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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

Axial diffusion-weighted images of a patient 24 months after matrix-associated autologous chondrocyte transplantation (MACT) (arrows) of the patella using a high-resolution, 3-D, balanced, steady-state gradient-echo pulse sequence (3-D diffusion-weighted reversed Fast Imaging with Steady State Precession [DW-PSIF]) without (a) and with a diffusion gradient of 130 T*ms*m−1 in 3 directions, slice (b), phase (c), read (d), resulting in an apparent diffusion coefficient (ADC) map (e) furthermore based on a T1 map and given T2 values. A clearly higher diffusivity of the repair tissue in contrast to the healthy surrounding cartilage is visible.
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fig8-1947603509360209: Axial diffusion-weighted images of a patient 24 months after matrix-associated autologous chondrocyte transplantation (MACT) (arrows) of the patella using a high-resolution, 3-D, balanced, steady-state gradient-echo pulse sequence (3-D diffusion-weighted reversed Fast Imaging with Steady State Precession [DW-PSIF]) without (a) and with a diffusion gradient of 130 T*ms*m−1 in 3 directions, slice (b), phase (c), read (d), resulting in an apparent diffusion coefficient (ADC) map (e) furthermore based on a T1 map and given T2 values. A clearly higher diffusivity of the repair tissue in contrast to the healthy surrounding cartilage is visible.

Mentions: Studies concerning DWI focusing on the SSFP sequence are based on a reversed FISP approach. The so-called 3-D diffusion-weighted reversed Fast Imaging with Steady State Precession (DW-PSIF) sequence is able to provide a semiquantitative assessment of the diffusional behavior of hyaline cartilage and cartilage repair tissue.61,151,152 Thus, in cartilage repair, the differentiation of the surrounding control cartilage and cartilage repair tissue after MACT is possible because of the higher diffusivity of the repair tissue even years after surgery (Fig. 8).61 In a longitudinal study, nevertheless, the diffusivity seems to decrease over time toward control healthy cartilage.151 In a multimodal approach, comparing repair tissue after microfracture and MACT, the diffusivity of the repair tissue after microfracture seems even higher than that after MACT, and an initial correlation with clinical results could be assessed.152 The feasibility of this technique was also shown in cartilage repair procedures of the thin ankle cartilage.130 Very recent SSFP DWI sequences provide direct quantification using apparent diffusion coefficient (ADC), which should be the goal for future approaches in the evaluation of cartilage repair procedures.


Magnetic Resonance Imaging of Cartilage Repair: A Review.

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

Axial diffusion-weighted images of a patient 24 months after matrix-associated autologous chondrocyte transplantation (MACT) (arrows) of the patella using a high-resolution, 3-D, balanced, steady-state gradient-echo pulse sequence (3-D diffusion-weighted reversed Fast Imaging with Steady State Precession [DW-PSIF]) without (a) and with a diffusion gradient of 130 T*ms*m−1 in 3 directions, slice (b), phase (c), read (d), resulting in an apparent diffusion coefficient (ADC) map (e) furthermore based on a T1 map and given T2 values. A clearly higher diffusivity of the repair tissue in contrast to the healthy surrounding cartilage is visible.
© Copyright Policy
Related In: Results  -  Collection

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

fig8-1947603509360209: Axial diffusion-weighted images of a patient 24 months after matrix-associated autologous chondrocyte transplantation (MACT) (arrows) of the patella using a high-resolution, 3-D, balanced, steady-state gradient-echo pulse sequence (3-D diffusion-weighted reversed Fast Imaging with Steady State Precession [DW-PSIF]) without (a) and with a diffusion gradient of 130 T*ms*m−1 in 3 directions, slice (b), phase (c), read (d), resulting in an apparent diffusion coefficient (ADC) map (e) furthermore based on a T1 map and given T2 values. A clearly higher diffusivity of the repair tissue in contrast to the healthy surrounding cartilage is visible.
Mentions: Studies concerning DWI focusing on the SSFP sequence are based on a reversed FISP approach. The so-called 3-D diffusion-weighted reversed Fast Imaging with Steady State Precession (DW-PSIF) sequence is able to provide a semiquantitative assessment of the diffusional behavior of hyaline cartilage and cartilage repair tissue.61,151,152 Thus, in cartilage repair, the differentiation of the surrounding control cartilage and cartilage repair tissue after MACT is possible because of the higher diffusivity of the repair tissue even years after surgery (Fig. 8).61 In a longitudinal study, nevertheless, the diffusivity seems to decrease over time toward control healthy cartilage.151 In a multimodal approach, comparing repair tissue after microfracture and MACT, the diffusivity of the repair tissue after microfracture seems even higher than that after MACT, and an initial correlation with clinical results could be assessed.152 The feasibility of this technique was also shown in cartilage repair procedures of the thin ankle cartilage.130 Very recent SSFP DWI sequences provide direct quantification using apparent diffusion coefficient (ADC), which should be the goal for future approaches in the evaluation of cartilage repair procedures.

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