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Biomedical subjects

C S Winalski

Publications and source records attributed to C S Winalski.

At least 19 recordsLinked to original sources
PubMed2007

Longitudinal in vivo reproducibility of cartilage volume and surface in osteoarthritis of the knee.

OBJECTIVE: The aim of this study was to evaluate the longitudinal reproducibility of cartilage volume and surface area measurements in moderate osteoarthritis (OA) of the knee. MATERIALS AND METHODS: We analysed 5 MRI (GE 1.5T, sagittal 3D SPGR) data sets of patients with osteoarthritis (OA) of the knee (Kellgren Lawrence grade I-II). Two scans were performed: one baseline scan and one follow-up scan 3 months later (96 +/- 10 days). For segmentation, 3D Slicer 2.5 software was used. Two segmentations were performed by two readers independently who were blinded to the scan dates. Tibial and femoral cartilage volume and surface were determined. Longitudinal and cross-sectional precision errors were calculated using the standard deviation (SD) and coefficient of variation (CV%=100x[SD/mean]) from the repeated measurements in each patient. The in vivo reproducibility was then calculated as the root mean square of these individual reproducibility errors. RESULTS: The cross-sectional root mean squared coefficient of variation (RMSE-CV) was 1.2, 2.2 and 2.4% for surface area measurements (femur, medial and lateral tibia respectively) and 1.4, 1.8 and 1.3% for the corresponding cartilage volumes. Longitudinal RMSE-CV was 3.3, 3.1 and 3.7% for the surface area measurements (femur, medial and lateral tibia respectively) and 2.3, 3.3 and 2.4% for femur, medial and lateral tibia cartilage volumes. CONCLUSION: The longitudinal in vivo reproducibility of cartilage surface and volume measurements in the knee using this segmentation method is excellent. To the best of our knowledge we measured, for the first time, the longitudinal reproducibility of cartilage volume and surface area in participants with mild to moderate OA.

Adult↗
PubMed2006

Use of a novel percutaneous biopsy localization device: initial musculoskeletal experience.

OBJECTIVE: To preliminarily evaluate a new CT-biopsy guidance device, the SeeStar (Radi, Uppsala, Sweden), for use in musculoskeletal applications. DESIGN: The device was evaluated using an imaging phantom and in various simulated clinical biopsy situations. The phantom study was undertaken to optimize the linear metallic artifacts produced by the guidance device. The phantom and guidance device were imaged with CT after altering different imaging parameters, including field of view, filter, focal spot size, kV, mAs, slice thickness and pitch. Clinical biopsy situations were simulated for a superficial biopsy, a deep biopsy and a horizontal biopsy approach. RESULTS: Altering CT parameters had little effect on the subjective appearance of the linear metal artifact, which is used to plan the biopsy approach. Placement of an 18-G needle inside of the biopsy device was subjectively helpful in exaggerating the artifact. Use of this artifact could be helpful in planning biopsy approach for deep lesions or lesions near critical structures. The metal guide on the device adequately supports a standard biopsy needle, making it potentially advantageous for biopsy of superficial lesions and lesions approached from a horizontal orientation. CONCLUSION: Use of this CT-biopsy guidance device is potentially useful for musculoskeletal applications. The linear metal artifact produced by the device can help plan the biopsy approach. The device can also be useful in biopsy situations where the biopsy needle requires external support during imaging.

Artifacts↗
PubMed2006

Proposal for a nomenclature for magnetic resonance imaging based measures of articular cartilage in osteoarthritis.

OBJECTIVE: Magnetic resonance imaging (MRI) of articular cartilage has evolved to be an important tool in research on cartilage (patho)physiology and osteoarthritis (OA). MRI provides a wealth of novel and quantitative information, but there exists no commonly accepted terminology for reporting these metrics. The objective of this initiative was to propose a nomenclature for definitions and names to be used in scientific communications and to give recommendations as to which minimal methodological information should be provided when reporting MRI-based measures of articular cartilage in OA. METHODS: An international group of experts with direct experience in MRI measurement of cartilage morphology or composition reviewed the existing literature. Through an iterative process that included a meeting with a larger group of scientists and clinicians (December 2nd, 2004, Chicago, IL, USA), they discussed, refined, and proposed a nomenclature for MRI-based measures of articular cartilage in OA. RESULTS: The group proposes a nomenclature that describes: (1) the anatomical location and (2) the structural feature being measured, each name consisting of a metric variable combined with a tissue label. In addition, the group recommends minimal methodological information that should be described. CONCLUSIONS: Utilization of this nomenclature should facilitate communication within the scientific community. Further, the uniform adoption of comprehensive nomenclature to describe quantitative MRI- features of articular cartilage should strengthen epidemiological, clinical, and pharmacological studies in OA.

Cartilage, Articular↗
PubMed2006

[Molecular imaging: future uses in arthritides].

Molecular imaging is an upcoming field in radiology as a result of great advances in imaging technology, genetics, and biochemistry in the recent past. Early-stage imaging of molecular pathological changes in cells opens the gates to new methods in medical treatment of diseases that otherwise would only be detected in advanced stages. Methods of imaging biochemical pathways with molecular agents are currently an issue of intensive research. This article reviews current modalities of molecular imaging in arthritis that should offer future perspective on early disease detection, diagnosis, and monitoring of treatment efficiency and how they can pave the way to optimized therapy.

Arthritis↗
PubMed2001

Magnetic resonance imaging of autologous chondrocyte implantation.

There is now over 10 years experience with autologous chondrocyte implantation (ACI) for the management of full-thickness chondral injuries in the knee. This article briefly reviews the surgical procedure, the time lines of graft maturation, and patient rehabilitation in the context of postoperative magnetic resonance imaging (MRI) assessment. The normal and abnormal appearances of ACI repair cartilage on MR images are described, with an emphasis on the MR appearances of the complications that may occur after this procedure, and the usefulness of MR imaging for the surgeon.

Cartilage, Articular↗
PubMed2001

Postoperative magnetic resonance imaging of articular cartilage repair.

The treatment of articular cartilage injuries remains a challenge because cartilage has a limited capacity for spontaneous repair. Over the past decade, a number of surgical interventions have been developed to produce a durable repair. This article reviews the available treatment options, including their indications, technique, and clinical results, and illustrates the MR imaging appearance of normal repair sites and postoperative complications.

Bone Nails↗
PubMed2001

Effect of chondrocalcinosis on the MR imaging of knee menisci.

OBJECTIVE: Our goal was to determine the influence of chondrocalcinosis on MR imaging in the detection of meniscal tears. MATERIALS AND METHODS: A retrospective review was performed of knee MR imaging and arthroscopy records from two university hospitals between 1996 and 1998. Seventy individuals had radiographic evidence of chondrocalcinosis and underwent knee MR imaging. Thirty-seven of these individuals had undergone arthroscopy for further evaluation of their symptoms. MR imaging sensitivity and specificity in the detection of medial and lateral meniscal tears were calculated in these 37 patients who had radiographic evidence of chondrocalcinosis and in a control group of 34 patients who underwent MR imaging and arthroscopy but did not have knee chondrocalcinosis. RESULTS: In the chondrocalcinosis group, MR imaging sensitivity, specificity, and accuracy for meniscal tear were 78%, 71%, and 78%, respectively, for the lateral meniscus, and 89%, 72%, and 81% for the medial meniscus. The control group showed sensitivity, specificity, and accuracy of 93%, 100%, and 97%, respectively, for the lateral meniscus and 100% in all cases for the medial meniscus. The MR imaging detection of meniscal tears in both the lateral and medial compartments combined is significantly poorer in the presence of chondrocalcinosis (p < 0.005). CONCLUSION: MR imaging sensitivity and specificity for detection of meniscal tear is decreased in the presence of meniscal chondrocalcinosis. Chondrocalcinosis appeared as a high-signal-intensity region on T1-weighted, intermediate-weighted, and inversion recovery sequences. The high signal of chondrocalcinosis on inversion recovery sequence is an interesting observation that to our knowledge has not been previously reported. Radiographic correlation with the MR imaging examination can help prevent overdiagnosing meniscal tears.

Adult↗
PubMed2000

An image processing strategy for the quantification and visualization of exercise-induced muscle MRI signal enhancement.

Exercise increases the skeletal muscle water signal in T2-weighted images. Potential medical applications of MR studies of exercise-induced muscle signal intensity changes are the assessment of myopathies, sport training regimens, and physical therapy approaches following surgeries. We developed an automated image processing technique that provides volumetric analysis and visualization of exercise-related T2-weighted image intensity changes. The image processing was applied to the segmentation and quantification of activated muscle volumes. Qualitative assessment of muscle activation is demonstrated with three-dimensional surface rendering. Quantitative determination of active muscle volume, signal intensity, and change over time is demonstrated. Visualization of the activated muscles allows functional anatomical assessment of exercise, which in turn allows detection of muscle utilization.

Exercise↗
PubMed2000

Indirect wrist MR arthrography: the effects of passive motion versus active exercise.

PURPOSE: In the wrist, to determine whether passive motion or active exercise yields a better indirect MR arthrographic effect following intravenous gadolinium administration. DESIGN AND PATIENTS: Twenty-six consecutive patients were studied by indirect wrist MR arthrography. In half active exercise and in half passive motion was performed. Four regions of interest were studied including the distal radioulnar joint, the radiocarpal joint, the midcarpal joint, and the triangular fibrocartilage. Ranges and means of signal intensity were calculated. Surgical follow-up was performed in 22 patients. RESULTS: The joint fluid intensity was greatest in the distal radioulnar joint. Fluid signal intensity was greater and more consistent in the passive motion group although the results did not achieve statistical significance. Imaging accuracy appeared similar in the two groups and was excellent for the triangular fibrocartilage (100%) and scapholunate ligaments (96%). CONCLUSION: Active exercise and passive motion yield similar degrees of wrist arthrographic effect, but the effect of passive motion is somewhat more consistent. Preliminary data show good accuracy for internal derangements.

Adolescent↗
PubMed1999

Magnetic resonance imaging-guided focused ultrasound synovectomy.

OBJECTIVE: To investigate the feasibility of magnetic resonance imaging (MRI)-guided high power focused ultrasound (FUS) to perform synovectomy noninvasively. METHODS: Five New Zealand white male rabbit knees with experimentally induced arthritis underwent MRI-guided thermal surgery by high power (60 W/10 s) sonication. Evidence of tissue coagulation was monitored during the procedure and confirmed by gross and microscopic evaluation and MRI. RESULTS: Partial synovectomy was performed in five animals. Necrotized synovial tissue was observed on gross and microscopic evaluation. Visible signal intensity alterations including high signal intensity on T2-weighted (T2W) images and lack of contrast-enhancement on T1-weighted (T1W) post-contrast, post-sonication images were characteristic and reproducible. CONCLUSION: Our results demonstrate the ability of high power sonication to destroy synovial tissue in vivo.

Animals↗
PubMed1999

Legg-Calvé-Perthes disease: MR imaging evaluation during manual positioning of the hip--comparison with conventional arthrography.

PURPOSE: To evaluate the use of magnetic resonance (MR) imaging during manual positioning of the hip, or multipositional MR imaging, in an open-magnet configuration to study femoral head containment, articular congruency, and femoral head deformity in Legg-Calvé-Perthes disease. MATERIALS AND METHODS: In 12 children with advanced Legg-Calvé-Perthes disease, multipositional MR imaging and conventional arthrography were compared in the assessment of containment, femoroacetabular congruency, and femoral head deformity. Images of the hips in several positions were compared subjectively and objectively. RESULTS: MR imging correlated well with arthrography for overall subjective assessment of severity of disease (r = 0.71, P = .01), with good interobserver agreement (kappa = 0.65, P < .001). MR images demonstrated all cases of hinge abduction shown arthrographically. However, MR imaging failed to depict one case of femoral head flattening. MR imaging correlated well with arthrography in the objective evaluation of joint fluid and lateral subluxation (r = 0.80, P < .01). MR imaging correlated poorly with arthrography in the measurement of sphericity of the femoral head. CONCLUSION: Multipositional MR imaging with an open-magnet configuration was comparable to arthrography for demonstration of femoral head containment and congruency of the articular surfaces of the hip. In the evaluation of deformity, it performed less well.

Arthrography↗
PubMed1996

Skeletal muscle lymphoma: observations at MR imaging.

We present the MR appearances of three patients with biopsy-proven primary lymphoma of skeletal muscle. In each case lymphoma resulted in bulky expansion of the involved muscle, homogeneously isointense to skeletal muscle on T1-weighted images, homogeneously hyperintense to skeletal muscle on T2-weighted images and diffusely enhancing following intravenous administration of gadopentate dimeglumine.

Adult↗
PubMed1996

Magnetic resonance imaging of rheumatoid arthritis.

MR imaging is able to demonstrate both the structural changes that occur in rheumatoid arthritis and the inflammatory changes, including synovial proliferation and joint effusion. MR imaging can demonstrate erosion before it is visible on radiographs. Although MR imaging appears to be very helpful in assessing the severity of rheumatoid arthritis and its response to therapy, the optimal technique for this assessment and the ultimate clinical value of MR imaging have yet to be determined.

Arthritis, Rheumatoid↗
PubMed1996

Pigmented villonodular synovitis.

Pigmented villonodular synovitis is a benign proliferative disorder of the synovium of uncertain cause. It may involve tendon sheaths, bursae, or joints, the latter occurring as diffuse involvement or a localized nodule. This article reviews the clinical features of the disorder and the imaging features of the disease, concentrating on the findings and utility of MR imaging.

Arthrography↗
PubMed1993

Enhancement of joint fluid with intravenously administered gadopentetate dimeglumine: technique, rationale, and implications.

This study reports findings on joint fluid enhancement after intravenous administration of gadopentetate dimeglumine. Ten subjects were studied: two asymptomatic volunteers and eight patients with suspected meniscal tears. The subjects underwent imaging at 1.5 T before, immediately after, and 42-60 minutes after intravenous administration of gadopentetate dimeglumine. The rate of fluid enhancement was assessed in three subjects, and the effects of exercise were studied. All subjects exhibited enhancement of joint fluid. Mean fluid enhancement for patients was 137% on initial and 262% on delayed images obtained after exercise. Exercise increased the rate and degree of fluid enhancement and distributed contrast material uniformly throughout the joint. The arthrographic effect of the fluid enhancement increased the number of perceived cartilage defects. This study documents enhancement of joint fluid in healthy subjects and in those with effusions. The arthrographic effect may provide a more convenient alternative to intraarticular injection of gadopentetate dimeglumine for MR arthrography.

Contrast Media↗
PubMed1993

Magnetic resonance imaging of arthritides affecting the shoulder.

MR imaging has thus far had a limited role in the evaluation of arthritis involving the shoulder. In certain cases, such as in amyloid and synovial osteo chondromatosis, however, MR imaging may be virtually diagnostic. It is likely that MR imaging will have an expanded role in the evaluation of arthritis in the future.

Arthritis↗