The recently developed multi-acquisition with variable resonance image combination (MAVRIC) and slice-encoding metal artifact correction (SEMAC) techniques can significantly reduce image artifacts commonly encountered near embedded metal hardware. These artifact reductions are enabled by applying alternative spectral and spatial-encoding schemes to conventional spin-echo imaging techniques. Here, the MAVRIC and SEMAC concepts are connected and discussed. The development of a hybrid technique that utilizes strengths of both methods is then introduced. The presented technique is shown capable of producing minimal artifact, high-resolution images near total joint replacements in a clinical setting. Magn Reson Med 65:71-82, 2011.
MAVRIC complements the information on FSE images after arthroplasty and is a useful additional sequence, particularly when there is concern about synovitis, periprosthetic osteolysis, or the presence of a supraspinatus tendon tear.
Purpose To determine the intermodality agreement of morphologic grading and clinically relevant quantitative measurements between computed tomography (CT) and zero echo time (ZTE) magnetic resonance (MR) imaging of the shoulder. The primary objective was to demonstrate the clinical applicability of ZTE in osseous shoulder imaging. Materials and Methods Thirty-four patients undergoing standard-of-care (SOC) MR imaging with concomitant CT were enrolled in this institutional review board-approved study. ZTE images were acquired after SOC MR imaging. Glenoid morphology (version, vault depth, erosion), injury or disease (osteoarthritis, Bankart and Hill-Sachs lesions, subchondral cysts), and evidence of prior surgery were graded or measured. κ Values, intraclass correlation coefficients (ICCs), and Bland-Altman limits of agreement were used to establish agreement. Qualitative comparison of osseous findings was performed between ZTE and SOC MR imaging. Results Binary classification and nominal/ordinal grades showed substantial or better agreement between raters and modalities (κ or ICC > 0.6). Continuous measurements exhibited strong correlation between raters and modalities, although not universally. Bankart ICCs were not significant, owing to low prevalence. ZTE exhibited greater conspicuity of enthesopathic cysts and marrow edema. In 21 of 34 cases, ZTE imaging of osseous features exceeded SOC MR imaging. Conclusion ZTE MR imaging provides "CT-like" contrast for bone. The results of this study demonstrate strong intermodality agreement between measurements and grades from CT and ZTE images in a cohort of patients undergoing imaging with both modalities. A majority of ZTE image sets provided superior visualization of osseous features when compared with SOC MR image sets. This superiority coupled with strong quantitative agreement with CT suggests that ZTE may be used clinically in lieu of CT in some cases. RSNA, 2017 Online supplemental material is available for this article.
OBJECTIVE
To evaluate the longitudinal reproducibility and variations of cartilage T1ρ and T2 measurements using different coils, MR systems and sites.
METHODS
Single-Site study: Phantom data were collected monthly for up to 29 months on four GE 3T MR systems. Data from phantoms and human subjects were collected on two MR systems using the same model of coil; and were collected on one MR system using two models of coils. Multi-site study: Three participating sites used the same model of MR systems and coils, and identical imaging protocols. Phantom data were collected monthly. Human subjects were scanned and rescanned on the same day at each site. Two traveling human subjects were scanned at all three sites.
RESULTS
Single-Site Study: The phantom longitudinal RMS-CVs ranged from 1.8% to 2.7% for T1ρ and 1.8% to 2.8% for T2. Significant differences were found in T1ρ and T2 values using different MR systems and coils. Multi-Site Study: The phantom longitudinal RMS-CVs ranged from 1.3% to 2.6% for T1ρ and 1.2% to 2.7% for T2. Across three sites (n=16), the in-vivo scan-rescan RMS-CV was 3.1% and 4.0% for T1ρ and T2, respectively. Phantom T1ρ and T2 values were significantly different between three sites but highly correlated (R>0.99). No significant difference was found in T1ρ and T2 values of traveling controls, with cross-site RMS-CV as 4.9% and 4.4% for T1ρ and T2, respectively.
CONCLUSION
With careful quality control and cross-calibration, quantitative MRI can be readily applied in multi-site studies and clinical trials for evaluating cartilage degeneration.
The results indicate the T2 values are not sensitive to changes in radiographic stages of OA. In addition, differences of T2 values with BMI signify structural changes occurring within the patello-femoral joint and that BMI may be considered a factor for a potential increase of T2 values. Future studies comparing different OA grading methods with T2 mapping may highlight the sensitivity of T2 mapping in a clinical setting.
Synovitis is common in patients with metal-on-metal hip prostheses and occurs with a similar incidence after resurfacing arthroplasty and after THA; osteolysis and extracapsular disease are uncommon. The MRI signs most suggestive of aseptic lymphocytic vasculitis-associated lesions are high volumes of synovitis, extracapsular disease, and intramuscular edema.
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