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Biomedical subjects

J B Kneeland

Publications and source records attributed to J B Kneeland.

At least 19 recordsLinked to original sources

T1rho relaxation mapping in human osteoarthritis (OA) cartilage: comparison of T1rho with T2.

PURPOSE: To quantify the spin-lattice relaxation time in the rotating frame (T1rho) in various clinical grades of human osteoarthritis (OA) cartilage specimens obtained from total knee replacement surgery, and to correlate the T1rho with OA disease progression and compare it with the transverse relaxation time (T2). MATERIALS AND METHODS: Human cartilage specimens were obtained from consenting patients (N = 8) who underwent total replacement of the knee joint at the Pennsylvania Hospital, Philadelphia, PA, USA. T2- and T1rho-weighted images were obtained on a 4.0 Tesla whole-body GE Signa scanner (GEMS, Milwaukee, WI, USA). A 7-cm diameter transmit/receive quadrature birdcage coil tuned to 170 MHz was employed. RESULTS: All of the surgical knee replacement OA cartilage specimens showed elevated relaxation times (T2 and T1rho) compared to healthy cartilage tissue. In various grades of OA specimens, the T1rho relaxation times varied from 62 +/- 5 msec to 100 +/- 8 msec (mean +/- SEM) depending on the degree of cartilage degeneration. However, T2 relaxation times varied only from 32 +/- 2 msec to 45 +/- 4 msec (mean +/- SEM) on the same cartilage specimens. The increase in T2 and T1rho in various clinical grades of OA specimens were approximately 5-50% and 30-120%, respectively, compared to healthy specimens. The degenerative status of the cartilage specimens was also confirmed by histological evaluation. CONCLUSION: Preliminary results from a limited number of knee specimens (N = 8) suggest that T1rho relaxation mapping is a sensitive noninvasive marker for quantitatively predicting and monitoring the status of macromolecules in early OA. Furthermore, T1rho has a higher dynamic range (>100%) for detecting early pathology compared to T2. This higher dynamic range can be exploited to measure even small macromolecular changes with greater accuracy compared to T2. Because of these advantages, T1rho relaxation mapping may be useful for evaluating early OA therapy.

Arthroplasty, Replacement, Knee↗

Proteoglycan-induced changes in T1rho-relaxation of articular cartilage at 4T.

Proteoglycan (PG) depletion-induced changes in T1rho (spin-lattice relaxation in rotating frame) relaxation and dispersion in articular cartilage were studied at 4T. Using a spin-lock cluster pre-encoded fast spin echo sequence, T1rho maps of healthy bovine specimens and specimens that were subjected to PG depletion were computed at varying spin-lock frequencies. Sequential PG depletion was induced by trypsinization of cartilage for varying amounts of time. Results demonstrated that over 50% depletion of PG from bovine articular cartilage resulted in average T1rho increases from 110-170 ms. Regression analysis of the data showed a strong correlation (R2 = 0.987) between changes in PG and T1rho. T1rho values were highest at the superficial zone and decreased gradually in the middle zone and again showed an increasing trend in the region near the subchondral bone. The potentials of this method in detecting early degenerative changes of cartilage are discussed. Also, T(1rho)-dispersion changes as a function of PG depletion are described.

Animals↗

The effect of observer experience on magnetic resonance imaging interpretation and localization of triangular fibrocartilage complex lesions.

This study investigates the effect of experience of the interpreter on the ability of magnetic resonance imaging (MRI) to identify the presence and anatomic location of a triangular fibrocartilage complex (TFCC) lesion. Fifty-one patients who underwent wrist arthroscopy with preoperative MRI studies were reviewed retrospectively. Two radiologists with different levels of training and experience evaluated the MRI scans in a blinded manner. The sensitivity rates of the 2 observers for detection of TFCC lesions were 86% and 80%. The specificity rates were 96% and 80%. The accuracy rates for prediction of a TFCC tear were 83% and 61% for the 2 observers. The correct location of a TFCC lesion was predicted by the more experienced observer for 12 of 19 central, 3 of 4 radial, and 6 of 12 peripheral lesions. The less experienced observer correctly identified 8 of 19 central, 2 of 4 radial, and 2 of 12 peripheral tears. The overall accuracy rates for prediction of a TFCC lesion and its location were 69% and 37%. Our data indicate that the published accuracy rates for prediction of TFCC lesion location may be reproducible only in very specialized centers.

Adolescent↗

Human knee: in vivo T1(rho)-weighted MR imaging at 1.5 T--preliminary experience.

A fast spin-echo sequence weighted with a time constant that defines the magnetic relaxation of spins under the influence of a radio-frequency field (T1(rho)) was used in six subjects to measure magnetic resonance (MR) relaxation times in the knee joint with a 1.5-T MR imager. A quantitative comparison of T2- and T1(rho)-weighted MR images was also performed. Substantial T1(rho) dispersion was demonstrated in human articular cartilage, but muscle did not demonstrate much dispersion. T1(rho)-weighted images depicted a chondral lesion with 25% better signal-difference-to-noise ratios than comparable T2-weighted images. This technique may depict cartilage and muscular abnormalities.

Adult↗

MRI of the knee: value of short echo time fast spin-echo using high performance gradients versus conventional spin-echo imaging for the detection of meniscal tears.

OBJECTIVE: Fast spin-echo (FSE) sequences reduce imaging time compared with conventional spin-echo (CSE) sequences, but may result in blurring. High-performance gradients permit shorter interecho spacing and use of the second echo as the effective TE (20 ms); both improvements reduce blurring. This randomized observer study compared a short TE, second-echo FSE sequence obtained using high-performance gradients and a CSE sequence with similar TR/TE for the detection of meniscal tears in the knee. DESIGN AND PATIENTS: One hundred consecutive MR examinations of the knee using FSE and CSE sequences at 1.5 T were evaluated. The FSE sequence used an effective TE of 20 ms (centered on the second echo at 2 times minimal interecho spacing) and an echo train length of 4. FSE and CSE parameters were otherwise similar. Four independent, masked readers reviewed randomized sagittal FSE and CSE sequences. RESULTS: Cases were assessed for the presence or absence of meniscal tears and, if present, whether tears were medial or lateral and anterior or posterior. Sequence concordance was 93.5% (1496 of 1600 meniscal segments); the intermethod kappa value was 0.78. Sequence quality was graded from 1 to 5. Average quality of CSE images was slightly but statistically significantly preferred by three of the four readers. CONCLUSION: There was no statistically significant difference between CSE imaging and FSE imaging centered on the second echo (20 ms) using high-performance gradients for the detection of meniscal tears in the knee. There was a small preference for the quality of CSE images.

Adolescent↗

Sensitivity of MRI to proteoglycan depletion in cartilage: comparison of sodium and proton MRI.

OBJECTIVE: The purpose of this work was to evaluate the results from sodium and proton magnetic resonance imaging (MRI) in detecting small changes in proteoglycan (PG) content in bovine articular cartilage specimens. DESIGN: Articular cartilage from 15 specimens of bovine patellae were subjected to partial PG depletion with different concentrations of trypsin for 30 min. Sodium and proton MR images of the intact specimen were obtained on a 4T GE clinical MRI system. Two custom-built 7 cm-diameter solenoid coils tuned to proton and sodium frequencies were employed. Fast gradient echo and spin echo imaging sequences were used to determine sodium density, proton density and proton relaxation times (T(1)and T(2)) of the specimens. Spectrophotometric assay was performed after MRI to determine PG concentrations of the cartilage specimens. RESULTS: The sodium signal change correlated well with the observed PG loss (R(2)=0.85, P< 0.01) whereas the proton signal change was inconsistent (R(2)=0.10, P< 0.8). The change in proton T(1)and T(2)between the two regions did not correlate with PG loss (R(2)=0. 07 and R(2)=0.06, respectively). CONCLUSIONS: Results from these studies demonstrate that sodium MRI is both sensitive and specific in detecting small changes in PG concentration, whereas proton density and relaxation properties are not sensitive to small changes in PG content.

Animals↗

MR imaging assessment of the pectoralis major myotendinous unit: an MR imaging-anatomic correlative study with surgical correlation.

OBJECTIVE: MR imaging is the optimal imaging technique to study the normal and abnormal conditions of the pectoralis major muscle and tendon unit. The purpose of this study was to use MR imaging to provide an anatomic survey of the normal pectoralis major tendon and its insertion and to compare these findings with surgically proven cases of rupture. CONCLUSION: MR imaging shows the normal pectoralis major myotendinous unit has low signal intensity on both T1- and T2-weighted images. Reliable anatomic landmarks for visualization and examination of injuries to the muscle and myotendinous unit include the quadrilateral space, or the origin of the lateral head of the triceps, as the superior boundary and the deltoid tuberosity as the inferior boundary of the intact tendon of insertion. Failure to visualize a normal insertion within these boundaries should prompt a dedicated search by the radiologist for rupture and retraction of the tendon medially.

Adult↗

A novel approach to observing articular cartilage deformation in vitro via magnetic resonance imaging.

The design of a pressure cell that compresses a cartilage specimen in one dimension within an imaging magnet is presented. One-dimensional projection images in a direction perpendicular to the articular surface of the cartilage specimen were used to generate a uniaxial confined deformation creep curve for normal and trypsin-degraded cartilage specimens during a continuous 0.690 MPa (100 psi) pressure application. The resulting curves are shown to fit a two time constant viscoelastic model well and also indicate that the elastic modulus of cartilage decreases and the deformation rate increases upon trypsin proteolysis. Furthermore, cartilage permeability is shown as a function of cartilage strain for both the normal and trypsin-degraded case. Several two-dimensional slice-selective images were collected both before and after 80 minutes of continuous compression. These images were used to evaluate the relative changes in the spin-lattice, T1, and spin-spin, T2, relaxation time constant maps for both normal and degraded cartilage specimens in response to compression. The results of this study demonstrate the utility of a novel, non-magnetic, cartilage compression device and also support the validity of a simple two-component rheological model of articular cartilage.

Animals↗

MR imaging of the arthritic rabbit knee joint using albumin-(Gd-DTPA)30 with correlation to histopathology.

The purpose of this study was to demonstrate a technique, in a pilot study, for measuring abnormal capillary permeability in synovial tissue of rabbit arthritic knees using dynamic MRI with a gadolinium-based blood pool agent. Arthritis, simulating rheumatoid arthritis, was induced in knees of 8 rabbits by intra-articular injection of carrageenan (n = 4) or ovalbumin (n = 4). Sequential fat presaturated T1-weighted Spoiled Grass images were obtained before and up to 30 min after intravenous administration of albumin-(Gd-DTPA)30. Estimates of synovial tissue plasma-volume (PV), fractional-leak-rate (FLR), and permeability-surface-area-product (PS) were computed. Histologic correlation was obtained in the corresponding regions. Dynamic MRI showed extravasation of albumin-(Gd-DTPA)30 into hypertrophic synovium in six of the eight arthritic knees. Histologic examination of these six knees showed markedly inflamed synovium. The two knees that did not show abnormal vascular permeability contained non-hypertrophic synovium. None of the rabbits showed abnormal permeability in muscle. MRI derived microvascular characteristics (PV, FLR and PS) correlated positively (r2 = 0.51, 0.97 and 0.86) with the histology. Factors involving the structural and functional microvascular characteristics of synovial tissue can be estimated non-invasively using albumin-(Gd-DTPA)30. This technique may be useful for monitoring disease progression and treatment response in rheumatoid arthritis.

Albumins↗

MR imaging of sports injuries of the hip.

While MR imaging studies of the hip have been directed routinely toward the diagnosis of atraumatic osteonecrosis (ON), interest has increased in the use of MR imaging to diagnose other disorders of the hip and surrounding soft tissues, especially in athletic injuries. In addition to reviewing MR imaging technical considerations and image appearance, this article discusses applications of MR imaging to diagnosing pelvic and hip fractures, muscle contusion and strain, tendon injuries, acetabular labral tears, bursitis, and osteitis pubis and chronic symphyseal injury.

Athletic Injuries↗

Sodium MRI of human articular cartilage in vivo.

Preliminary results from in vivo sodium MRI of human patellar articular cartilage are presented. Sodium images generated of an in vitro bovine patella clearly distinguish the region of proteoglycan depletion from the region of healthy cartilage. This provides the first evidence that sodium imaging may be used to detect changes due to osteoarthritis in vivo. The process of optimizing imaging time and signal-to-noise ratio, as well as potential implications in the detection of osteoarthritic change, are discussed.

Animals↗

Sodium multiple quantum spectroscopy of articular cartilage: effects of mechanical compression.

The effects of mechanical compression on the multiple quantum coherences generated from sodium ions in articular cartilage were investigated. Cartilage samples obtained from bovine patellae were studied during compression at 0.7 MPa (100 psi) for 1 hour. The double quantum filtered spectra showed marked lineshape changes in the compressed samples. Compression did not seem to influence the lineshapes of the single quantum and triple quantum filtered spectra significantly. We found that the residual quadrupolar interaction was reduced in the compressed samples. Changes in the ordering of collagen fibers may be responsible for the observed effect.

Animals↗

A new in vivo technique for three-dimensional shoulder kinematics analysis.

OBJECTIVE: The field of shoulder kinematics research has long relied upon the use of cadaveric models or invasive techniques in human volunteers. In this paper, a novel method is presented that utilizes magnetic resonance imaging (MRI) and a software system called 3DVEWNIX. This method permits non-invasive, repetitive evaluation of living patients for glenohumeral kinematics analysis. The objectives of this study were twofold: to validate the quantitative accuracy of this technique; and to demonstrate glenohumeral relationships in asymptomatic volunteers during internal and external rotation of the arm. DESIGN: The translational accuracy was first assessed by comparing known cadaveric glenohumeral translations with calculations from MR images of the cadaver. Nine asymptomatic volunteers were subsequently placed in an external shoulder positioning device in the scanner and imaged in 10 degrees increments of actively achieved internal and external rotation. Three-dimensional reconstructions of the glenoid and humerus were used to evaluate the glenohumeral relationships in the tested positions of rotation. RESULTS: The quantitative analysis revealed an error of 0.61 mm (SEM 0.11 mm). Examination of the volunteers demonstrated normal relationships about the glenohumeral joint in internal and external rotation. In addition, this method provided detailed images of the bony surface architecture from any perspective. These images can be transformed into a cinematic three-dimensional depiction of active shoulder rotation. CONCLUSION: This new technique offers an accurate, non-invasive method for assessing the normal glenohumeral relationships in shoulder kinematics. We now possess the capability to investigate the kinematics of normal and abnormal shoulder conditions non-invasively in a large patient population.

Adult↗

Analysis of in vivo 3-D internal kinematics of the joints of the foot.

This paper describes a methodology for the analysis of three-dimensional (3-D) kinematics of live joints of the foot based on tomographic image data acquired via magnetic resonance (MR) imaging. A mechanical jig facilitates acquisition of MR images corresponding to different positions of the joint in a pronation-supination motion. The surfaces of the individual tarsal bones are constructed by segmenting the MR images. A mathematical description of the motion of the individual bones and of their relative motion is derived by computing the rigid transformation required to match the centroids and the principal axes of the surfaces. The mathematically described motion is animated via surface renditions of the bones. The kinematics of the bones are analyzed based on features extracted from the motion description and on how they vary with motion. Based on 17 joints that have been imaged, which includes an abnormal joint and the same joint after surgical correction, we conclude that this methodology offers a practical tool for measuring internal 3-D kinematics of joints in vivo and for characterizing and quantifying with specificity normal kinematics and their pathological deviations. Some of the 3-D kinematic animations generated using the methods of this paper for normal joints can be seen at: http:(/)/www.mipg.upenn.edu.

Biomechanical Phenomena↗

Complete atraumatic rupture of the flexor hallucis longus tendon: a case report and review of the literature.

A complete atraumatic rupture of the flexor hallucis longus tendon in a patient without systemic disease is a rare occurrence. Although four cases of complete traumatic ruptures have been cited in the literature, only one case of a complete atraumatic rupture has been previously reported. Presented here is a second case with a review of the literature and a discussion of the surgical indications.

Adult↗

In vivo sodium multiple quantum spectroscopy of human articular cartilage.

The authors report, for the first time, sodium properties of human articular cartilage in vivo using sodium multiple-quantum-filtered methods with a surface coil. A flip angle-independent, phase-cycled pulse sequence was used to obtain triple-quantum-filtered spectra as a function of preparation time. Biexponential relaxation rates were calculated by fitting the triple-quantum-filtered spectral amplitudes to a theoretical expression. Theoretical analysis of the flip angle dependence of even rank two-quantum coherence (T2[2]), odd rank two-quantum coherence (T2[3]), and triple-quantum coherence are presented and verified against experimental results on a cartilage specimen. Sodium multiple-quantum-filtered spectral lineshapes obtained in vivo correlate well with those observed on in vitro specimens. Relaxation rates obtained from asymptomatic volunteers were found to be: T(2rise) = 1.0 + 0.12 ms, T(2decay) = 12.0 +/- 0.75 ms (mean +/- SD). The diagnostic potential of this method in detecting early changes in articular cartilage is described.

Animals↗