Hip Cartilage on Bilateral Knee Patellar Cartilage Subregions: Subjects with None to Moderate Radiographic Hip Osteoarthritis". J Magn Reson Imaging 2023. [PMID: 37811604 DOI: 10.1002/jmri.29050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 10/10/2023] Open
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Bhattacharjee R, Thahakoya R, Luitjens J, Han M, Roach KE, Jiang F, Souza RB, Pedoia V, Majumdar S. Effects of T 1p Characteristics of Load-Bearing Hip Cartilage on Bilateral Knee Patellar Cartilage Subregions: Subjects With None to Moderate Radiographic Hip Osteoarthritis. J Magn Reson Imaging 2023. [PMID: 37702305 DOI: 10.1002/jmri.29009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND The polyarticular nature of Osteoarthritis (OA) tends to manifest in multi-joints. Associations between cartilage health in connected joints can help identify early degeneration and offer the potential for biomechanical intervention. Such associations between hip and knee cartilages remain understudied. PURPOSE To investigate T1p associations between hip-femoral and acetabular-cartilage subregions with Intra-limb and Inter-limb patellar cartilage; whole and deep-medial (DM), deep-lateral (DL), superficial-medial (SM), superficial-lateral (SL) subregions. STUDY TYPE Prospective. SUBJECTS Twenty-eight subjects (age 55.1 ± 12.8 years, 15 females) with none-to-moderate hip-OA while no radiographic knee-OA. FIELD STRENGTH/SEQUENCE 3-T, bilateral hip, and knee: 3D-proton-density-fat-saturated (PDFS) Cube and Magnetization-Prepared-Angle-Modulated-Partitioned-k-Space-Spoiled-Gradient-Echo-Snapshots (MAPSS). ASSESSMENT Ages of subjects were categorized into Group-1 (≤40), Group-2 (41-50), Group-3 (51-60), Group-4 (61-70), Group-5 (71-80), and Group-6 (≥81). Hip T1p maps, co-registered to Cube, underwent an atlas-based algorithm to quantify femoral and acetabular subregional (R2 -R7 ) cartilage T1p . For knee Cube, a combination of V-Net architectures was used to segment the patellar cartilage and subregions (DM, DL, SM, SL). T1p values were computed from co-registered MAPSS. STATISTICAL TESTS For Intra-and-Inter-limb, 5 optimum predictors out of 13 (Hip subregional T1p , age group, gender) were selected by univariate linear-regression, to predict outcome (patellar T1p ). The top five predictors were stepwise added to six linear mixed-effect (LME) models. In all LME models, we assume the data come from the same subject sharing the same random effect. The best-performing models (LME-modelbest ) selected via ANOVA, were tested with DM, SM, SL, and DL subregional-mean T1p . LME assumptions were verified (normality of residuals, random-effects, and posterior-predictive-checks). RESULTS LME-modelbest (Intra-limb) had significant negative and positive fixed-effects of femoral-R5 and acetabular-R2 T1p , respectively (conditional-R2 = 0.581). LME-modelbest (Inter-limb) had significant positive fixed-effects of femoral-R3 T1p (conditional-R2 = 0.26). DATA CONCLUSION Significant positive and negative T1p associations were identified between load-bearing hip cartilage-subregions vs. ipsilateral and contralateral patellar cartilages respectively. The effects were localized on medial subregions of Inter-limb, in particular. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Rupsa Bhattacharjee
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Rafeek Thahakoya
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Johanna Luitjens
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Misung Han
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Koren E Roach
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Fei Jiang
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Richard B Souza
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco, California, USA
| | - Valentina Pedoia
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Sharmila Majumdar
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
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Kim BR, Yoo HJ, Chae HD, Hong SH, Choi JY. Fat-suppressed T2 mapping of human knee femoral articular cartilage: comparison with conventional T2 mapping. BMC Musculoskelet Disord 2021; 22:662. [PMID: 34372797 PMCID: PMC8351355 DOI: 10.1186/s12891-021-04542-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 07/27/2021] [Indexed: 11/18/2022] Open
Abstract
Background There is paucity of studies applying fat suppressed (FS) technique to T2 mapping to overcome chemical shift artifacts. The purpose of the study is to difference between FS T2 and conventional T2 mapping and reproducibility of FS T2 mapping in the femoral articular cartilage. Methods Eighteen patients who had normal-looking femoral cartilage and underwent knee MRI with conventional T2 and FS T2 mapping were included. T2 values of each mapping were measured by two readers independently from nine regions in the medial femoral condyle (MFC) and lateral femoral condyle (LFC). Each anatomical region was divided by lines at ± 10°, 30°, 50°, 70°, 90°, and 110°. Comparisons of T2 values between conventional and FS T2 mapping were statistically analyzed. The T2 values between FS and conventional T2 mapping in the anterior, central and posterior femoral condyles were compared. Results The overall femoral condyle T2 values from the FS T2 map were significantly lower than those from the conventional T2 map (48.5ms vs. 51.0ms, p < 0.001). The differences in the T2 values between the two maps were significantly different among the three divisions of the LFC (p = 0.009) and MFC (p = 0.031). The intra-class correlation coefficients indicated higher agreement in the FS T2 map than in the conventional T2 map (0.943 vs. 0.872). Conclusions The T2 values of knee femoral cartilage are significantly lower on FS T2 mapping than on conventional T2 mapping. FS T2 mapping is a more reproducible method for evaluating knee femoral cartilage.
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Affiliation(s)
- Bo Ram Kim
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Korea
| | - Hye Jin Yoo
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080, Seoul, Korea
| | - Hee-Dong Chae
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080, Seoul, Korea
| | - Sung Hwan Hong
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080, Seoul, Korea
| | - Ja-Young Choi
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 03080, Seoul, Korea.
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Horiuchi S, Yu HJ, Luk A, Rudd A, Ton J, Kuoy E, Russell JA, Sharp K, Yoshioka H. T1rho and T2 mapping of ankle cartilage of female and male ballet dancers. Acta Radiol 2020; 61:1365-1376. [PMID: 32028774 DOI: 10.1177/0284185120902381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Since ballet dancers begin their training before skeletal maturity, accurate and non-invasive identification of cartilage diseases is clinically important. Angle-dependent analysis of T1rho and T2 sequences can be useful for quantification of the composition of cartilage. PURPOSE To investigate the angle-dependent T1rho and T2 profiles of ankle cartilage in non-dancers and dancers. MATERIAL AND METHODS Ten female non-dancers, ten female dancers, and 9 male dancers were evaluated using T1rho and T2 mapping sequences. Manual segmentation of talar and tibial cartilage on these images was performed by two radiologists. Inter- and intra-rater reliabilities were calculated using intraclass correlation coefficients (ICCs) and Bland-Altman analysis. Mean thickness and volume of cartilage were estimated. Angle-dependent relaxation time profiles of talar and tibial cartilage were created. RESULTS ICCs of the number of segmented pixels were poor to excellent. Bland-Altman plots indicated that differences were associated with segment sizes. Segmented cartilage on T1rho demonstrated larger thickness and volume than those on T2 in all populations. Male dancers showed larger cartilage thickness and volume than female dancers and non-dancers. Each cartilage demonstrated angular-dependent T1rho and T2 profiles. Minimal T1rho and T2 values were observed at approximately 180°-200°; higher values were seen at the angle closer to the magic angle. Minimal T2 value of talar cartilage of dancers was larger than that of non-dancers. CONCLUSION In this small cohort study, regional and sex variations of ankle cartilage T1rho and T2 values in dancers and non-dancers were demonstrated using an angle-dependent approach.
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Affiliation(s)
- Saya Horiuchi
- Department of Radiological Sciences, University of California, Irvine, CA, USA
| | - Hon J Yu
- Department of Radiological Sciences, University of California, Irvine, CA, USA
| | - Alex Luk
- Department of Radiological Sciences, University of California, Irvine, CA, USA
| | - Adam Rudd
- Department of Radiological Sciences, University of California, Irvine, CA, USA
| | - Jimmy Ton
- Department of Radiological Sciences, University of California, Irvine, CA, USA
| | - Edward Kuoy
- Department of Radiological Sciences, University of California, Irvine, CA, USA
| | - Jeffrey A Russell
- Science and Health in Artistic Performance, Ohio University, Athens, OH, USA
| | - Kelli Sharp
- Department of Dance, The Claire Trevor School of the Arts, University of California, Irvine, CA, USA
| | - Hiroshi Yoshioka
- Department of Radiological Sciences, University of California, Irvine, CA, USA
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Abstract
OBJECTIVE. For many years, MRI of the musculoskeletal system has relied mostly on conventional sequences with qualitative analysis. More recently, using quantitative MRI applications to complement qualitative imaging has gained increasing interest in the MRI community, providing more detailed physiologic or anatomic information. CONCLUSION. In this article, we review the current state of quantitative MRI, technical and software advances, and the most relevant clinical and research musculoskeletal applications of quantitative MRI.
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Han X, Hong G, Chen L, Zhao M, Guo Y, Xu L, Wu M, Leng X, Sun P. T1
ρ and T2
mapping for the determination of articular cartilage denaturalization with osteonecrosis of the femoral head: A prospective controlled trial. J Magn Reson Imaging 2018; 49:760-767. [PMID: 30461119 DOI: 10.1002/jmri.26267] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 07/06/2018] [Accepted: 07/06/2018] [Indexed: 01/14/2023] Open
Affiliation(s)
- Xiaorui Han
- Department of Radiography; Guangzhou First People's Hospital, Second Affiliated Hospital of South China University of Technology; Guangzhou P.R. China
| | - Guoju Hong
- Department of Surgery; University of Alberta; Edmonton AB Canada
| | - Leilei Chen
- Orthopedic Department; First Affiliated Hospital of Guangzhou University of Chinese Medicine; Guangzhou P.R. China
| | - Man Zhao
- Department of Radiography; First Affiliated Hospital of Clinical Medicine of Guangdong Pharmaceutical University; Guangzhou P.R. China
| | - Yuan Guo
- Department of Radiography; Guangzhou First People's Hospital, Second Affiliated Hospital of South China University of Technology; Guangzhou P.R. China
| | - Ling Xu
- Department of Ultrasound; Guangdong Women and Children Hospital; Guangzhou P.R. China
| | - Mei Wu
- Department of Radiography; Guangzhou First People's Hospital, Second Affiliated Hospital of South China University of Technology; Guangzhou P.R. China
| | - Xiaoming Leng
- Universal Medical Imaging Diagnostic Center; Guangzhou P.R. China
| | - Ping Sun
- Orthopedic Department; First Affiliated Hospital of Clinical Medicine of Guangdong Pharmaceutical University; Guangzhou P.R. China
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Abstract
Objective To evaluate the feasibility of synthetic magnetic resonance imaging (MRI) compared to conventional MRI for the diagnosis of internal derangements of the knee at 3T. Materials and Methods Following Institutional Review Board approval, image sets of conventional and synthetic MRI in 39 patients were included. Two musculoskeletal radiologists compared the image sets and qualitatively analyzed the images. Subjective image quality was assessed using a four-grade scale. Interobserver agreement and intersequence agreement between conventional and synthetic images for cartilage lesions, tears of the cruciate ligament, and tears of the meniscus were independently assessed using Kappa statistics. In patients who underwent arthroscopy (n = 8), the sensitivity, specificity, and accuracy for evaluated internal structures were calculated using arthroscopic findings as the gold standard. Results There was no statistically significant difference in image quality (p = 0.90). Interobserver agreement (κ = 0.649– 0.981) and intersequence agreement (κ = 0.794–0.938) were nearly perfect for all evaluated structures. The sensitivity, specificity, and accuracy for detecting cartilage lesions (sensitivity, 63.6% vs. 54.6–63.6%; specificity, 91.9% vs. 91.9%; accuracy, 83.3–85.4% vs. 83.3–85.4%) and tears of the cruciate ligament (sensitivity, specificity, accuracy, 100% vs. 100%) and meniscus (sensitivity, 50.0–62.5% vs. 62.5%; specificity, 100% vs. 87.5–100%; accuracy, 83.3–85.4% vs. 83.3–85.4%) were similar between the two MRI methods. Conclusion Conventional and synthetic MRI showed substantial to almost perfect degree of agreement for the assessment of internal derangement of knee joints. Synthetic MRI may be feasible in the diagnosis of internal derangements of the knee.
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Affiliation(s)
- Jisook Yi
- Department of Radiology, Research Institute of Radiological Science, YUHS-KRIBB Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Young Han Lee
- Department of Radiology, Research Institute of Radiological Science, YUHS-KRIBB Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Ho-Taek Song
- Department of Radiology, Research Institute of Radiological Science, YUHS-KRIBB Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Jin-Suck Suh
- Department of Radiology, Research Institute of Radiological Science, YUHS-KRIBB Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul 03722, Korea
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