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Magnetic Resonance Imaging of Cartilage Repair: A Review.

Trattnig S, Winalski CS, Marlovits S, Jurvelin JS, Welsch GH, Potter HG - Cartilage (2011)

Bottom Line: Articular cartilage lesions are a common pathology of the knee joint, and many patients may benefit from cartilage repair surgeries that offer the chance to avoid the development of osteoarthritis or delay its progression.This goal is best fulfilled by magnetic resonance imaging (MRI).In the third section, a short overview is provided on the regulatory issues of the United States Food and Drug Administration (FDA) and the European Medicines Agency (EMEA) regarding MR follow-up studies of patients after cartilage repair surgeries.

View Article: PubMed Central - PubMed

Affiliation: MR Centre - High Field MR, Department of Radiology, Medical University of Vienna, Vienna, Austria.

ABSTRACT
Articular cartilage lesions are a common pathology of the knee joint, and many patients may benefit from cartilage repair surgeries that offer the chance to avoid the development of osteoarthritis or delay its progression. Cartilage repair surgery, no matter the technique, requires a noninvasive, standardized, and high-quality longitudinal method to assess the structure of the repair tissue. This goal is best fulfilled by magnetic resonance imaging (MRI). The present article provides an overview of the current state of the art of MRI of cartilage repair. In the first 2 sections, preclinical and clinical MRI of cartilage repair tissue are described with a focus on morphological depiction of cartilage and the use of functional (biochemical) MR methodologies for the visualization of the ultrastructure of cartilage repair. In the third section, a short overview is provided on the regulatory issues of the United States Food and Drug Administration (FDA) and the European Medicines Agency (EMEA) regarding MR follow-up studies of patients after cartilage repair surgeries.

No MeSH data available.


Related in: MedlinePlus

Dual flip angle excitation pulse 3-D gradient-echo (GRE) sequence (TR/TE: 15/3.94) (320 × 320; 16 cm; slice thickness: 3 mm). A flip angle of both 4.6° and 26.1° was used. The acquisition of 22 slices took 1 minute and 53 seconds. The sequence was performed before and after the intravenous application of ionic Gd-DTPA2−. In a 23-year-old male patient 22 months after matrix-associated autologous chondrocyte transplantation (MACT), the repair tissue shows significantly lower T1 values and thus lower glycosaminoglycan (GAG) content compared with normal hyaline cartilage. This is well demonstrated on the postcontrast T1 map but cannot be differentiated on the precontrast T1 map.
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fig5-1947603509360209: Dual flip angle excitation pulse 3-D gradient-echo (GRE) sequence (TR/TE: 15/3.94) (320 × 320; 16 cm; slice thickness: 3 mm). A flip angle of both 4.6° and 26.1° was used. The acquisition of 22 slices took 1 minute and 53 seconds. The sequence was performed before and after the intravenous application of ionic Gd-DTPA2−. In a 23-year-old male patient 22 months after matrix-associated autologous chondrocyte transplantation (MACT), the repair tissue shows significantly lower T1 values and thus lower glycosaminoglycan (GAG) content compared with normal hyaline cartilage. This is well demonstrated on the postcontrast T1 map but cannot be differentiated on the precontrast T1 map.

Mentions: A recent study by Trattnig et al.99 used a 3-D variable flip angle dGEMRIC technique in patients following matrix-induced ACI (MACI) surgery to obtain information related to the long-term development and maturation of grafts within clinically acceptable scan times. This 3-D technique allowed the acquisition of a slab of 36 slices covering a whole compartment of the knee joint with a relatively high resolution, 0.6 mm × 0.5 mm × 1.0 mm (Fig. 5). In principle, this sequence can also be used as an isotropic sequence to provide high-resolution reformatting in all planes, without loss of resolution, from one acquisition. Precise registration of precontrast and postcontrast images from the isotropic data set should be possible and further enhance 3-D visualization of the biochemical composition of articular cartilage. As shown in a phantom study, central positioning of the 3-D GRE slab is critical to achieve best results for T1 mapping to eliminate partial volume effects and increase the SNR. When this positioning is performed, a good correlation between variable flip angle technique and standard inversion recovery technique for T1 mapping was shown in phantoms99 and in vivo.101


Magnetic Resonance Imaging of Cartilage Repair: A Review.

Trattnig S, Winalski CS, Marlovits S, Jurvelin JS, Welsch GH, Potter HG - Cartilage (2011)

Dual flip angle excitation pulse 3-D gradient-echo (GRE) sequence (TR/TE: 15/3.94) (320 × 320; 16 cm; slice thickness: 3 mm). A flip angle of both 4.6° and 26.1° was used. The acquisition of 22 slices took 1 minute and 53 seconds. The sequence was performed before and after the intravenous application of ionic Gd-DTPA2−. In a 23-year-old male patient 22 months after matrix-associated autologous chondrocyte transplantation (MACT), the repair tissue shows significantly lower T1 values and thus lower glycosaminoglycan (GAG) content compared with normal hyaline cartilage. This is well demonstrated on the postcontrast T1 map but cannot be differentiated on the precontrast T1 map.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4300792&req=5

fig5-1947603509360209: Dual flip angle excitation pulse 3-D gradient-echo (GRE) sequence (TR/TE: 15/3.94) (320 × 320; 16 cm; slice thickness: 3 mm). A flip angle of both 4.6° and 26.1° was used. The acquisition of 22 slices took 1 minute and 53 seconds. The sequence was performed before and after the intravenous application of ionic Gd-DTPA2−. In a 23-year-old male patient 22 months after matrix-associated autologous chondrocyte transplantation (MACT), the repair tissue shows significantly lower T1 values and thus lower glycosaminoglycan (GAG) content compared with normal hyaline cartilage. This is well demonstrated on the postcontrast T1 map but cannot be differentiated on the precontrast T1 map.
Mentions: A recent study by Trattnig et al.99 used a 3-D variable flip angle dGEMRIC technique in patients following matrix-induced ACI (MACI) surgery to obtain information related to the long-term development and maturation of grafts within clinically acceptable scan times. This 3-D technique allowed the acquisition of a slab of 36 slices covering a whole compartment of the knee joint with a relatively high resolution, 0.6 mm × 0.5 mm × 1.0 mm (Fig. 5). In principle, this sequence can also be used as an isotropic sequence to provide high-resolution reformatting in all planes, without loss of resolution, from one acquisition. Precise registration of precontrast and postcontrast images from the isotropic data set should be possible and further enhance 3-D visualization of the biochemical composition of articular cartilage. As shown in a phantom study, central positioning of the 3-D GRE slab is critical to achieve best results for T1 mapping to eliminate partial volume effects and increase the SNR. When this positioning is performed, a good correlation between variable flip angle technique and standard inversion recovery technique for T1 mapping was shown in phantoms99 and in vivo.101

Bottom Line: Articular cartilage lesions are a common pathology of the knee joint, and many patients may benefit from cartilage repair surgeries that offer the chance to avoid the development of osteoarthritis or delay its progression.This goal is best fulfilled by magnetic resonance imaging (MRI).In the third section, a short overview is provided on the regulatory issues of the United States Food and Drug Administration (FDA) and the European Medicines Agency (EMEA) regarding MR follow-up studies of patients after cartilage repair surgeries.

View Article: PubMed Central - PubMed

Affiliation: MR Centre - High Field MR, Department of Radiology, Medical University of Vienna, Vienna, Austria.

ABSTRACT
Articular cartilage lesions are a common pathology of the knee joint, and many patients may benefit from cartilage repair surgeries that offer the chance to avoid the development of osteoarthritis or delay its progression. Cartilage repair surgery, no matter the technique, requires a noninvasive, standardized, and high-quality longitudinal method to assess the structure of the repair tissue. This goal is best fulfilled by magnetic resonance imaging (MRI). The present article provides an overview of the current state of the art of MRI of cartilage repair. In the first 2 sections, preclinical and clinical MRI of cartilage repair tissue are described with a focus on morphological depiction of cartilage and the use of functional (biochemical) MR methodologies for the visualization of the ultrastructure of cartilage repair. In the third section, a short overview is provided on the regulatory issues of the United States Food and Drug Administration (FDA) and the European Medicines Agency (EMEA) regarding MR follow-up studies of patients after cartilage repair surgeries.

No MeSH data available.


Related in: MedlinePlus