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Zbýň Š, Ludwig KD, Watkins LE, Lagore RL, Nowacki A, Tóth F, Tompkins MA, Zhang L, Adriany G, Gold GE, Shea KG, Nagel AM, Carlson CS, Metzger GJ, Ellermann JM. Changes in tissue sodium concentration and sodium relaxation times during the maturation of human knee cartilage: Ex vivo 23 Na MRI study at 10.5 T. Magn Reson Med 2024; 91:1099-1114. [PMID: 37997011 PMCID: PMC10751033 DOI: 10.1002/mrm.29930] [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] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 11/25/2023]
Abstract
PURPOSE To evaluate the influence of skeletal maturation on sodium (23 Na) MRI relaxation parameters and the accuracy of tissue sodium concentration (TSC) quantification in human knee cartilage. METHODS Twelve pediatric knee specimens were imaged with whole-body 10.5 T MRI using a density-adapted 3D radial projection sequence to evaluate 23 Na parameters: B1 + , T1 , biexponentialT 2 * $$ {\mathrm{T}}_2^{\ast } $$ , and TSC. Water, collagen, and sulfated glycosaminoglycan (sGAG) content were calculated from osteochondral biopsies. The TSC was corrected for B1 + , relaxation, and water content. The literature-based TSC (TSCLB ) used previously published values for corrections, whereas the specimen-specific TSC (TSCSP ) used measurements from individual specimens. 23 Na parameters were evaluated in eight cartilage compartments segmented on proton images. Associations between 23 Na parameters, TSCLB - TSCSP difference, biochemical content, and age were determined. RESULTS From birth to 12 years, cartilage water content decreased by 18%; collagen increased by 59%; and sGAG decreased by 36% (all R2 ≥ 0.557). The shortT 2 * $$ {\mathrm{T}}_2^{\ast } $$ (T 2 * S $$ {{\mathrm{T}}_2^{\ast}}_{\mathrm{S}} $$ ) decreased by 72%, and the signal fraction relaxing withT 2 * S $$ {{\mathrm{T}}_2^{\ast}}_{\mathrm{S}} $$ (fT 2 * S $$ {{\mathrm{fT}}_2^{\ast}}_{\mathrm{S}} $$ ) increased by 55% during the first 5 years but remained relatively stable after that. TSCSP was significantly correlated with sGAG content from biopsies (R2 = 0.739). Depending on age, TSCLB showed higher or lower values than TSCSP . The TSCLB - TSCSP difference was significantly correlated withT 2 * S $$ {{\mathrm{T}}_2^{\ast}}_{\mathrm{S}} $$ (R2 = 0.850),fT 2 * S $$ {{\mathrm{fT}}_2^{\ast}}_{\mathrm{S}} $$ (R2 = 0.651), and water content (R2 = 0.738). CONCLUSION TSC and relaxation parameters measured with 23 Na MRI provide noninvasive information about changes in sGAG content and collagen matrix during cartilage maturation. Cartilage TSC quantification assuming fixed relaxation may be feasible in children older than 5 years.
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Affiliation(s)
- Štefan Zbýň
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN
- Department of Radiology, University of Minnesota, Minneapolis, MN
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH
| | - Kai D. Ludwig
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN
- Department of Radiology, University of Minnesota, Minneapolis, MN
| | - Lauren E. Watkins
- Department of Radiology, Department of Bioengineering, Stanford University, Palo Alto, CA
- Steadman Philippon Research Institute, Vail, CO
| | - Russell L. Lagore
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN
| | - Amanda Nowacki
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN
- University of Texas, Austin, TX
| | - Ferenc Tóth
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN
| | - Marc A. Tompkins
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN
| | - Lin Zhang
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Gregor Adriany
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN
| | - Garry E. Gold
- Department of Radiology, Department of Bioengineering, Stanford University, Palo Alto, CA
| | - Kevin G. Shea
- Lucile Packard Children’s Hospital, Stanford University School of Medicine, Palo Alto, CA
| | - Armin M. Nagel
- Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Cathy S. Carlson
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN
| | - Gregory J. Metzger
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN
| | - Jutta M. Ellermann
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN
- Department of Radiology, University of Minnesota, Minneapolis, MN
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Mostert JM, Dur NB, Li X, Ellermann JM, Hemke R, Hales L, Mazzoli V, Kogan F, Griffith JF, Oei EH, van der Heijden RA. Advanced Magnetic Resonance Imaging and Molecular Imaging of the Painful Knee. Semin Musculoskelet Radiol 2023; 27:618-631. [PMID: 37935208 PMCID: PMC10629992 DOI: 10.1055/s-0043-1775741] [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] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
Chronic knee pain is a common condition. Causes of knee pain include trauma, inflammation, and degeneration, but in many patients the pathophysiology remains unknown. Recent developments in advanced magnetic resonance imaging (MRI) techniques and molecular imaging facilitate more in-depth research focused on the pathophysiology of chronic musculoskeletal pain and more specifically inflammation. The forthcoming new insights can help develop better targeted treatment, and some imaging techniques may even serve as imaging biomarkers for predicting and assessing treatment response in the future. This review highlights the latest developments in perfusion MRI, diffusion MRI, and molecular imaging with positron emission tomography/MRI and their application in the painful knee. The primary focus is synovial inflammation, also known as synovitis. Bone perfusion and bone metabolism are also addressed.
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Affiliation(s)
- Jacob M. Mostert
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Niels B.J. Dur
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Orthopedics and Sports Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Xiufeng Li
- Department of Radiology, Center for Magnetic Resonance Research (CMRR), University of Minnesota, Minneapolis, Minnesota
| | - Jutta M. Ellermann
- Department of Radiology, Center for Magnetic Resonance Research (CMRR), University of Minnesota, Minneapolis, Minnesota
| | - Robert Hemke
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Laurel Hales
- Department of Radiology, Stanford University, Stanford, California
| | | | - Feliks Kogan
- Department of Radiology, Stanford University, Stanford, California
| | - James F. Griffith
- Department of Imaging and Interventional Radiology Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Edwin H.G. Oei
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Rianne A. van der Heijden
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin
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3
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Lin DJ, Schwier M, Geiger B, Raithel E, von Busch H, Fritz J, Kline M, Brooks M, Dunham K, Shukla M, Alaia EF, Samim M, Joshi V, Walter WR, Ellermann JM, Ilaslan H, Rubin D, Winalski CS, Recht MP. Deep Learning Diagnosis and Classification of Rotator Cuff Tears on Shoulder MRI. Invest Radiol 2023; 58:405-412. [PMID: 36728041 DOI: 10.1097/rli.0000000000000951] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Detection of rotator cuff tears, a common cause of shoulder disability, can be time-consuming and subject to reader variability. Deep learning (DL) has the potential to increase radiologist accuracy and consistency. PURPOSE The aim of this study was to develop a prototype DL model for detection and classification of rotator cuff tears on shoulder magnetic resonance imaging into no tear, partial-thickness tear, or full-thickness tear. MATERIALS AND METHODS This Health Insurance Portability and Accountability Act-compliant, institutional review board-approved study included a total of 11,925 noncontrast shoulder magnetic resonance imaging scans from 2 institutions, with 11,405 for development and 520 dedicated for final testing. A DL ensemble algorithm was developed that used 4 series as input from each examination: fluid-sensitive sequences in 3 planes and a sagittal oblique T1-weighted sequence. Radiology reports served as ground truth for training with categories of no tear, partial tear, or full-thickness tear. A multireader study was conducted for the test set ground truth, which was determined by the majority vote of 3 readers per case. The ensemble comprised 4 parallel 3D ResNet50 convolutional neural network architectures trained via transfer learning and then adapted to the targeted domain. The final tear-type prediction was determined as the class with the highest probability, after averaging the class probabilities of the 4 individual models. RESULTS The AUC overall for supraspinatus, infraspinatus, and subscapularis tendon tears was 0.93, 0.89, and 0.90, respectively. The model performed best for full-thickness supraspinatus, infraspinatus, and subscapularis tears with AUCs of 0.98, 0.99, and 0.95, respectively. Multisequence input demonstrated higher AUCs than single-sequence input for infraspinatus and subscapularis tendon tears, whereas coronal oblique fluid-sensitive and multisequence input showed similar AUCs for supraspinatus tendon tears. Model accuracy for tear types and overall accuracy were similar to that of the clinical readers. CONCLUSIONS Deep learning diagnosis of rotator cuff tears is feasible with excellent diagnostic performance, particularly for full-thickness tears, with model accuracy similar to subspecialty-trained musculoskeletal radiologists.
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Affiliation(s)
- Dana J Lin
- From the Department of Radiology, NYU Grossman School of Medicine, New York, NY
| | | | | | | | | | - Jan Fritz
- From the Department of Radiology, NYU Grossman School of Medicine, New York, NY
| | - Mitchell Kline
- From the Department of Radiology, NYU Grossman School of Medicine, New York, NY
| | - Michael Brooks
- From the Department of Radiology, NYU Grossman School of Medicine, New York, NY
| | - Kevin Dunham
- From the Department of Radiology, NYU Grossman School of Medicine, New York, NY
| | - Mehool Shukla
- From the Department of Radiology, NYU Grossman School of Medicine, New York, NY
| | - Erin F Alaia
- From the Department of Radiology, NYU Grossman School of Medicine, New York, NY
| | - Mohammad Samim
- From the Department of Radiology, NYU Grossman School of Medicine, New York, NY
| | - Vivek Joshi
- From the Department of Radiology, NYU Grossman School of Medicine, New York, NY
| | - William R Walter
- From the Department of Radiology, NYU Grossman School of Medicine, New York, NY
| | - Jutta M Ellermann
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN
| | | | | | | | - Michael P Recht
- From the Department of Radiology, NYU Grossman School of Medicine, New York, NY
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Armstrong AR, Zbýň Š, Kajabi AW, Metzger GJ, Ellermann JM, Carlson CS, Tóth F. Naturally occurring osteochondrosis latens lesions identified by quantitative and morphological 10.5 T MRI in pigs. J Orthop Res 2023; 41:663-673. [PMID: 35716161 PMCID: PMC9759621 DOI: 10.1002/jor.25401] [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: 12/18/2021] [Revised: 05/31/2022] [Accepted: 06/15/2022] [Indexed: 02/04/2023]
Abstract
Juvenile osteochondritis dissecans (JOCD) is a pediatric orthopedic disorder that involves the articular-epiphyseal cartilage complex and underlying bone. Clinical disease is often characterized by the presence of radiographically apparent osteochondral flaps and fragments. The existence of early JOCD lesions (osteochondrosis latens [OCL] and osteochondrosis manifesta [OCM]) that precede the development of osteochondral flaps and fragments is also well recognized. However, identification of naturally occurring OCL lesions (confined to cartilage) using noninvasive imaging techniques has not yet been accomplished. We hypothesized that 10.5 T magnetic resonance imaging (MRI) can identify naturally occurring OCL lesions at predilection sites in intact joints of juvenile pigs. Unilateral elbows and knees (stifles) were harvested from three pigs aged 4, 8, and 12 weeks, and scanned in a 10.5 T MRI to obtain morphological 3D DESS images, and quantitative T2 and T1ρ relaxation time maps. Areas with increased T2 and T1ρ relaxation times in the articular-epiphyseal cartilage complex were identified in 1/3 distal femora and 3/3 distal humeri and were considered suspicious for OCL or OCM lesions. Histological assessment confirmed the presence of OCL or OCM lesions at each of these sites and failed to identify additional lesions. Histological findings included necrotic vascular profiles associated with areas of chondronecrosis either confined to the epiphyseal cartilage (OCL, 4- and 8-week-old specimens) or resulting in a delay in endochondral ossification (OCM, 12-week-old specimen). Future studies with clinical MR systems (≤7 T) are needed to determine whether these MRI methods are suitable for the in vivo diagnosis of early JOCD lesions in humans.
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Affiliation(s)
- Alexandra R. Armstrong
- Department of Veterinary Clinical Sciences, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Štefan Zbýň
- Center for Magnetic Resonance Research, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Abdul Wahed Kajabi
- Center for Magnetic Resonance Research, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Gregory J. Metzger
- Center for Magnetic Resonance Research, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Jutta M. Ellermann
- Center for Magnetic Resonance Research, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Cathy S. Carlson
- Department of Veterinary Clinical Sciences, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Ferenc Tóth
- Department of Veterinary Clinical Sciences, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
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Kajabi AW, Zbýň Š, Johnson CP, Tompkins MA, Nelson BJ, Takahashi T, Shea KG, Marette S, Carlson CS, Ellermann JM. Longitudinal 3T MRI T 2 * mapping of Juvenile osteochondritis dissecans (JOCD) lesions differentiates operative from non-operative patients-Pilot study. J Orthop Res 2023; 41:150-160. [PMID: 35430743 PMCID: PMC9573934 DOI: 10.1002/jor.25343] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 01/21/2022] [Revised: 03/21/2022] [Accepted: 04/13/2022] [Indexed: 02/04/2023]
Abstract
Juvenile osteochondritis dissecans (JOCD) is an orthopedic joint disorder of children and adolescents that can lead to premature osteoarthritis. Thirteen patients (mean age: 12.3 years, 4 females), 15 JOCD-affected and five contralateral healthy knees, that had a baseline and a follow-up magnetic resonance imaging (MRI) (mean interval of 8.9 months) and were treated nonoperatively during this interval were included. Retrospectively, patients were assigned to operative or nonoperative groups based on their electronic medical records. Volumetric mean T2 * values were calculated within regions of interest (progeny lesion, interface, parent bone) and region matched control bone in healthy contralateral knees and condyles. The normalized percentage difference of T2 * between baseline and follow up MRI in nonoperative patients significantly increased in progeny lesion (-47.8%, p < 0.001), parent bone (-13.9%, p < 0.001), and interface (-32.3%, p = 0.011), whereas the differences in operative patients were nonsignificant and below 11%. In nonoperative patients, the progeny lesion (p < 0.001) and interface T2 * values (p = 0.012) were significantly higher than control bone T2 * at baseline, but not at follow-up (p = 0.219, p = 1.000, respectively). In operative patients, the progeny lesion and interface T2 * values remained significantly elevated compared to the control bone both at baseline (p < 0.001, p < 0.001) and follow-up (p < 0.001, p < 0.001), respectively. Clinical Significance: Longitudinal T2 * mapping differentiated nonhealing from healing JOCD lesions following initial nonoperative treatment, which may assist in prognosis and improve the ability of surgeons to make recommendations regarding operative versus nonoperative treatment.
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Affiliation(s)
- Abdul Wahed Kajabi
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
- Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | - Štefan Zbýň
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
- Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | - Casey P. Johnson
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN, USA
| | - Marc A. Tompkins
- Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Bradley J. Nelson
- Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Takashi Takahashi
- Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | | | - Shelly Marette
- Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | - Cathy S. Carlson
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN, USA
| | - Jutta M. Ellermann
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
- Department of Radiology, University of Minnesota, Minneapolis, MN, USA
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6
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Zbýň Š, Kajabi AW, Nouraee CM, Ludwig KD, Johnson CP, Tompkins MA, Nelson BJ, Zhang L, Moeller S, Marette S, Metzger GJ, Carlson CS, Ellermann JM. Evaluation of lesion and overlying articular cartilage in patients with juvenile osteochondritis dissecans of the knee using quantitative diffusion MRI. J Orthop Res 2022. [PMID: 36484124 DOI: 10.1002/jor.25505] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 11/06/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022]
Abstract
Current clinical MRI of patients with juvenile osteochondritis dissecans (JOCD) is limited by the low reproducibility of lesion instability evaluation and inability to predict which lesions will heal after nonoperative treatment and which will later require surgery. The aim of this study is to verify the ability of apparent diffusion coefficient (ADC) to detect differences in lesion microstructure between different JOCD stages, treatment groups, and healthy, unaffected contralateral knees. Pediatric patients with JOCD received quantitative diffusion MRI between January 2016 and September 2020 in this prospective research study. A disease stage (I-IV) and stability of each JOCD lesion was evaluated. ADCs were calculated in progeny lesion, interface, parent bone, cartilage overlying lesion, control bone, and control cartilage regions. ADC differences were evaluated using linear mixed models with Bonferroni correction. Evaluated were 30 patients (mean age, 13 years; 21 males), with 40 JOCD-affected and 12 healthy knees. Nine patients received surgical treatment after MRI. Negative Spearman rank correlations were found between ADCs and JOCD stage in the progeny lesion (ρ = -0.572; p < 0.001), interface (ρ = -0.324; p = 0.041), and parent bone (ρ = -0.610; p < 0.001), demonstrating the sensitivity of ADC to microstructural differences in lesions at different JOCD stages. We observed a significant increase in the interface ADCs (p = 0.007) between operative (mean [95% CI] = 1.79 [1.56-2.01] × 10-3 mm2 /s) and nonoperative group (1.27 [0.98-1.57] × 10-3 mm2 /s). Quantitative diffusion MRI detects microstructural differences in lesions at different stages of JOCD progression towards healing and reveals differences between patients assigned for operative versus nonoperative treatment.
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Affiliation(s)
- Štefan Zbýň
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Abdul Wahed Kajabi
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Cyrus M Nouraee
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA
| | - Kai D Ludwig
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Casey P Johnson
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, Minnesota, USA
| | - Marc A Tompkins
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA.,TRIA Orthopedic Center, Minneapolis, Minnesota, USA.,Gillette Children's Specialty Healthcare, St. Paul, Minnesota, USA
| | - Bradley J Nelson
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA.,TRIA Orthopedic Center, Minneapolis, Minnesota, USA
| | - Lin Zhang
- Division of Biostatistics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Steen Moeller
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA
| | - Shelly Marette
- Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Gregory J Metzger
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA
| | - Cathy S Carlson
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, Minnesota, USA
| | - Jutta M Ellermann
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
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Armstrong AR, Bhave S, Buko EO, Chase KL, Tóth F, Carlson CS, Ellermann JM, Kim HKW, Johnson CP. Quantitative T2 and T1ρ mapping are sensitive to ischemic injury to the epiphyseal cartilage in an in vivo piglet model of Legg-Calvé-Perthes disease. Osteoarthritis Cartilage 2022; 30:1244-1253. [PMID: 35644462 PMCID: PMC9378508 DOI: 10.1016/j.joca.2022.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 11/23/2021] [Revised: 04/27/2022] [Accepted: 05/17/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine if the quantitative MRI techniques T2 and T1ρ mapping are sensitive to ischemic injury to epiphyseal cartilage in vivo in a piglet model of Legg-Calvé-Perthes disease using a clinical 3T MRI scanner. We hypothesized that T2 and T1ρ relaxation times would be increased in the epiphyseal cartilage of operated vs contralateral-control femoral heads 1 week following onset of ischemia. DESIGN Unilateral femoral head ischemia was surgically induced in eight piglets. Piglets were imaged 1 week post-operatively in vivo at 3T MRI using a magnetization-prepared 3D fast spin echo sequence for T2 and T1ρ mapping and a 3D gradient echo sequence for cartilage segmentation. Ischemia was confirmed in all piglets using gadolinium contrast-enhanced MRI. Median T2 and T1ρ relaxation times were measured in the epiphyseal cartilage of the ischemic and control femoral heads and compared using paired t-tests. Histological assessment was performed on a subset of five piglets. RESULTS T2 and T1ρ relaxation times were significantly increased in the epiphyseal cartilage of the operated vs control femoral heads (ΔT2 = 11.9 ± 3.7 ms, 95% CI = [8.8, 15.0] ms, P < 0.0001; ΔT1ρ = 12.8 ± 4.1 ms, 95% CI = [9.4, 16.2] ms, P < 0.0001). Histological assessment identified chondronecrosis in the hypertrophic and deep proliferative zones within ischemic epiphyseal cartilage. CONCLUSIONS T2 and T1ρ mapping are sensitive to ischemic injury to the epiphyseal cartilage in vivo at clinical 3T MRI. These techniques may be clinically useful to assess injury and repair to the epiphyseal cartilage to better stage the extent of ischemic damage in Legg-Calvé-Perthes disease.
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Affiliation(s)
- A R Armstrong
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN, USA.
| | - S Bhave
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN, USA.
| | - E O Buko
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN, USA; Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA.
| | - K L Chase
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN, USA.
| | - F Tóth
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN, USA.
| | - C S Carlson
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN, USA.
| | - J M Ellermann
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA; Department of Radiology, University of Minnesota, Minneapolis, MN, USA.
| | - H K W Kim
- Center for Excellence in Hip, Scottish Rite for Children, Dallas, TX, USA; Department of Orthopedic Surgery, UT Southwestern Medical Center, Dallas, TX, USA.
| | - C P Johnson
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN, USA; Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA.
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Zbýň Š, Santiago C, Johnson CP, Ludwig KD, Zhang L, Marette S, Tompkins MA, Nelson BJ, Takahashi T, Metzger GJ, Carlson CS, Ellermann JM. Compositional evaluation of lesion and parent bone in patients with juvenile osteochondritis dissecans of the knee using T 2 * mapping. J Orthop Res 2022; 40:1632-1644. [PMID: 34637164 PMCID: PMC9001743 DOI: 10.1002/jor.25187] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 09/13/2021] [Accepted: 09/30/2021] [Indexed: 02/04/2023]
Abstract
Juvenile osteochondritis dissecans (JOCD) lesions contain cartilaginous, fibrous and osseous tissues which are difficult to distinguish with clinical, morphological magnetic resonance imaging (MRI). Quantitative T2 * mapping has earlier been used to evaluate microstructure and composition of all aforementioned tissues as well as bone mineral density. However, the ability of T2 * mapping to detect changes in tissue composition between different JOCD lesion regions, different disease stages, and between stable and unstable lesions has not been demonstrated. This study analyzed morphological and T2 * MRI data from 25 patients (median age, 12.1 years) with 34 JOCD-affected and 13 healthy knees. Each lesion was assigned a stage reflecting the natural history of JOCD, with stages I and IV representing early and healed lesion, respectively. T2 * values were evaluated within the progeny lesion, interface and parent bone of each lesion and in the control bone region. T2 * was negatively correlated with JOCD stage in progeny lesion (ρ = -0.871; p < 0.001) and interface regions (ρ = -0.649; p < 0.001). Stage IV progeny showed significantly lower T2 * than control bone (p = 0.028). T2 * was significantly lower in parent bone than in control bone of patients with stable lesions (p = 0.009), but not in patients with unstable lesions (p = 0.14). Clinical significance: T2 * mapping enables differentiation between different stages of JOCD and quantitative measurement of the ossification degree in progeny lesion and interface. The observed T2 * decrease in healed and stable lesions may indicate increased bone density as a result of the active repair process. T2 * mapping provides quantitative information about JOCD lesion composition.
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Affiliation(s)
- Štefan Zbýň
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA,Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Cassiano Santiago
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA
| | - Casey P. Johnson
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA,Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, Minnesota, USA
| | - Kai D. Ludwig
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA,Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Lin Zhang
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Shelly Marette
- Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Marc A. Tompkins
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA,TRIA Orthopedic Center, Minneapolis, Minnesota, USA,Gillette Children’s Specialty Healthcare, St. Paul, Minnesota, USA
| | - Bradley J. Nelson
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA,TRIA Orthopedic Center, Minneapolis, Minnesota, USA
| | - Takashi Takahashi
- Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Gregory J. Metzger
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA
| | - Cathy S. Carlson
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, Minnesota, USA
| | - Jutta M. Ellermann
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA,Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
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9
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Johnson CP, Tóth F, Carlson CS, Armstrong AR, Zbýň Š, Wu B, Ellermann JM, Kim HKW. T1ρ and T2 mapping detect acute ischemic injury in a piglet model of Legg-Calvé-Perthes disease. J Orthop Res 2022; 40:484-494. [PMID: 33788301 PMCID: PMC8481332 DOI: 10.1002/jor.25044] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/22/2021] [Accepted: 03/24/2021] [Indexed: 02/04/2023]
Abstract
This study investigated the sensitivity of T1ρ and T2 relaxation time mapping to detect acute ischemic injury to the secondary ossification center (SOC) and epiphyseal cartilage of the femoral head in a piglet model of Legg-Calvé-Perthes disease. Six piglets underwent surgery to induce global right femoral head ischemia and were euthanized 48 h later. Fresh operated and contralateral-control femoral heads were imaged ex vivo with T1, T2, and T1ρ mapping using a 9.4T magnetic resonance imaging scanner. The specimens were imaged a second time after a freeze/thaw cycle and then processed for histology. T1, T2, and T1ρ measurements in the SOC, epiphyseal cartilage, articular cartilage, and metaphysis were compared between operated and control femoral heads using paired t tests. The effects of freeze/thaw, T1ρ spin-lock frequency, and fat saturation were also investigated. Five piglets with histologically confirmed ischemic injury were quantitatively analyzed. T1ρ was increased in the SOC (101 ± 15 vs. 73 ± 16 ms; p = 0.0026) and epiphyseal cartilage (84.9 ± 9.2 vs. 74.3 ± 3.6 ms; p = 0.031) of the operated versus control femoral heads. T2 was also increased in the SOC (28.7 ± 2.0 vs. 22.7 ± 1.7; p = 0.0037) and epiphyseal cartilage (57.4 ± 4.7 vs. 49.0 ± 2.7; p = 0.0041). No changes in T1 were detected. The sensitivities of T1ρ and T2 mapping in detecting ischemic injury were maintained after a freeze/thaw cycle, and T1ρ sensitivity was maintained after varying spin-lock frequency and applying fat saturation. In conclusion, T1ρ and T2 mapping are sensitive in detecting ischemic injury to the SOC and epiphyseal cartilage of the femoral head as early as 48 h after ischemia induction.
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Affiliation(s)
- Casey P. Johnson
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN,Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN
| | - Ferenc Tóth
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN
| | - Cathy S. Carlson
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN
| | | | - Štefan Zbýň
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN,Department of Radiology, University of Minnesota, Minneapolis, MN
| | - Baolin Wu
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Jutta M. Ellermann
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN,Department of Radiology, University of Minnesota, Minneapolis, MN
| | - Harry K. W. Kim
- Center for Excellence in Hip, Scottish Rite for Children, Dallas, TX,Department of Orthopedic Surgery, UT Southwestern Medical Center, Dallas, TX
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10
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Nissen CW, Albright JC, Anderson CN, Busch MT, Carlson C, Carsen S, Chambers HG, Edmonds EW, Ellermann JM, Ellis HB, Erickson JB, Fabricant PD, Ganley TJ, Green DW, Grimm NL, Heyworth BE, Po JHH, Kocher MS, Kostyun RO, Krych AJ, Latz KH, Loveland DM, Lyon RM, Mayer SW, Meenen NM, Milewski MD, Myer GD, Nelson BJ, Nepple JJ, Nguyen JC, Pace JL, Paterno MV, Pennock AT, Perkins CA, Polousky JD, Saluan P, Shea KG, Shearier E, Tompkins MA, Wall EJ, Weiss JM, Willimon SC, Wilson PL, Wright RW, Zbojniewicz AM, Carey JL. Descriptive Epidemiology From the Research in Osteochondritis Dissecans of the Knee (ROCK) Prospective Cohort. Am J Sports Med 2022; 50:118-127. [PMID: 34818065 DOI: 10.1177/03635465211057103] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Osteochondritis dissecans (OCD) occurs most commonly in the knees of young individuals. This condition is known to cause pain and discomfort in the knee and can lead to disability and early knee osteoarthritis. The cause is not well understood, and treatment plans are not well delineated. The Research in Osteochondritis Dissecans of the Knee (ROCK) group established a multicenter, prospective cohort to better understand this disease. PURPOSE To provide a baseline report of the ROCK multicenter prospective cohort and present a descriptive analysis of baseline data for patient characteristics, lesion characteristics, and clinical findings of the first 1000 cases enrolled into the prospective cohort. STUDY DESIGN Cross-sectional study; Level of evidence, 3. METHODS Patients were recruited from centers throughout the United States. Baseline data were obtained for patient characteristics, sports participation, patient-reported measures of functional capabilities and limitations, physical examination, diagnostic imaging results, and initial treatment plan. Descriptive statistics were completed for all outcomes of interest. RESULTS As of November 2020, a total of 27 orthopaedic surgeons from 17 institutions had enrolled 1004 knees with OCD, representing 903 patients (68.9% males; median age, 13.1 years; range, 6.3-25.4 years), into the prospective cohort. Lesions were located on the medial femoral condyle (66.2%), lateral femoral condyle (18.1%), trochlea (9.5%), patella (6.0%), and tibial plateau (0.2%). Most cases involved multisport athletes (68.1%), with the most common primary sport being basketball for males (27.3% of cases) and soccer for females (27.6% of cases). The median Pediatric International Knee Documentation Committee (Pedi-IKCD) score was 59.9 (IQR, 45.6-73.9), and the median Pediatric Functional Activity Brief Scale (Pedi-FABS) score was 21.0 (IQR, 5.0-28.0). Initial treatments were surgical intervention (55.4%) and activity restriction (44.0%). When surgery was performed, surgeons deemed the lesion to be stable at intraoperative assessment in 48.1% of cases. CONCLUSION The multicenter ROCK group has been able to enroll the largest knee OCD cohort to date. This information is being used to further understand the pathology of OCD, including its cause, associated comorbidities, and initial presentation and symptoms. The cohort having been established is now being followed longitudinally to better define and elucidate the best treatment algorithms based on these presenting signs and symptoms.
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Affiliation(s)
- Carl W Nissen
- PRISM Sports Medicine, Hartford, Connecticut; Hartford Healthcare's Bone and Joint Institute, Hartford, Connecticut, USA
| | | | | | | | - Cathy Carlson
- College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota, USA
| | - Sasha Carsen
- Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Henry G Chambers
- Rady Children's Hospital and UC San Diego, San Diego, California, USA
| | - Eric W Edmonds
- Rady Children's Hospital and UC San Diego, San Diego, California, USA
| | | | - Henry B Ellis
- Scottish Rite for Children Sports Medicine, Frisco, Texas, USA
| | - John B Erickson
- Children's Hospital of Wisconsin, Greenfield, Wisconsin, USA
| | | | - Theodore J Ganley
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | | | | | | | | | | | - Regina O Kostyun
- Hartford Healthcare's Bone and Joint Institute, Hartford, Connecticut, USA
| | | | | | | | - Roger M Lyon
- Children's Hospital of Wisconsin, Milwaukee, Wisconsin, USA
| | | | - Norbert M Meenen
- Asklepios Hospital St. George, Children's Sports Medicine, Hamburg, Germany
| | | | - Gregory D Myer
- Emory Sport Performance and Research Center, Flowery Branch, Georgia; Emory Sports Medicine Center, Atlanta, Georgia; Department of Orthopaedics, Emory University School of Medicine, Atlanta, Georgia, USA
| | | | - Jeffrey J Nepple
- Washington University School of Medicine, St. Louis, Missouri, USA
| | - Jie C Nguyen
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - J Lee Pace
- Andrew's Institute, Children's Health, Plano, Texas, USA
| | - Mark V Paterno
- Cincinnati Children's Hospital and University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Andrew T Pennock
- Rady Children's Hospital and UC San Diego, San Diego, California, USA
| | | | - John D Polousky
- Akron Children's Hospital Department of Orthopedics, Akron, Ohio, USA
| | | | - Kevin G Shea
- Stanford Children's Hospital, Sunnyvale, California, USA
| | - Emily Shearier
- Hartford Healthcare's Bone and Joint Institute, Hartford, Connecticut, USA
| | - Marc A Tompkins
- Gillette Children's Specialty Healthcare; University of Minnesota; TRIA Orthopaedic Center, Minneapolis, Minnesota, USA
| | - Eric J Wall
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Jennifer M Weiss
- Southern California Permanente Medical Group, Los Angeles, California, USA
| | | | - Philip L Wilson
- Scottish Rite for Children Sports Medicine, Frisco, Texas, USA
| | - Rick W Wright
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Andrew M Zbojniewicz
- Michigan State University; Advanced Radiology Services, Grand Rapids, Michigan, USA
| | - James L Carey
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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- Investigation performed at multiple sites
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11
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Pagliazzi G, Ellermann JM, Carlson CS, Shea KG, Arendt EA. Trochlear Development in Children From 1 Month to 10 Years of Age: A Descriptive Study Utilizing Analysis by Magnetic Resonance Imaging. Orthop J Sports Med 2021; 9:23259671211028269. [PMID: 34552991 PMCID: PMC8450999 DOI: 10.1177/23259671211028269] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [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: 01/22/2021] [Accepted: 02/24/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Understanding the morphology of cartilage/bony maturation in preadolescents may help explain adult trochlear variation. PURPOSE To study trochlear morphology during maturation in children and infants using magnetic resonance imaging (MRI). STUDY DESIGN Descriptive laboratory study. METHODS Twenty-four pediatric cadaveric knees (10 male and 14 female knees; age, 1 month to 10 years) were included. High-resolution imaging of the distal femoral secondary ossification center was performed using 7-T or 9.4-T MRI scanners. Three-dimensional MRI scans were produced, and images were reformatted; 3 slices in the axial, sagittal, and coronal planes images were analyzed, with coronal and sagittal imaging used for image orientation. Biometric analysis included lateral and medial trochlear height (TH); cartilaginous sulcus angle (CSA); osseous sulcus angle (OSA); trochlear depth; and trochlear facet (TF) length symmetry. Sex comparisons were considered when ≥1 specimen from both sexes of the same age was available; these included 11 knees spanning 4 age groups (ages 1, 3, 4, and 7 years). RESULTS The analysis of trochlear morphology showed a lateral TH greater than the medial TH at all ages. The thickest cartilage was found on the lateral TF in the younger specimens. Regarding the development of osseous and cartilaginous trochlear contour, a cartilaginous sulcus was present in the 3-month-old specimen and continued to deepen up to the age of 4 years. The shape of the osseous center evolved from round (1 month) to oval (9 months) to rectangular (2 years); no distinct bony trochlear sulcus was present, although a well-formed cartilaginous sulcus was present. The first evidence of formation of a bony sulcus was at 4 years. By the age of 7 to 8 years, the bony contour of the adult distal femur resembled its cartilaginous contour. Female samples had a shallower CSA and OSA than did the male ones in all samples that had a defined OSA. CONCLUSION Female trochlear grooves tended to be shallower (flatter). The lateral trochlea was higher (TH) and wider (TF length) during growth than was the medial trochlea in both sexes; furthermore, the development of the osseous sulcus shape lagged behind the development of the cartilaginous sulcus shape in the authors' study population. CLINICAL RELEVANCE Bony anatomy of the trochlear groove did not match the cartilaginous anatomy in preadolescent children, suggesting that caution should be used when interpreting bony anatomy in this age group.
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Affiliation(s)
- Gherardo Pagliazzi
- Rizzoli Orthopaedic Institute, Bologna, Italy
- Lugano Regional Hospital, Lugano, Switzerland
| | - Jutta M. Ellermann
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Cathy S. Carlson
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Kevin G. Shea
- Department of Orthopaedic Surgery, Stanford University, Stanford, California, USA
| | - Elizabeth A. Arendt
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA
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12
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Özütemiz C, Krystosek LA, Church AL, Chauhan A, Ellermann JM, Domingo-Musibay E, Steinberger D. Lymphadenopathy in COVID-19 Vaccine Recipients: Diagnostic Dilemma in Oncologic Patients. Radiology 2021; 300:E296-E300. [PMID: 33625300 DOI: 10.1148/radiol.202121027511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Five cases of axillary lymphadenopathy are presented, which occurred after COVID-19 vaccination and mimicked metastasis in a vulnerable oncologic patient group. Initial radiologic diagnosis raised concerns for metastasis. However, further investigation revealed that patients received COVID-19 vaccinations in the ipsilateral arm prior to imaging. In two cases, lymph node biopsy results confirmed vaccination-related reactive lymphadenopathy. Ipsilateral axillary swelling or lymphadenopathy was reported based on symptoms and physical examination in COVID-19 vaccine trials. Knowledge of the potential for COVID-19 vaccine-related ipsilateral adenopathy is necessary to avoid unnecessary biopsy and change in therapy. © RSNA, 2021.
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Affiliation(s)
- Can Özütemiz
- From the Department of Radiology (C.Ö., L.A.K., A.L.C., A.C., J.M.E., D.S.) and Department of Medicine, Division of Hematology, Oncology and Transplantation (E.D.M.), University of Minnesota, 420 Delaware St SE, MMC 292, Minneapolis, MN 55455
| | - Luke A Krystosek
- From the Department of Radiology (C.Ö., L.A.K., A.L.C., A.C., J.M.E., D.S.) and Department of Medicine, Division of Hematology, Oncology and Transplantation (E.D.M.), University of Minnesota, 420 Delaware St SE, MMC 292, Minneapolis, MN 55455
| | - An L Church
- From the Department of Radiology (C.Ö., L.A.K., A.L.C., A.C., J.M.E., D.S.) and Department of Medicine, Division of Hematology, Oncology and Transplantation (E.D.M.), University of Minnesota, 420 Delaware St SE, MMC 292, Minneapolis, MN 55455
| | - Anil Chauhan
- From the Department of Radiology (C.Ö., L.A.K., A.L.C., A.C., J.M.E., D.S.) and Department of Medicine, Division of Hematology, Oncology and Transplantation (E.D.M.), University of Minnesota, 420 Delaware St SE, MMC 292, Minneapolis, MN 55455
| | - Jutta M Ellermann
- From the Department of Radiology (C.Ö., L.A.K., A.L.C., A.C., J.M.E., D.S.) and Department of Medicine, Division of Hematology, Oncology and Transplantation (E.D.M.), University of Minnesota, 420 Delaware St SE, MMC 292, Minneapolis, MN 55455
| | - Evidio Domingo-Musibay
- From the Department of Radiology (C.Ö., L.A.K., A.L.C., A.C., J.M.E., D.S.) and Department of Medicine, Division of Hematology, Oncology and Transplantation (E.D.M.), University of Minnesota, 420 Delaware St SE, MMC 292, Minneapolis, MN 55455
| | - Daniel Steinberger
- From the Department of Radiology (C.Ö., L.A.K., A.L.C., A.C., J.M.E., D.S.) and Department of Medicine, Division of Hematology, Oncology and Transplantation (E.D.M.), University of Minnesota, 420 Delaware St SE, MMC 292, Minneapolis, MN 55455
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13
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Chau MM, Klimstra MA, Wise KL, Ellermann JM, Tóth F, Carlson CS, Nelson BJ, Tompkins MA. Osteochondritis Dissecans: Current Understanding of Epidemiology, Etiology, Management, and Outcomes. J Bone Joint Surg Am 2021; 103:1132-1151. [PMID: 34109940 PMCID: PMC8272630 DOI: 10.2106/jbjs.20.01399] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [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] [Indexed: 02/01/2023]
Abstract
➤ Osteochondritis dissecans occurs most frequently in the active pediatric and young adult populations, commonly affecting the knee, elbow, or ankle, and may lead to premature osteoarthritis. ➤ While generally considered an idiopathic phenomenon, various etiopathogenetic theories are being investigated, including local ischemia, aberrant endochondral ossification of the secondary subarticular physis, repetitive microtrauma, and genetic predisposition. ➤ Diagnosis is based on the history, physical examination, radiography, and advanced imaging, with elbow ultrasonography and novel magnetic resonance imaging protocols potentially enabling early detection and in-depth staging. ➤ Treatment largely depends on skeletal maturity and lesion stability, defined by the presence or absence of articular cartilage fracture and subchondral bone separation, as determined by imaging and arthroscopy, and is typically nonoperative for stable lesions in skeletally immature patients and operative for those who have had failure of conservative management or have unstable lesions. ➤ Clinical practice guidelines have been limited by a paucity of high-level evidence, but a multicenter effort is ongoing to develop accurate and reliable classification systems and multimodal decision-making algorithms with prognostic value.
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Affiliation(s)
- Michael M Chau
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Mikhail A Klimstra
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Kelsey L Wise
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Jutta M Ellermann
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, Minnesota
| | - Ferenc Tóth
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota
| | - Cathy S Carlson
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota
| | - Bradley J Nelson
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota
- TRIA Orthopedic Center, Bloomington, Minnesota
| | - Marc A Tompkins
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota
- TRIA Orthopedic Center, Bloomington, Minnesota
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14
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Özütemiz C, Krystosek LA, Church AL, Chauhan A, Ellermann JM, Domingo-Musibay E, Steinberger D. Lymphadenopathy in COVID-19 Vaccine Recipients: Diagnostic Dilemma in Oncologic Patients. Radiology 2021; 300:E296-E300. [PMID: 33625300 PMCID: PMC7909072 DOI: 10.1148/radiol.2021210275] [Citation(s) in RCA: 109] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
We present five cases of axillary lymphadenopathy which occurred after COVID-19 vaccination and that mimicked metastasis in oncologic patients. Initial radiologic diagnosis raised concerns for metastasis. However, further investigation revealed that patients received COVID-19 vaccinations in the ipsilateral arm prior to imaging. In two cases, lymph node biopsy confirmed vaccination related reactive lymphadenopathy. Ipsilateral axillary swelling / lymphadenopathy was reported based on symptoms and physical examination in COVID-19 vaccine trials. Knowledge of the potential for COVID-19 vaccine-related ipsilateral adenopathy is necessary to avoid unnecessary biopsy and change in therapy.
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Affiliation(s)
- Can Özütemiz
- From the Department of Radiology (C.Ö., L.A.K., A.L.C., A.C., J.M.E., D.S.) and Department of Medicine, Division of Hematology, Oncology and Transplantation (E.D.M.), University of Minnesota, 420 Delaware St SE, MMC 292, Minneapolis, MN 55455
| | - Luke A Krystosek
- From the Department of Radiology (C.Ö., L.A.K., A.L.C., A.C., J.M.E., D.S.) and Department of Medicine, Division of Hematology, Oncology and Transplantation (E.D.M.), University of Minnesota, 420 Delaware St SE, MMC 292, Minneapolis, MN 55455
| | - An L Church
- From the Department of Radiology (C.Ö., L.A.K., A.L.C., A.C., J.M.E., D.S.) and Department of Medicine, Division of Hematology, Oncology and Transplantation (E.D.M.), University of Minnesota, 420 Delaware St SE, MMC 292, Minneapolis, MN 55455
| | - Anil Chauhan
- From the Department of Radiology (C.Ö., L.A.K., A.L.C., A.C., J.M.E., D.S.) and Department of Medicine, Division of Hematology, Oncology and Transplantation (E.D.M.), University of Minnesota, 420 Delaware St SE, MMC 292, Minneapolis, MN 55455
| | - Jutta M Ellermann
- From the Department of Radiology (C.Ö., L.A.K., A.L.C., A.C., J.M.E., D.S.) and Department of Medicine, Division of Hematology, Oncology and Transplantation (E.D.M.), University of Minnesota, 420 Delaware St SE, MMC 292, Minneapolis, MN 55455
| | - Evidio Domingo-Musibay
- From the Department of Radiology (C.Ö., L.A.K., A.L.C., A.C., J.M.E., D.S.) and Department of Medicine, Division of Hematology, Oncology and Transplantation (E.D.M.), University of Minnesota, 420 Delaware St SE, MMC 292, Minneapolis, MN 55455
| | - Daniel Steinberger
- From the Department of Radiology (C.Ö., L.A.K., A.L.C., A.C., J.M.E., D.S.) and Department of Medicine, Division of Hematology, Oncology and Transplantation (E.D.M.), University of Minnesota, 420 Delaware St SE, MMC 292, Minneapolis, MN 55455
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15
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Ludwig KD, Johnson CP, Zbýň Š, Nowacki A, Marette S, Takahashi T, Macalena JA, Nelson BJ, Tompkins MA, Carlson CS, Ellermann JM. MRI evaluation of articular cartilage in patients with juvenile osteochondritis dissecans (JOCD) using T2∗ mapping at 3T. Osteoarthritis Cartilage 2020; 28:1235-1244. [PMID: 32278071 PMCID: PMC8576840 DOI: 10.1016/j.joca.2020.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 07/15/2019] [Revised: 03/31/2020] [Accepted: 04/01/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Evaluate articular cartilage by magnetic resonance imaging (MRI) T2∗ mapping within the distal femur and proximal tibia in adolescents with juvenile osteochondritis dissecans (JOCD). DESIGN JOCD imaging studies acquired between August 2011 and February 2019 with clinical and T2∗ mapping MRI knee images were retrospectively collected and analyzed for 31 participants (9F/22M, 15.0 ± 3.8 years old) with JOCD lesions in the medial femoral condyle (MFC). In total, N = 32 knees with JOCD lesions and N = 14 control knees were assessed. Mean T2∗ values in four articular cartilage regions-of-interest (MFC, lateral femoral condyle (LFC), medial tibia (MT), and lateral tibia (LT)) and lesion volume were measured and analyzed using Wilcoxon-rank-sum tests and Spearman correlation coefficients (R). RESULTS Mean ± standard error T2∗ differences observed between the lesion-sided MFC and the LFC in JOCD-affected knees (28.5 ± 0.9 95% confidence interval [26.8, 30.3] vs 26.3 ± 0.7 [24.8, 27.7] ms, P = 0.088) and between the affected- and control-knee MFC (28.5 ± 0.9 [26.8, 30.3] vs 28.5 ± 0.6 [27.1, 29.9] ms, P = 0.719) were nonsignificant. T2∗ was significantly increased in the lesion-sided MT vs the LT for the JOCD-affected knees (21.5 ± 0.7 [20.1, 22.9] vs 18.0 ± 0.7 [16.5, 19.5] ms, P = 0.002), but this same difference was also observed between the MT and LT in control knees (21.0 ± 0.6 [19.7, 22.3] vs 18.1 ± 1.1 [15.8, 20.4] ms, P = 0.037). There was no significant T2∗ difference between the affected- and control-knee MT (21.5 ± 0.7 [20.1, 22.9] vs 21.0 ± 0.6 [19.7, 22.3] ms, P = 0.905). T2∗ within the lesion-sided MFC was not correlated with patient age (R = 0.20, P = 0.28) or lesion volume (R = 0.06, P = 0.75). T2∗ values were slightly increased near lesions in later-stage JOCD subjects but without statistical significance. CONCLUSIONS T2∗ relaxations times were not significantly different from control sites in the articular cartilage overlying JOCD lesions in the MFC or adjacent MT cartilage in early-stage JOCD.
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Affiliation(s)
- Kai D. Ludwig
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
- Department of Radiology, University of Minnesota, Minneapolis, MN, USA
- Corresponding Author Info: Jutta M. Ellermann, MD, PhD, Center for Magnetic Resonance Research, 2021 6th St SE, Minneapolis, Minnesota, USA 53705-2275. Telephone: 612-626-2001.
| | - Casey P. Johnson
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
- Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | - Štefan Zbýň
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
- Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | - Amanda Nowacki
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
- Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | - Shelly Marette
- Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | - Takashi Takahashi
- Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | - Jeffrey A. Macalena
- Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Bradley J. Nelson
- Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA
- TRIA Orthopaedic Center, Minneapolis, MN, USA
| | - Marc A. Tompkins
- Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA
- TRIA Orthopaedic Center, Minneapolis, MN, USA
| | - Cathy S. Carlson
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN, USA
| | - Jutta M. Ellermann
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
- Department of Radiology, University of Minnesota, Minneapolis, MN, USA
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Ellermann JM, Ludwig KD, Nissi MJ, Johnson CP, Strupp JP, Wang L, Zbýň Š, Tóth F, Arendt E, Tompkins M, Shea K, Carlson CS. Three-Dimensional Quantitative Magnetic Resonance Imaging of Epiphyseal Cartilage Vascularity Using Vessel Image Features: New Insights into Juvenile Osteochondritis Dissecans. JB JS Open Access 2019; 4:JBJSOA-D-19-00031. [PMID: 32043049 PMCID: PMC6959910 DOI: 10.2106/jbjs.oa.19.00031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
We introduce a quantitative measure of epiphyseal cartilage vascularity and examine vessel networks during human skeletal maturation. Understanding early morphological changes in the distal femoral condyle is expected to provide information on the pathogenesis of developmental diseases such as juvenile osteochondritis dissecans. Methods Twenty-two cadaveric knees from donors ranging from 1 month to 10 years of age were included in the study. Images of bone, cartilage, and vascularity were acquired simultaneously with a 3-dimensional gradient-recalled-echo magnetic resonance imaging (MRI) sequence. The secondary ossification center volume and total epiphysis cartilage volume ratio and articular-epiphyseal cartilage complex and epiphyseal cartilage widths were measured. Epiphyseal cartilage vascularity was visualized for 9 data sets with quantitative susceptibility mapping and vessel filtering, resulting in 3-dimensional data to inform vessel network segmentation and to calculate vascular density. Results Three distinct, non-anastomosing vascular networks (2 peripheral and 1 central) supply the distal femoral epiphyseal cartilage. The central network begins regression as early as 3 months and is absent by 4 years. From 1 month to 3 years, the ratio of central to peripheral vascular area density decreased from 1.0 to 0.5, and the ratio of central to peripheral vascular skeletal density decreased from 0.9 to 0.6. A narrow, peripheral vascular rim was present at 8 years but had disappeared by 10 years. The secondary ossification center progressively acquires the shape of the articular-epiphyseal cartilage complex by 8 years of age, and the central areas of the medial and lateral femoral condyles are the last to ossify. Conclusions Using cadaveric pediatric knees, we provide quantitative, 3-dimensional measures of epiphyseal cartilage vascular regression during skeletal development using vessel image features. Central areas with both early vascular regression and delayed ossification correspond to predilection sites of juvenile osteochondritis dissecans in this limited case series. Our findings highlight specific vascular vulnerabilities that may lead to improved understanding of the pathogenesis and better-informed clinical management decisions in developmental skeletal diseases. Clinical Relevance This paradigm shift in understanding of juvenile osteochondritis dissecans etiology and disease progression may critically impact future patient management. Our findings highlight specific vascular vulnerabilities during skeletal maturation in a group of active young patients seen primarily by orthopaedic surgeons and sports medicine professionals.
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Affiliation(s)
- Jutta M Ellermann
- Center for Magnetic Resonance Research (CMRR) (J.M.E., K.D.L., M.J.N., C.P.J., J.P.S., L.W., and S.Z.), Department of Radiology, and Department of Orthopaedic Surgery (E.A. and M.T.), Medical School, University of Minnesota, Minneapolis, Minnesota
| | - Kai D Ludwig
- Center for Magnetic Resonance Research (CMRR) (J.M.E., K.D.L., M.J.N., C.P.J., J.P.S., L.W., and S.Z.), Department of Radiology, and Department of Orthopaedic Surgery (E.A. and M.T.), Medical School, University of Minnesota, Minneapolis, Minnesota
| | - Mikko J Nissi
- Center for Magnetic Resonance Research (CMRR) (J.M.E., K.D.L., M.J.N., C.P.J., J.P.S., L.W., and S.Z.), Department of Radiology, and Department of Orthopaedic Surgery (E.A. and M.T.), Medical School, University of Minnesota, Minneapolis, Minnesota.,Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Casey P Johnson
- Center for Magnetic Resonance Research (CMRR) (J.M.E., K.D.L., M.J.N., C.P.J., J.P.S., L.W., and S.Z.), Department of Radiology, and Department of Orthopaedic Surgery (E.A. and M.T.), Medical School, University of Minnesota, Minneapolis, Minnesota.,Departments of Veterinary Population Medicine (F.T.) and Veterinary Clinical Sciences (C.P.J.,C.S.C.), College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota
| | - John P Strupp
- Center for Magnetic Resonance Research (CMRR) (J.M.E., K.D.L., M.J.N., C.P.J., J.P.S., L.W., and S.Z.), Department of Radiology, and Department of Orthopaedic Surgery (E.A. and M.T.), Medical School, University of Minnesota, Minneapolis, Minnesota
| | - Luning Wang
- Center for Magnetic Resonance Research (CMRR) (J.M.E., K.D.L., M.J.N., C.P.J., J.P.S., L.W., and S.Z.), Department of Radiology, and Department of Orthopaedic Surgery (E.A. and M.T.), Medical School, University of Minnesota, Minneapolis, Minnesota
| | - Štefan Zbýň
- Center for Magnetic Resonance Research (CMRR) (J.M.E., K.D.L., M.J.N., C.P.J., J.P.S., L.W., and S.Z.), Department of Radiology, and Department of Orthopaedic Surgery (E.A. and M.T.), Medical School, University of Minnesota, Minneapolis, Minnesota
| | - Ferenc Tóth
- Departments of Veterinary Population Medicine (F.T.) and Veterinary Clinical Sciences (C.P.J.,C.S.C.), College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota
| | - Elizabeth Arendt
- Center for Magnetic Resonance Research (CMRR) (J.M.E., K.D.L., M.J.N., C.P.J., J.P.S., L.W., and S.Z.), Department of Radiology, and Department of Orthopaedic Surgery (E.A. and M.T.), Medical School, University of Minnesota, Minneapolis, Minnesota
| | - Marc Tompkins
- Center for Magnetic Resonance Research (CMRR) (J.M.E., K.D.L., M.J.N., C.P.J., J.P.S., L.W., and S.Z.), Department of Radiology, and Department of Orthopaedic Surgery (E.A. and M.T.), Medical School, University of Minnesota, Minneapolis, Minnesota
| | - Kevin Shea
- Department of Orthopaedic Surgery, Stanford University, Stanford, California
| | - Cathy S Carlson
- Departments of Veterinary Population Medicine (F.T.) and Veterinary Clinical Sciences (C.P.J.,C.S.C.), College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota
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Johnson CP, Ellermann JM. re: MRI as Diagnostic Modality for Analyzing the Problematic Knee Arthroplasty: A Systematic Review. J Magn Reson Imaging 2019; 51:459-460. [PMID: 31577055 DOI: 10.1002/jmri.26932] [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: 09/03/2019] [Accepted: 09/03/2019] [Indexed: 11/08/2022] Open
Affiliation(s)
- Casey P Johnson
- Veterinary Clinical Sciences Department, University of Minnesota, Saint Paul, Minnesota, USA.,Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jutta M Ellermann
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
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Tóth F, Tompkins MA, Shea KG, Ellermann JM, Carlson CS. Identification of Areas of Epiphyseal Cartilage Necrosis at Predilection Sites of Juvenile Osteochondritis Dissecans in Pediatric Cadavers. J Bone Joint Surg Am 2018; 100:2132-2139. [PMID: 30562294 PMCID: PMC6738538 DOI: 10.2106/jbjs.18.00464] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The pathogenesis of human juvenile osteochondritis dissecans (JOCD) remains poorly understood, with multiple factors implicated, including ischemia, repetitive trauma, and genetic predisposition. Similarities in the predilection site and the diagnostic and clinical features of JOCD to the well-characterized veterinary counterpart, osteochondrosis dissecans, suggest that, similar to the animal disease, the pathogenesis JOCD may also be initiated in the first few years of life, when disruption of blood supply to the epiphyseal growth cartilage leads to failure of endochondral ossification. To gather data in support of the hypothesis that JOCD and osteochondrosis dissecans have a shared pathogenesis, biopsy specimens obtained from predilection sites of JOCD in juvenile human cadavers were histologically examined to determine whether they contained lesions similar to those found in animals diagnosed with subclinical osteochondrosis dissecans. METHODS In this descriptive laboratory study, 59 biopsy specimens (6 mm in diameter) were harvested from the central aspect (i.e., the notch side) of the femoral condyles of 26 human cadavers (1 month to 11 years old). Specimens were histologically evaluated for the presence of areas of cartilage necrosis and the morphology of cartilage canal blood vessels. RESULTS Locally extensive areas of necrotic epiphyseal cartilage were identified in 4 specimens obtained from 3 donors (ages 2 to 4 years). Areas of cartilage necrosis accompanied by focal failure of endochondral ossification or surrounded by subchondral bone were identified in biopsy specimens from 4 donors (ages 4 to 9 years). CONCLUSIONS The identification of epiphyseal cartilage necrosis identical to that described in animals with subclinical osteochondrosis, found in biopsy specimens obtained from femoral predilection sites of JOCD in pediatric cadavers, suggests a shared pathogenesis of JOCD in humans and osteochondrosis dissecans in animals. CLINICAL RELEVANCE These findings imply that the pathogenesis of human JOCD likely starts 5 to 10 years prior to the development of clinical symptoms. Enhanced understanding of the temporal features of JOCD pathogenesis provides an opportunity for earlier diagnosis and treatment, likely resulting in improved outcomes for this condition in the future.
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Affiliation(s)
- Ferenc Tóth
- Department of Veterinary Population Medicine, University of Minnesota, St. Paul, Minnesota
| | - Marc A Tompkins
- Department of Orthopaedic Surgery, University of Minnesota Medical School, Minneapolis, Minnesota
- TRIA Orthopedic Center, Minneapolis, Minnesota
| | - Kevin G Shea
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California
| | - Jutta M Ellermann
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, Minnesota
| | - Cathy S Carlson
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, Minnesota
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Johnson CP, Wang L, Tóth F, Aruwajoye O, Kirkham B, Carlson CS, Kim HKW, Ellermann JM. Quantitative susceptibility mapping detects neovascularization of the epiphyseal cartilage after ischemic injury in a piglet model of legg-calvé-perthes disease. J Magn Reson Imaging 2018; 50:106-113. [PMID: 30556613 DOI: 10.1002/jmri.26552] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 10/08/2018] [Accepted: 10/08/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Legg-Calvé-Perthes disease (LCPD) is a childhood hip disorder thought to be caused by disruption of blood supply to the developing femoral head. There is potential for imaging to help assess revascularization of the femoral head. PURPOSE To investigate whether quantitative susceptibility mapping (QSM) can detect neovascularization in the epiphyseal cartilage following ischemic injury to the developing femoral head. STUDY TYPE Prospective. ANIMAL MODEL Right femoral head ischemia was surgically induced in 6-week-old male piglets. The animals were sacrificed 48 hours (n = 3) or 4 weeks (n = 7) following surgery, and the operated and contralateral control femoral heads were harvested for ex vivo MRI. FIELD STRENGTH/SEQUENCE Preclinical 9.4T MRI to acquire susceptibility-weighted 3D gradient echo (GRE) images with 0.1 mm isotropic spatial resolution. ASSESSMENT The 3D GRE images were used to manually segment the cartilage overlying the femoral head and were subsequently postprocessed using QSM. Vessel volume, cartilage volume, and vessel density were measured and compared between operated and control femoral heads at each timepoint. Maximum intensity projections of the QSM images were subjectively assessed to identity differences in cartilage canal appearance, location, and density. STATISTICAL TESTS Paired t-tests with Bonferroni correction were used (P < 0.008 considered significant). RESULTS Increased vascularity of the epiphyseal cartilage following ischemic injury was clearly identified using QSM. No changes were detected 48 hours after surgery. Vessel volume, cartilage volume, and vessel density were all increased in the operated vs. control femoral heads 4 weeks after surgery (P = 0.001, 0.002, and 0.001, respectively). Qualitatively, the increase in vessel density at 4 weeks was due to the formation of new vessels that were organized in a brush-like orientation in the epiphyseal cartilage, consistent with the histological appearance of neovascularization. DATA CONCLUSION QSM can detect neovascularization in the epiphyseal cartilage following ischemic injury to the femoral head. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;50:106-113.
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Affiliation(s)
- Casey P Johnson
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Luning Wang
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ferenc Tóth
- Department of Veterinary Population Medicine, University of Minnesota, St. Paul, Minnesota, USA
| | - Olumide Aruwajoye
- Center for Excellence in Hip Disorders, Texas Scottish Rite Hospital, Dallas, Texas, USA
| | - Brooke Kirkham
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA
| | - Cathy S Carlson
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, Minnesota, USA
| | - Harry K W Kim
- Center for Excellence in Hip Disorders, Texas Scottish Rite Hospital, Dallas, Texas, USA.,Department of Orthopaedic Surgery, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Jutta M Ellermann
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
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Johnson CP, Wang L, Tóth F, Aruwajoye O, Carlson CS, Kim HKW, Ellermann JM. Quantitative MRI Helps to Detect Hip Ischemia: Preclinical Model of Legg-Calvé-Perthes Disease. Radiology 2018; 289:386-395. [PMID: 30063188 DOI: 10.1148/radiol.2018180497] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Purpose To determine whether quantitative MRI relaxation time mapping techniques can help to detect ischemic injury to the developing femoral head. Materials and Methods For this prospective animal study conducted from November 2015 to February 2018, 10 male 6-week-old piglets underwent an operation to induce complete right femoral head ischemia. Animals were humanely killed at 48 hours (n = 2) or 4 weeks (n = 8) after the operation, and the operated and contralateral-control femoral heads were harvested and frozen. Thawed specimens were imaged at 9.4-T MRI by using T1, T2, T1 in the rotating frame (T1ρ), adiabatic T1ρ, relaxation along a fictitious field (RAFF), and T2* mapping and evaluated with histologic analysis. Paired relaxation time differences between the operated and control femoral heads were measured in the secondary ossification center (SOC), epiphyseal cartilage, articular cartilage, and metaphysis and were analyzed by using a paired t test. Results In the SOC, T1ρ and RAFF had the greatest percent increases in the operated versus control femoral heads at both 48 hours (112% and 72%, respectively) and 4 weeks (74% and 70%, respectively). In the epiphyseal and articular cartilage, T2, T1ρ, and RAFF were similarly increased at both points (range, 24%-49%). At 4 weeks, T2, T1ρ, adiabatic T1ρ, and RAFF were increased in the SOC (P = .004, .018, < .001, and .001, respectively), epiphyseal cartilage (P = .009, .008, .011, and .007, respectively), and articular cartilage (P = .005, .016, .033, and .018, respectively). Histologic assessment identified necrosis in SOC and deep layer of the epiphyseal cartilage at both points. Conclusion T2, T1 in the rotating frame, adiabatic T1 in the rotating frame, and relaxation along a fictitious field maps are sensitive in helping to detect ischemic injury to the developing femoral head. © RSNA, 2018 Online supplemental material is available for this article.
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Affiliation(s)
- Casey P Johnson
- From the Center for Magnetic Resonance Research (C.P.J., L.W., J.M.E.) and Departments of Radiology (C.P.J., L.W., J.M.E.), Veterinary Population Medicine (F.T.), and Veterinary Clinical Sciences (C.S.C.), University of Minnesota, 2021 6th St SE, Minneapolis, MN 55455; Center for Excellence in Hip Disorders, Texas Scottish Rite Hospital, Dallas, Tex (O.A., H.K.W.K.); and Department of Orthopedic Surgery, UT Southwestern Medical Center, Dallas, Tex (H.K.W.K.)
| | - Luning Wang
- From the Center for Magnetic Resonance Research (C.P.J., L.W., J.M.E.) and Departments of Radiology (C.P.J., L.W., J.M.E.), Veterinary Population Medicine (F.T.), and Veterinary Clinical Sciences (C.S.C.), University of Minnesota, 2021 6th St SE, Minneapolis, MN 55455; Center for Excellence in Hip Disorders, Texas Scottish Rite Hospital, Dallas, Tex (O.A., H.K.W.K.); and Department of Orthopedic Surgery, UT Southwestern Medical Center, Dallas, Tex (H.K.W.K.)
| | - Ferenc Tóth
- From the Center for Magnetic Resonance Research (C.P.J., L.W., J.M.E.) and Departments of Radiology (C.P.J., L.W., J.M.E.), Veterinary Population Medicine (F.T.), and Veterinary Clinical Sciences (C.S.C.), University of Minnesota, 2021 6th St SE, Minneapolis, MN 55455; Center for Excellence in Hip Disorders, Texas Scottish Rite Hospital, Dallas, Tex (O.A., H.K.W.K.); and Department of Orthopedic Surgery, UT Southwestern Medical Center, Dallas, Tex (H.K.W.K.)
| | - Olumide Aruwajoye
- From the Center for Magnetic Resonance Research (C.P.J., L.W., J.M.E.) and Departments of Radiology (C.P.J., L.W., J.M.E.), Veterinary Population Medicine (F.T.), and Veterinary Clinical Sciences (C.S.C.), University of Minnesota, 2021 6th St SE, Minneapolis, MN 55455; Center for Excellence in Hip Disorders, Texas Scottish Rite Hospital, Dallas, Tex (O.A., H.K.W.K.); and Department of Orthopedic Surgery, UT Southwestern Medical Center, Dallas, Tex (H.K.W.K.)
| | - Cathy S Carlson
- From the Center for Magnetic Resonance Research (C.P.J., L.W., J.M.E.) and Departments of Radiology (C.P.J., L.W., J.M.E.), Veterinary Population Medicine (F.T.), and Veterinary Clinical Sciences (C.S.C.), University of Minnesota, 2021 6th St SE, Minneapolis, MN 55455; Center for Excellence in Hip Disorders, Texas Scottish Rite Hospital, Dallas, Tex (O.A., H.K.W.K.); and Department of Orthopedic Surgery, UT Southwestern Medical Center, Dallas, Tex (H.K.W.K.)
| | - Harry K W Kim
- From the Center for Magnetic Resonance Research (C.P.J., L.W., J.M.E.) and Departments of Radiology (C.P.J., L.W., J.M.E.), Veterinary Population Medicine (F.T.), and Veterinary Clinical Sciences (C.S.C.), University of Minnesota, 2021 6th St SE, Minneapolis, MN 55455; Center for Excellence in Hip Disorders, Texas Scottish Rite Hospital, Dallas, Tex (O.A., H.K.W.K.); and Department of Orthopedic Surgery, UT Southwestern Medical Center, Dallas, Tex (H.K.W.K.)
| | - Jutta M Ellermann
- From the Center for Magnetic Resonance Research (C.P.J., L.W., J.M.E.) and Departments of Radiology (C.P.J., L.W., J.M.E.), Veterinary Population Medicine (F.T.), and Veterinary Clinical Sciences (C.S.C.), University of Minnesota, 2021 6th St SE, Minneapolis, MN 55455; Center for Excellence in Hip Disorders, Texas Scottish Rite Hospital, Dallas, Tex (O.A., H.K.W.K.); and Department of Orthopedic Surgery, UT Southwestern Medical Center, Dallas, Tex (H.K.W.K.)
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Lawrence RL, Schlangen DM, Schneider KA, Schoenecker J, Senger AL, Starr WC, Staker JL, Ellermann JM, Braman JP, Ludewig PM. Effect of glenohumeral elevation on subacromial supraspinatus compression risk during simulated reaching. J Orthop Res 2017; 35:2329-2337. [PMID: 28071815 PMCID: PMC5503805 DOI: 10.1002/jor.23515] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 12/28/2016] [Indexed: 02/04/2023]
Abstract
Mechanical subacromial rotator cuff compression is one theoretical mechanism in the pathogenesis of rotator cuff disease. However, the relationship between shoulder kinematics and mechanical subacromial rotator cuff compression across the range of humeral elevation motion is not well understood. The purpose of this study was to investigate the effect of humeral elevation on subacromial compression risk of the supraspinatus during a simulated functional reaching task. Three-dimensional anatomical models were reconstructed from shoulder magnetic resonance images acquired from 20 subjects (10 asymptomatic, 10 symptomatic). Standardized glenohumeral kinematics from a simulated reaching task were imposed on the anatomic models and analyzed at 0, 30, 60, and 90° humerothoracic elevation. Five magnitudes of humeral retroversion were also imposed on the models at each angle of humerothoracic elevation to investigate the impact of retroversion on subacromial proximities. The minimum distance between the coracoacromial arch and supraspinatus tendon and footprint were quantified. When contact occurred, the magnitude of the intersecting volume between the supraspinatus tendon and coracoacromial arch was also quantified. The smallest minimum distance from the coracoacromial arch to the supraspinatus footprint occurred between 30 and 90°, while the smallest minimum distance to the supraspinatus tendon occurred between 0 and 60°. The magnitude of humeral retroversion did not significantly affect minimum distance to the supraspinatus tendon except at 60 or 90° humerothoracic elevation. The results of this study provide support for mechanical rotator cuff compression as a potential mechanism for the development of rotator cuff disease. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2329-2337, 2017.
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Tóth F, David FH, LaFond E, Wang L, Ellermann JM, Carlson CS. In vivo visualization using MRI T 2 mapping of induced osteochondrosis and osteochondritis dissecans lesions in goats undergoing controlled exercise. J Orthop Res 2017; 35:868-875. [PMID: 27283998 PMCID: PMC5458739 DOI: 10.1002/jor.23332] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [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: 02/12/2016] [Accepted: 06/05/2016] [Indexed: 02/04/2023]
Abstract
In vivo visualization of subclinical osteochondrosis (OC) lesions, characterized by necrosis of epiphyseal growth cartilage, is necessary to clarify the pathogenesis of this disease. Hence, our objectives were to demonstrate induced necrosis of the epiphyseal cartilage in vivo using MRI and to monitor progression or resolution of resulting lesions. We also aimed to improve the goat model of OC by introducing controlled exercise. Vascular supply to the epiphyseal cartilage was surgically interrupted in four 5-day-old goats to induce ischemic cartilage necrosis in a medial femoral condyle. Starting 3 weeks postoperatively, goats underwent daily controlled exercise until euthanasia at 6, 10, 11 (n = 2) weeks postoperatively. T2 maps of operated and control femora were obtained in vivo at 3 (n = 4), 6 (n = 4), 9 (n = 3), and 11 (n = 2) weeks postoperatively using a 3 T MR scanner. In vivo MRI findings were validated against MRI results obtained ex vivo at 9.4 T in three goats and compared to histological results in all goats. Surgical interruption of the vascular supply caused ischemic cartilage necrosis in three out of four goats. T2 maps obtained in vivo at 3 T identified regions of increased relaxation time consistent with discrete areas of cartilage necrosis 3-11 weeks postoperatively and demonstrated delayed progression of the ossification front at 9 (n = 1) and 11 (n = 2) weeks postoperatively. In vivo MRI findings were confirmed by ex vivo MRI at 9.4 T and by histology. Identification of cartilage necrosis in clinical patients in the early stages of OC using T2 maps may provide valuable insight into the pathogenesis of this condition. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:868-875, 2017.
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Affiliation(s)
- Ferenc Tóth
- Veterinary Population Medicine Department, University of Minnesota, St. Paul, MN, USA
| | - Frédéric H. David
- Veterinary Clinical Sciences Department, University of Minnesota, St. Paul, MN, USA
| | - Elizabeth LaFond
- Veterinary Clinical Sciences Department, University of Minnesota, St. Paul, MN, USA
| | - Luning Wang
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | - Jutta M. Ellermann
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | - Cathy S. Carlson
- Veterinary Population Medicine Department, University of Minnesota, St. Paul, MN, USA
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Ellermann JM, Donald B, Rohr S, Takahashi T, Tompkins M, Nelson B, Crawford A, Rud C, Macalena J. Magnetic Resonance Imaging of Osteochondritis Dissecans: Validation Study for the ICRS Classification System. Acad Radiol 2016; 23:724-9. [PMID: 26976624 DOI: 10.1016/j.acra.2016.01.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Revised: 01/16/2016] [Accepted: 01/17/2016] [Indexed: 10/22/2022]
Abstract
RATIONALE AND OBJECTIVES In this retrospective case series, we utilize arthroscopy as the gold standard to determine if magnetic resonance imaging (MRI) of the knee can predict osteochondritis dissecans (OCD) lesion stability, the most important information to guide patient treatment decisions. It is hypothesized that the classification system of the International Cartilage Repair Society (ICRS) will allow for improved assessment of lesion grade and stability in OCD. MATERIALS AND METHODS Routine MRI studies of 46 consecutive patients with arthroscopically proven OCD lesions (mean age: 23.7 years; 26 male, 16 female) were assessed by three radiologists who were blinded to arthroscopic results. Arthroscopic images were evaluated by two orthopedic surgeons in consensus. The OCD criteria of the ICRS were applied to arthroscopy and imaging interpretations. Inter-rater correlation statistics and accuracy of magnetic resonance (MR) grading with respect to arthroscopy were determined. RESULTS Only 56% of the available MR reports assigned a label of stable or unstable to the lesion description. Of these, 58% of the lesions were deemed unstable and 42% were stable. Accuracy was 53% when reports addressed stability. Utilizing the ICRS classification system, for all three readers combined, the respective sensitivity, specificity, and accuracy of MR imaging to determine lesion stability were 70%, 81%, and 76%. When compared to the original MRI report, the overall accuracy increased from 53% to 76% when readers were given the specific criteria of the OCD ICRS classification. However, inter-reader variability remained high, with Krippendorf's alpha ranging from 0.48 to 0.57. CONCLUSIONS In this paper, we utilize arthroscopy as the gold standard to determine if MRI can predict OCD lesion stability, the most important information to guide patient treatment decisions. To our surprise, the analysis of the existing radiology reports that addressed stability revealed an overall accuracy in defining OCD lesion stability of about 53%. The classification system of the ICRS, created by an international multidisciplinary, multi-expert consortium, did markedly improve the accuracy, but consistency among different readers was lacking. This retrospective study on OCD reporting and classification highlights the inadequacy of existing classification schemes, and emphasizes the critical need for improved diagnostic MRI protocols in musculoskeletal radiology in order to propel it toward evidence-based medicine.
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Tóth F, Nissi MJ, Ellermann JM, Wang L, Shea KG, Polousky J, Carlson CS. Novel Application of Magnetic Resonance Imaging Demonstrates Characteristic Differences in Vasculature at Predilection Sites of Osteochondritis Dissecans. Am J Sports Med 2015; 43:2522-7. [PMID: 26286878 PMCID: PMC4766866 DOI: 10.1177/0363546515596410] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Understanding the pathogenesis of osteochondrosis/osteochondritis dissecans and other developmental orthopaedic diseases that are thought to occur secondary to defects in vascular supply to growth/epiphyseal cartilage has been hampered by the inability to image the vasculature in this tissue. This is particularly true in human beings due to limitations of current imaging techniques and the lack of availability of appropriate cadaveric samples for histological studies. HYPOTHESIS Susceptibility-weighted imaging, an MRI sequence, allows identification of characteristic differences in the vascular architecture in species that are affected by osteochondrosis/osteochondritis dissecans on the femoral condyle (humans and pigs) versus a species that is free of the disease (goat). STUDY DESIGN Controlled laboratory study. MATERIALS Distal femora from cadavers of juvenile humans (n = 5), pigs (n = 3), and goats (n = 3) were scanned in a 9.4-T MRI scanner using susceptibility-weighted imaging. Three-dimensional reconstructions were created, and minimum intensity projections were calculated in 3 planes to enhance visualization of the vascular architecture. RESULTS Susceptibility-weighted imaging allowed clear visualization of the epiphyseal vasculature in all species. Vascular architecture, with vessels primarily arising from the perichondrium, was similar in humans and pigs, which are predisposed to osteochondrosis/osteochondritis dissecans, and was starkly different from that present in goats, a species in which there are no reports of osteochondrosis/osteochondritis dissecans. Furthermore, vessels in the distal femoral predilection site disappeared with age in humans in a pattern similar to that reported previously in pigs. CONCLUSION Nearly identical vascular architecture at the shared primary predilection site of osteochondrosis/osteochondritis dissecans in the femoral condyles in human beings and pigs suggests that vascular failure, which is known to be central to the pathogenesis of this disease in pigs, may also play a role in humans. CLINICAL RELEVANCE This assumption of a shared pathogenesis is supported by the pattern of disappearance of vessels with age at the primary predilection site of osteochondritis dissecans in humans, which is essentially identical to that which has been reported in pigs. Susceptibility-weighted imaging will likely help further elucidate this potential relationship in the future.
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Affiliation(s)
- Ferenc Tóth
- Department of Veterinary Population Medicine, University of Minnesota, St. Paul, MN, USA,Correspondence to: Ferenc Toth, 435H AnSci/VetMed, 1988 Fitch Avenue, St. Paul, MN 55108, USA; Tel.: 1-612-624-7727;
| | - Mikko J. Nissi
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA,Department of Radiology, Institute of Diagnostics, University of Oulu, Oulu, Finland,Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Jutta M. Ellermann
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Luning Wang
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Kevin G. Shea
- St Lukes Health System, Boise, ID,Department of Orthopedics, University of Utah, Salt Lake City, UT
| | - John Polousky
- The Rocky Mountain Hospital for Children, Denver, CO
| | - Cathy S. Carlson
- Department of Veterinary Population Medicine, University of Minnesota, St. Paul, MN, USA
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Nissi MJ, Tóth F, Wang L, Carlson CS, Ellermann JM. Improved Visualization of Cartilage Canals Using Quantitative Susceptibility Mapping. PLoS One 2015; 10:e0132167. [PMID: 26168296 PMCID: PMC4500468 DOI: 10.1371/journal.pone.0132167] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 06/10/2015] [Indexed: 11/18/2022] Open
Abstract
Purpose Cartilage canal vessels are critical to the normal function of epiphyseal (growth) cartilage and damage to these vessels is demonstrated or suspected in several important developmental orthopaedic diseases. High-resolution, three-dimensional (3-D) visualization of cartilage canals has recently been demonstrated using susceptibility weighted imaging (SWI). In the present study, a quantitative susceptibility mapping (QSM) approach is evaluated for 3-D visualization of the cartilage canals. It is hypothesized that QSM post-processing improves visualization of the cartilage canals by resolving artifacts present in the standard SWI post-processing while retaining sensitivity to the cartilage canals. Methods Ex vivo distal femoral specimens from 3- and 8-week-old piglets and a 1-month-old human cadaver were scanned at 9.4 T with a 3-D gradient recalled echo sequence suitable for SWI and QSM post-processing. The human specimen and the stifle joint of a live, 3-week-old piglet also were scanned at 7.0 T. Datasets were processed using the standard SWI method and truncated k-space division QSM approach. To compare the post-processing methods, minimum/maximum intensity projections and 3-D reconstructions of the processed datasets were generated and evaluated. Results Cartilage canals were successfully visualized using both SWI and QSM approaches. The artifactual splitting of the cartilage canals that occurs due to the dipolar phase, which was present in the SWI post-processed data, was eliminated by the QSM approach. Thus, orientation-independent visualization and better localization of the cartilage canals was achieved with the QSM approach. Combination of GRE with a mask based on QSM data further improved visualization. Conclusions Improved and artifact-free 3-D visualization of the cartilage canals was demonstrated by QSM processing of the data, especially by utilizing susceptibility data as an enhancing mask. Utilizing tissue-inherent contrast, this method allows noninvasive assessment of the vasculature in the epiphyseal cartilage in the developing skeleton and potentially increases the opportunity to diagnose disease of this tissue in the preclinical stages, when treatment likely will have increased efficacy.
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Affiliation(s)
- Mikko J. Nissi
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN, United States of America
- Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, United States of America
- Research Group of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
- * E-mail:
| | - Ferenc Tóth
- Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, United States of America
| | - Luning Wang
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN, United States of America
- Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, United States of America
| | - Cathy S. Carlson
- Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, United States of America
| | - Jutta M. Ellermann
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN, United States of America
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Nissi MJ, Lehto LJ, Corum CA, Idiyatullin D, Ellermann JM, Gröhn OHJ, Nieminen MT. Measurement of T 1 relaxation time of osteochondral specimens using VFA-SWIFT. Magn Reson Med 2014; 74:175-184. [PMID: 25111731 DOI: 10.1002/mrm.25398] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 07/02/2014] [Accepted: 07/14/2014] [Indexed: 01/12/2023]
Abstract
PURPOSE To evaluate the feasibility of SWIFT with variable flip angle (VFA) for measurement of T1 relaxation time in Gd-agarose-phantoms and osteochondral specimens, including regions of very short T2 *, and compare with T1 measured using standard methods METHODS: T1 s of agarose phantoms with variable concentration of Gd-DTPA2- and nine pairs of native and trypsin-treated bovine cartilage-bone specimens were measured. For specimens, VFA-SWIFT, inversion recovery (IR) fast spin echo (FSE) and saturation recovery FSE were used. For phantoms, additionally spectroscopic IR was used. Differences and agreement between the methods were assessed using nonparametric Wilcoxon and Kruskal-Wallis tests and intraclass correlation. RESULTS The different T1 mapping methods agreed well in the phantoms. VFA-SWIFT allowed reliable measurement of T1 in the osteochondral specimens, including regions where FSE-based methods failed. The T1 s measured by VFA-SWIFT were shifted toward shorter values in specimens. However, the measurements correlated significantly (highest correlation VFA-SWIFT versus FSE was r = 0.966). SNR efficiency was generally highest for SWIFT, especially in the subchondral bone. CONCLUSION Feasibility of measuring T1 relaxation time using VFA-SWIFT in osteochondral specimens and phantoms was demonstrated. A shift toward shorter T1 s was observed for VFA-SWIFT in specimens, reflecting the higher sensitivity of SWIFT to short T2 * spins. Magn Reson Med 74:175-184, 2015. © 2014 Wiley Periodicals, Inc.
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Affiliation(s)
- Mikko J Nissi
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Lauri J Lehto
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Neurobiology, A.I. Virtanen Institute for Molecular Medicine, University of Eastern Finland, Kuopio, Finland
| | - Curtis A Corum
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Djaudat Idiyatullin
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jutta M Ellermann
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Olli H J Gröhn
- Department of Neurobiology, A.I. Virtanen Institute for Molecular Medicine, University of Eastern Finland, Kuopio, Finland
| | - Miika T Nieminen
- Department of Diagnostic Radiology, Oulu University Hospital and University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
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Tóth F, Nissi MJ, Zhang J, Benson M, Schmitter S, Ellermann JM, Carlson CS. Histological confirmation and biological significance of cartilage canals demonstrated using high field MRI in swine at predilection sites of osteochondrosis. J Orthop Res 2013; 31:2006-12. [PMID: 23939946 PMCID: PMC4034470 DOI: 10.1002/jor.22449] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Accepted: 06/26/2013] [Indexed: 02/04/2023]
Abstract
Cartilage canal vessels in epiphyseal cartilage have a pivotal role in the pathogenesis of osteochondrosis/osteochondritis dissecans. The present study aimed to validate high field magnetic resonance imaging (MRI) methods to visualize these vessels in young pigs. Osteochondral samples from the distal femur and distal humerus (predilection sites of osteochondrosis) of piglets were imaged post-mortem: (1) using susceptibility-weighted imaging (SWI) in an MRI scanner, followed by histological evaluation; and (2) after barium perfusion using µCT, followed by clearing techniques. In addition, both stifle joints of a 25-day-old piglet were imaged in vivo using SWI and gadolinium enhanced T1-weighted MRI, after which distal femoral samples were harvested and evaluated using µCT and histology. Histological sections were compared to corresponding MRI slices, and three-dimensional visualizations of vessels identified using MRI were compared to those obtained using µCT and to the cleared specimens. Vessels contained in cartilage canals were identified using MRI, both ex vivo and in vivo; their locations matched those observed in the histological sections, µCT images, and cleared specimens of barium-perfused tissues. The ability to visualize cartilage canal blood vessels by MRI, without using a contrast agent, will allow future longitudinal studies to evaluate their role in developmental orthopedic disease.
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Affiliation(s)
- Ferenc Tóth
- Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota
| | - Mikko J. Nissi
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota,Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Jinjin Zhang
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota,Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Michael Benson
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota,Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Sebastian Schmitter
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota
| | - Jutta M. Ellermann
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota
| | - Cathy S. Carlson
- Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota
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Nissi MJ, Toth F, Zhang J, Schmitter S, Benson M, Carlson CS, Ellermann JM. Susceptibility weighted imaging of cartilage canals in porcine epiphyseal growth cartilage ex vivo and in vivo. Magn Reson Med 2013; 71:2197-205. [PMID: 23857631 DOI: 10.1002/mrm.24863] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 06/10/2013] [Accepted: 06/10/2013] [Indexed: 01/27/2023]
Abstract
PURPOSE High-resolution visualization of cartilage canals has been restricted to histological methods and contrast-enhanced imaging. In this study, the feasibility of non-contrast-enhanced susceptibility weighted imaging (SWI) for visualization of the cartilage canals was investigated ex vivo at 9.4 T, further explored at 7 and 3 T and demonstrated in vivo at 7 T, using a porcine animal model. METHODS SWI scans of specimens of distal femur and humerus from 1 to 8 week-old piglets were conducted at 9.4 T using 3D-GRE sequence and SWI post-processing. The stifle joints of a 2-week old piglet were scanned ex vivo at 7 and 3 T. Finally, the same sites of a 3-week-old piglet were scanned, in vivo, at 7 T under general anesthesia using the vendor-provided sequences. RESULTS High-contrast visualization of the cartilage canals was obtained ex vivo, especially at higher field strengths; the results were confirmed histologically. In vivo feasibility was demonstrated at 7 T and comparison of ex vivo scans at 3 and 7 T indicated feasibility of using SWI at 3 T. CONCLUSIONS High-resolution 3D visualization of cartilage canals was demonstrated using SWI. This demonstration of fully noninvasive visualization opens new avenues to explore skeletal maturation and the role of vascular supply for diseases such as osteochondrosis.
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Affiliation(s)
- Mikko J Nissi
- Center for Magnetic Resonance Research and Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA; Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA
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Flament D, Ellermann JM, Kim SG, Ugurbil K, Ebner TJ. Functional magnetic resonance imaging of cerebellar activation during the learning of a visuomotor dissociation task. Hum Brain Mapp 2010; 4:210-26. [PMID: 20408199 DOI: 10.1002/hbm.460040302] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
We have used functional magnetic resonance imaging (fMRI) to study the changes in cerebellar activation that occur during the acquisition of motor skill in human subjects presented with a new task. The standard paradigm consisted of a center-out movement in which subjects used a joystick to superimposed a cursor onto viusual targets. Two variations of this paradigm were introduced: (1) a learning paradigm, where the relationship between movement of the joystick and cursor was reversed, requiring the learning of a visuomotor transformation to optimize performance and (2) a random paradigm, where the joystick/cursor relationship was changed randomly for each trial. Activation in the cerebellum was highest during the random paradigm and during the early stages of the learning paradigm. In the early stages of learning and during the random paradigm performance was poor with a decrease in the number of completed movements, and an increase in the time and length of movements. With repeated practice at the learning paradigm performance improbed and reached the same level of proficiency as in the standard task. Commensurate with the improbement in performance was a decrease in cerebellar activation, that is, activation in the cerebellum changed in a parallel, but inverse relationship with performance. Linear regression analysis demonstarated that the inverse correlation between cerebellar activation and motor performance was significant. Repeated practice at the random paradigm did not produce improvements in performance and cerebellar activity remained high. The data support the hypothesis that the cerebellum is strongly activated when motor performance is inaccurate, consistent with a role for the cerebellum in the detection of, and correction for visuomotor errors.
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Affiliation(s)
- D Flament
- Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota 55455, USA
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Ellermann JM, Siegal JD, Strupp JP, Ebner TJ, Ugurbil K. Activation of visuomotor systems during visually guided movements: a functional MRI study. J Magn Reson 1998; 131:272-285. [PMID: 9571103 DOI: 10.1006/jmre.1998.1379] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The dorsal stream is a dominant visuomotor pathway that connects the striate and extrastriate cortices to posterior parietal areas. In turn, the posterior parietal areas send projections to the frontal primary motor and premotor areas. This cortical pathway is hypothesized to be involved in the transformation of a visual input into the appropriate motor output. In this study we used functional magnetic resonance imaging (fMRI) of the entire brain to determine the patterns of activation that occurred while subjects performed a visually guided motor task. In nine human subjects, fMRI data were acquired on a 4-T whole-body MR system equipped with a head gradient coil and a birdcage RF coil using a T2*-weighted EPI sequence. Functional activation was determined for three different tasks: (1) a visuomotor task consisting of moving a cursor on a screen with a joystick in relation to various targets, (2) a hand movement task consisting of moving the joystick without visual input, and (3) a eye movement task consisting of moving the eyes alone without visual input. Blood oxygenation level-dependent (BOLD) contrast-based activation maps of each subject were generated using period cross-correlation statistics. Subsequently, each subject's brain was normalized to Talairach coordinates, and the individual maps were compared on a pixel by pixel basis. Significantly activated pixels common to at least four out of six subjects were retained to construct the final functional image. The pattern of activation during visually guided movements was consistent with the flow of information from striate and extrastriate visual areas, to the posterior parietal complex, and then to frontal motor areas. The extensive activation of this network and the reproducibility among subjects is consistent with a role for the dorsal stream in transforming visual information into motor behavior. Also extensively activated were the medial and lateral cerebellar structures, implicating the cortico-pontocerebellar pathway in visually guided movements. Thalamic activation, particularly of the pulvinar, suggests that this nucleus is an important subcortical target of the dorsal stream.
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Affiliation(s)
- J M Ellermann
- Center for Magnetic Resonance Research, University of Minnesota, School of Medicine, Minneapolis 55455, USA
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Kim SG, Ashe J, Hendrich K, Ellermann JM, Merkle H, Uğurbil K, Georgopoulos AP. Functional magnetic resonance imaging of motor cortex: hemispheric asymmetry and handedness. Science 1993; 261:615-7. [PMID: 8342027 DOI: 10.1126/science.8342027] [Citation(s) in RCA: 740] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
A hemispheric asymmetry in the functional activation of the human motor cortex during contralateral (C) and ipsilateral (I) finger movements, especially in right-handed subjects, was documented with nuclear magnetic resonance imaging at high field strength (4 tesla). Whereas the right motor cortex was activated mostly during contralateral finger movements in both right-handed (C/I mean area of activation = 36.8) and left-handed (C/I = 29.9) subjects, the left motor cortex was activated substantially during ipsilateral movements in left-handed subjects (C/I = 5.4) and even more so in right-handed subjects (C/I = 1.3).
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Affiliation(s)
- S G Kim
- Center for Magnetic Resonance Research (CMRR), University of Minnesota Medical School, Minneapolis 55455
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Abstract
In vivo 1H MRS can be used to detect and quantify the lactate resonance at 1.3 ppm provided that overlapping lipid resonances are eliminated. A homonuclear spectral editing method was developed to acquire uncontaminated 1H spectra of lactate with adiabatic pulses. An advantage of the adiabatic pulse sequence is the ability to induce uniform flip angles and to maximize sensitivity in applications employing surface coil transmitters which produce highly inhomogeneous B1. Glycolytic activity in an intracerebral C6 glioma in rats was monitored by using adiabatic editing sequences to observe [3-13C]lactate produced from infused [1-13C]glucose. Acute hyperglycemia (serum glucose > 22 mM, n = 10) had no significant effect (P = 0.08) on the total ([12C] + [13C]) tumor lactate signal intensity.
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Affiliation(s)
- D G Schupp
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis
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Ogawa S, Menon RS, Tank DW, Kim SG, Merkle H, Ellermann JM, Ugurbil K. Functional brain mapping by blood oxygenation level-dependent contrast magnetic resonance imaging. A comparison of signal characteristics with a biophysical model. Biophys J 1993; 64:803-12. [PMID: 8386018 PMCID: PMC1262394 DOI: 10.1016/s0006-3495(93)81441-3] [Citation(s) in RCA: 1208] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
It recently has been demonstrated that magnetic resonance imaging can be used to map changes in brain hemodynamics produced by human mental operations. One method under development relies on blood oxygenation level-dependent (BOLD) contrast: a change in the signal strength of brain water protons produced by the paramagnetic effects of venous blood deoxyhemoglobin. Here we discuss the basic quantitative features of the observed BOLD-based signal changes, including the signal amplitude and its magnetic field dependence and dynamic effects such as a pronounced oscillatory pattern that is induced in the signal from primary visual cortex during photic stimulation experiments. The observed features are compared with the results of Monte Carlo simulations of water proton intravoxel phase dispersion produced by local field gradients generated by paramagnetic deoxyhemoglobin in nearby venous blood vessels. The simulations suggest that the effect of water molecule diffusion is strong for the case of blood capillaries, but, for larger venous blood vessels, water diffusion is not an important determinant of deoxyhemoglobin-induced signal dephasing. We provide an expression for the apparent in-plane relaxation rate constant (R2*) in terms of the main magnetic field strength, the degree of the oxygenation of the venous blood, the venous blood volume fraction in the tissue, and the size of the blood vessel.
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Affiliation(s)
- S Ogawa
- Biological Computation Research Department, AT&T Bell Laboratories, Murray Hill, New Jersey 07974
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Kim SG, Ashe J, Georgopoulos AP, Merkle H, Ellermann JM, Menon RS, Ogawa S, Ugurbil K. Functional imaging of human motor cortex at high magnetic field. J Neurophysiol 1993; 69:297-302. [PMID: 8433133 DOI: 10.1152/jn.1993.69.1.297] [Citation(s) in RCA: 281] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
1. We used conventional gradient echo magnetic resonance imaging (MRI) at high field strength (4 Tesla) to functionally image the right motor cortex in six normal human subjects during the performance of a sequence of self-paced thumb to digit oppositions with the left hand (contralateral task), the right hand (ipsilateral task), and both hands (bilateral task). 2. A localized increase in activity in the lateral motor cortex was observed in all subjects during the task. The area of activation was similar in the contralateral and bilateral tasks but 20 times smaller in the ipsilateral task. The intensity of activation was 2.3 times greater in the contralateral than the ipsilateral task.
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Affiliation(s)
- S G Kim
- Center for Magnetic Resonance Research, University of Minnesota Medical School, Minneapolis 55455
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Menon RS, Ogawa S, Kim SG, Ellermann JM, Merkle H, Tank DW, Ugurbil K. Functional brain mapping using magnetic resonance imaging. Signal changes accompanying visual stimulation. Invest Radiol 1992; 27 Suppl 2:S47-53. [PMID: 1468875 DOI: 10.1097/00004424-199212002-00009] [Citation(s) in RCA: 91] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Easily detectable (5%-20%) transient increases in the intensity of water proton magnetic resonance (MR) signals in human primary visual cortex were observed during visual stimulation in gradient echo images at 4-T field strength. The signal intensity increases were predominantly restricted to areas containing gray matter and were used to produce high-spatial-resolution human functional brain maps. Time dependence of the functional brain maps also was monitored during visual stimulation using images acquired every approximately 5 seconds; these images with high spatial and temporal resolution demonstrated that photic stimulation first resulted in signal increases in a large area of the visual cortex followed by a reduction in the size of the area, and that signal intensity increases in the gray matter were time dependent. Reducing the image acquisition echo times reduced the amplitude of the fractional signal change, suggesting that it is produced by a change in T2 or T2*. The amplitude, sign, and echo time dependence of these intrinsic signal changes are consistent with the idea that neural activation increases regional cerebral with the idea that neural activation increases regional cerebral blood flow (rCBF) with a concomitant increase in venous blood oxygenation.
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Affiliation(s)
- R S Menon
- Center for Magnetic Resonance Research, University of Minnesota Medical School, Minneapolis
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Blamire AM, Ogawa S, Ugurbil K, Rothman D, McCarthy G, Ellermann JM, Hyder F, Rattner Z, Shulman RG. Dynamic mapping of the human visual cortex by high-speed magnetic resonance imaging. Proc Natl Acad Sci U S A 1992; 89:11069-73. [PMID: 1438317 PMCID: PMC50485 DOI: 10.1073/pnas.89.22.11069] [Citation(s) in RCA: 241] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
We report the use of high-speed magnetic resonance imaging to follow the changes in image intensity in the human visual cortex during stimulation by a flashing checkerboard stimulus. Measurements were made in a 2.1-T, 1-m-diameter magnet, part of a Bruker Biospec spectrometer that we had programmed to do echo-planar imaging. A 15-cm-diameter surface coil was used to transmit and receive signals. Images were acquired during periods of stimulation from 2 s to 180 s. Images were acquired in 65.5 ms in a 10-mm slice with in-plane voxel size of 6 x 3 mm. Repetition time (TR) was generally 2 s, although for the long flashing periods, TR = 8 s was used. Voxels were located onto an inversion recovery image taken with 2 x 2 mm in-plane resolution. Image intensity increased after onset of the stimulus. The mean change in signal relative to the prestimulation level (delta S/S) was 9.7% (SD = 2.8%, n = 20) with an echo time of 70 ms. Irrespective of the period of stimulation, the increase in magnetic resonance signal intensity was delayed relative to the stimulus. The mean delay measured from the start of stimulation for each protocol was as follows: 2-s stimulation, delay = 3.5 s (SD = 0.5 s, n = 10) (the delay exceeds stimulus duration); 20- to 24-s stimulation, delay = 5 s (SD = 2 s, n = 20).
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Affiliation(s)
- A M Blamire
- Department of Molecular Biophysics and Biochemistry, Yale University, New Haven, CT 06510
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Ogawa S, Tank DW, Menon R, Ellermann JM, Kim SG, Merkle H, Ugurbil K. Intrinsic signal changes accompanying sensory stimulation: functional brain mapping with magnetic resonance imaging. Proc Natl Acad Sci U S A 1992; 89:5951-5. [PMID: 1631079 PMCID: PMC402116 DOI: 10.1073/pnas.89.13.5951] [Citation(s) in RCA: 2237] [Impact Index Per Article: 69.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
We report that visual stimulation produces an easily detectable (5-20%) transient increase in the intensity of water proton magnetic resonance signals in human primary visual cortex in gradient echo images at 4-T magnetic-field strength. The observed changes predominantly occur in areas containing gray matter and can be used to produce high-spatial-resolution functional brain maps in humans. Reducing the image-acquisition echo time from 40 msec to 8 msec reduces the amplitude of the fractional signal change, suggesting that it is produced by a change in apparent transverse relaxation time T*2. The amplitude, sign, and echo-time dependence of these intrinsic signal changes are consistent with the idea that neural activation increases regional cerebral blood flow and concomitantly increases venous-blood oxygenation.
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Affiliation(s)
- S Ogawa
- Biological Computation Research Department, AT&T Bell Laboratories, Murray Hill, NJ 07974
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Ellermann JM. Clinical Magnetic Resonance Spectroscopy. Radiology 1991. [DOI: 10.1148/radiology.180.3.760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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