Comparison of pre-operative dGEMRIC imaging with intra-operative findings in femoroacetabular impingement: preliminary findings

Objectives: To study standard MRI and dGEMRIC in patients with symptomatic FAI undergoing surgical intervention and compare them with intra-operative findings to see if they were corroborative. Methods: Sixteen patients with symptomatic FAI that warranted surgical intervention were prospectively studied. All patients underwent plain radiographic series for FAI assessment followed by standard MRI and dGEMRIC. Subsequently, patients were surgically treated with safe dislocation and the joint was evaluated for any macroscopic signs of damaged cartilage. Data were statistically analyzed. Results: A total of 224 zones in 16 patients were evaluated. One hundred and sixteen zones were intra-operatively rated as normal with mean T1 values of 510.1ms ± 141.2ms. Eighty zones had evidence of damage with mean T1 values of 453.1ms ± 113.6ms. The difference in these T1 values was significant (p = 0.003). Correlation between standard MRI and intra-operative findings was moderate (r = 0.535, p < 0.001). Intra-operative findings revealed more damage than standard MRI. On standard MRI, 68.6% zones were graded normal while 31.4% had evidence of damage. On intra-operative visualization, 56.4% zones were graded normal and 43.6% had evidence of damage. Correlation between dGEMRIC and intra-operative findings turned out to be weak (r = 0.114, p < 0.126). On T1 assessment 31.4% of zones were graded as normal and 68.6% as damaged. Conclusions: dGEMRIC was significantly different between normal and affected cartilage based on intra-operative assessment. The correlation for morphological findings was limited, underestimating defects. By combining morphological with biochemical assessment dGEMRIC may play some role in the future to prognosticate outcomes and facilitate surgical planning and interventio

Comparison of pre-operative dGEMRIC imaging with intra-operative findings in femoroacetabular impingement: preliminary findings

To study standard MRI and dGEMRIC in patients with symptomatic FAI undergoing surgical intervention and compare them with intra-operative findings to see if they were corroborative

Biochemical (T2, T2* and magnetisation transfer ratio) MRI of knee cartilage : feasibility at ultra-high field (7T) compared with high field (3T) strength

This study compares the performance and the reproducibility of quantitative T2, T2* and the magnetisation transfer ratio (MTR) of articular cartilage at 7T and 3T

Morphological and biochemical T2 evaluation of cartilage repair tissue based on a hybrid double echo at steady state (DESS-T2d) approach

To use a new approach which provides, based on the widely used three-dimensional double-echo steady-state (DESS) sequence, in addition to the morphological information, the generation of biochemical T2 maps in one hybrid sequence

Preoperative MRI is helpful but not sufficient to detect associated lesions in patients with chronic ankle instability

Purpose The aim of this study was to determine the reliability and validity of preoperative magnetic resonance imaging (MRI) scans for the detection of additional pathologies in patients with chronic ankle instability (CAI) compared to arthroscopic findings. Methods Preoperative MRI images of 30 patients were evaluated regarding articular and periarticular comorbidities and compared to intraoperative findings. The reliability of MRI was determined by calculating specificity, sensitivity, as well as positive and negative predictive values. The accuracy of the classification of cartilage lesions by Outerbridge and Berndt and Harty rating scales was determined by calculating the area under the receiver operating curve (AUC). Results In total, 72 additional pathologies were found arthroscopically compared to 73 lesions gathered from MRI images. Sensitivity ranged from 89% for peroneal tendinopathy to 28% for additional ligamentous lesions. Specificity ranged from 100% for anterolateral impingement, loose bodies and peroneal tendinopathy to 38% for additional ligamentous lesions. For cartilage lesions, sensitivity was at 91% and specificity was at 55% for the Outerbridge grading scale. For the Berndt and Harty classification system, sensitivity was at 91% and specificity was at 28%. Correlation of additional pathologies ranged from weak (r s = 0.48; p = 0.02) to moderate results (r s = 0.67; p < 0.001). Conclusion CAI is associated with a high incidence of additional pathologies. In some cases, MRI delivers insufficient results, which may lead to misinterpretation of present comorbidities. MRI is a helpful tool for preoperative evaluation, but arthroscopy remains gold standard in the diagnosis of associated lesions in patients with CAI. Level of evidence III.(VLID)359027

European Spine Journal / Does T2 mapping of the posterior annulus fibrosus indicate the presence of lumbar intervertebral disc herniation? : A 3.0 Tesla magnetic resonance study

Purpose Indicating lumbar disc herniation via magnetic resonance imaging (MRI) T2 mapping in the posterior annulus fibrosus (AF). Methods Sagittal T2 maps of 313 lumbar discs of 64 patients with low back pain were acquired at 3.0 Tesla (3T). The discs were rated according to disc herniation and bulging. Region of interest (ROI) analysis was performed on median, sagittal T2 maps. T2 values of the AF, in the most posterior 10% (PAF-10) and 20% of the disc (PAF-20), were compared. Results A significant increase in the T2 values of discs with herniations affecting the imaged area, compared to bulging discs and discs with lateral herniation, was shown in the PAF-10, where no association to the NP was apparent. The PAF-20 exhibited a moderate correlation to the nucleus pulposus (NP). Conclusions High T2 values in the PAF-10 suggest the presence of disc herniation (DH). The results indicate that T2 values in the PAF-20 correspond more to changes in the NP.(VLID)352441

Gadolinium diethylenetriaminepentaacetate enhancement kinetics in the menisci of asymptomatic subjects: a first step towards a dedicated dGEMRIC (delayed gadolinium-enhanced MRI of cartilage)-like protocol for biochemical imaging of the menisci

It was our aim to investigate the gadolinium diethylenetriaminepentaacetate (Gd-DTPA(2-) ) enhancement kinetics in the menisci of the knee joint over a prolonged period of time. Six asymptomatic volunteers (four men and two women; mean age, 25 ± 2.4 years) were enrolled. Sagittal, T(1) -weighted, spin-echo MR sequences of the right knee joint were obtained at 3 T. Imaging was performed before (baseline), 1 h after and in half-hour intervals up to 9 h after the intravenous administration of 0.2 mmol/kg of Gd-DTPA(2-) . To measure the rates of contrast enhancement relative to the baseline, regions of interest that covered the anterior and posterior horns of the medial and lateral meniscus were defined on each of two adjacent sections, and enhancement curves were constructed. An enhancement peak between 2.5 and 4.5 h after Gd-DTPA(2-) administration was observed, and analysis of variance also revealed no significant difference (p=0.94), in terms of enhancement, within this time interval. Pair-wise, post hoc testing also revealed no significant differences between 2.5 and 3, 3 and 3.5, 3.5 and 4, and 4 and 4.5 h post Gd-DTPA(2-) application. Our preliminary data therefore suggest that the time window suitable for a dGEMRIC (delayed gadolinium-enhanced MRI of cartilage)-like T(1) mapping of the menisci is relatively short, and lies between 2.5 and 4.5 h after Gd-DTPA(2-) injection