MRI UTE‐T2* shows high incidence of cartilage subsurface matrix changes 2 years after ACL reconstruction

Aw, Williams; Titchenal, Matthew R.; H., Bao; Guha, Aditi; Chu, Constance R.

doi:10.1002/jor.24110

Cited by 37 publications

(29 citation statements)

References 32 publications

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“…Classically, elevated T2 values in cartilage have been considered to represent irreversible damage to the extracellular matrix . Most recently, investigators have demonstrated that T2*, as measured by a multi‐echo UTE technique similar to that used in this study, was significantly elevated in cartilage of injured knees compared with uninjured controls . Based on these results from studies in non‐haemophilic populations with injury or osteoarthritis, we expected to find a positive correlation between increasing T2* relaxation times and worsening joint status.…”

Section: Discussionmentioning

confidence: 54%

Advanced magnetic resonance imaging of cartilage components in haemophilic joints reveals that cartilage hemosiderin correlates with joint deterioration

et al. 2019

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Introduction: Evidence suggests that toxic iron is involved in haemophilic joint destruction. Aim:To determine whether joint iron deposition is linked to clinical and imaging outcomes in order to optimize management of haemophilic joint disease. Methods: Adults with haemophiliaA or haemophilia B (n = 23, ≥ age 21) of all severities were recruited prospectively to undergo assessment with Hemophilia Joint Health Scores (HJHS), pain scores (visual analogue scale [VAS]) and magnetic resonance imaging (MRI) at 3T using conventional MRI protocols and 4-echo 3D-UTE-Cones sequences for one affected arthropathic joint. MRI was scored blinded by two musculoskeletal radiologists using the International Prophylaxis Study Group (IPSG) MRI scale. Additionally, UTE-T2* values of cartilage were quantified. Correlations between parameters were performed using Spearman rank correlation. Two patients subsequently underwent knee arthroplasty, which permitted linking of histological findings (including Perl's reaction) with MRI results.Results: MRI scores did not correlate with pain scores or HJHS. Sixteen joints had sufficient cartilage for UTE-T2* analysis. T2* values for cartilage correlated inversely with HJHS (r s = −0.81, P < 0.001) and MRI scores (r s = −0.52, P = 0.037). This was unexpected since UTE-T2* values decrease with better joint status in patients with osteoarthritis, suggesting that iron was present and responsible for the effects.Histological analysis of cartilage confirmed iron deposition within chondrocytes, associated with low UTE-T2* values. Conclusions: Iron accumulation can occur in cartilage (not only in synovium) andshows a clear association with joint health. Cartilage iron is a novel biomarker which, if quantifiable with innovative joint-specific MRI T2* sequences, may guide treatment optimization.

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Section: Discussionmentioning

confidence: 54%

Advanced magnetic resonance imaging of cartilage components in haemophilic joints reveals that cartilage hemosiderin correlates with joint deterioration

et al. 2019

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“…Compared with 2D UTE sequences, 3D UTE sequences have the advantage of reducing through‐plane partial volume effects, which is important for imaging the thin (ie 100–200 μm) and curved OCJ region . Multi‐echo 3D UTE techniques with echo subtraction or T 2 * fitting have been used for this purpose, but there have been problems with low OCJ region contrast and the need for intensive post‐processing . For clinical purposes, an optimal 3D UTE sequence should provide whole joint coverage, show the OCJ region with high contrast, be obtainable in clinically acceptable scan time and require little or no post‐processing.…”

Section: Introductionmentioning

confidence: 99%

Imaging of the region of the osteochondral junction (OCJ) using a 3D adiabatic inversion recovery prepared ultrashort echo time cones (3D IR‐UTE‐cones) sequence at 3 T

Jerban

Carl³

et al. 2019

NMR in Biomedicine

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The purpose of this study is to develop a 3D adiabatic inversion recovery prepared ultrashort echo time Cones (3D IR-UTE-Cones) sequence for high resolution and contrast imaging of the region of osteochondral junction (OCJ) of human knee joint using a clinical 3 T scanner. A feasibility study on direct imaging of the OCJ region was performed on a human patellar cartilage sample and on eight cadaveric knee joints using T 1 -weighted, proton density (PD)-weighted and short-T 2 -weighted 3D IR-UTE-Cones sequences. Contrast to noise ratio was measured to evaluate the effectiveness of the 3D IR-UTE-Cones sequences for selective imaging of the OCJ region. Computed tomography imaging was performed in parallel for the cadaveric knee joints. The optimized T 1 -weighted 3D IR-UTE-Cones sequence was used to image the knee joints of eight healthy volunteers and six patients with osteoarthritis (OA) to evaluate morphological changes in the OCJ region. Clinical PD-and T 2 -weighted FSE sequences were also performed for comparison. The T 1 -weighted 3D IR-UTE-Cones sequence showed high resolution and contrast bright band of the normal OCJ region in the cadaveric joints. Normal OCJ appearances were also seen in healthy volunteers. Abnormal OCJ regions, manifested as ill-defined, focal loss or non-visualization of the high intensity band adjacent to the subchondral bone plate, were observed in the knee joints of both ex vivo and in vivo OA patients. The 3D IR-UTE-Cones sequence can image OCJ regions ex vivo and in vivo, with abnormalities depicted with high resolution and contrast. The technique may be useful for demonstrating involvement of OCJ regions in early OA. KEYWORDS 3D ultrashort echo time, adiabatic inversion recovery, calcified cartilage, osteochondral junction

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“…Williams et al [86], using a monoexponential decay model, found that UTE T2* values were more sensitive to matrix degeneration than conventional T2 values based on histologic standards, showing lower UTE T2* values associated with severely degraded cartilage. In a recent study of patients 2 years after anterior cruciate ligament reconstruction, UTE T2* assessment could identify deep articular pathologic abnormalities in subclinical disease that were not evident at conventional MRI [94]. Chu et al [95] showed that UTE T2* values were significantly elevated in patients who had undergone ACL reconstruction with arthroscopically normal articular cartilage and menisci.…”

Section: Ultrashort-te T2* Mappingmentioning

confidence: 99%

Quantitative MRI Musculoskeletal Techniques: An Update

Mello

et al. 2019

American Journal of Roentgenology

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T2 Mapping Different MRI parametric mapping techniques are available, such as T2, T2*, and T1 mapping, but the most widely available and frequently obtained is T2 mapping. This technique typically requires acquisition of multiple images with different TEs that will yield signal intensities that follow a T2 relaxation curve, such as with the single-echo spin-echo, multiecho spin-echo, and doubleecho steady-state sequences [5, 6]. When implementing T2 mapping in clinical practice, considerations should be given to acquisition, postprocessing, and interpretation. Acquisition of T2-mapping techniques can be lengthy, and patient motion during the sequence can result in inaccurate mapping. In addition, a technical challenge that can be seen with some parametric mapping techniques, such as multiecho spin-echo T2 mapping, is sensitivity to B 1 inhomogeneity [7]. B 1 inhomogeneity is particularly prominent at high field strengths, such as 3 T, and can lead to inaccuracies in quantification. Different T2-mapping methods have been proposed to overcome this limitation, including the use of a T2-preparation pulse to ensure B 1 insensitivity, followed by either a gradientecho readout or 3D turbo spin-echo readout [8]. The T2-preparation pulse consists of a spin-echo-like preparation pulse to transmit the T2-weighted contrast and a readout design for fast image data gathering. T2-preparation techniques have faster acquisition times than the multiecho spin-echo technique, but they

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MRI UTE‐T2* shows high incidence of cartilage subsurface matrix changes 2 years after ACL reconstruction

Cited by 37 publications

References 32 publications

Advanced magnetic resonance imaging of cartilage components in haemophilic joints reveals that cartilage hemosiderin correlates with joint deterioration

Advanced magnetic resonance imaging of cartilage components in haemophilic joints reveals that cartilage hemosiderin correlates with joint deterioration

Imaging of the region of the osteochondral junction (OCJ) using a 3D adiabatic inversion recovery prepared ultrashort echo time cones (3D IR‐UTE‐cones) sequence at 3 T

Quantitative MRI Musculoskeletal Techniques: An Update

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