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01.12.2019 | Research article | Ausgabe 1/2019 Open Access

BMC Musculoskeletal Disorders 1/2019

Abbreviated quantitative UTE imaging in anterior cruciate ligament reconstruction

Zeitschrift:
BMC Musculoskeletal Disorders > Ausgabe 1/2019
Autoren:
Takeshi Fukuda, Kenneth Wengler, Dharmesh Tank, Seth Korbin, James M. Paci, David E. Komatsu, Megan Paulus, Mingqian Huang, Elaine Gould, Mark E. Schweitzer, Xiang He
Wichtige Hinweise
Takeshi Fukuda and Kenneth Wengler contributed equally to this work.

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Abstract

Background

Existing ultrashort echo time magnetic resonance imaging (UTE MRI) methods require prohibitively long acquisition times (~ 20–40 min) to quantitatively assess the clinically relevant fast decay T2* component in ligaments and tendons. The purpose of this study was to evaluate the feasibility and clinical translatability of a novel abbreviated quantitative UTE MRI paradigm for monitoring graft remodeling after anterior cruciate ligament (ACL) reconstruction.

Methods

Eight patients who had Graftlink™ hamstring autograft reconstruction were recruited for this prospective study. A 3D double-echo UTE sequence at 3.0 Tesla was performed at 3- and 6-months post-surgery. An abbreviated UTE MRI paradigm was established based on numerical simulations and in vivo validation from healthy knees. This proposed approach was used to assess the T2* for fast decay component (\( {T}_{2s}^{\ast } \)) and bound water signal fraction (fbw) of ACL graft in regions of interest drawn by a radiologist.

Results

Compared to the conventional bi-exponential model, the abbreviated UTE MRI paradigm achieved low relative estimation bias for \( {T}_{2s}^{\ast } \) and fbw over a range of clinically relevant values for ACL grafts. A decrease in \( {T}_{2s}^{\ast } \) of the intra-articular graft was observed in 7 of the 8 ACL reconstruction patients from 3- to 6-months (− 0.11 ± 0.16 ms, P = 0.10). Increases in \( {T}_{2s}^{\ast } \) and fbw from 3- to 6-months were observed in the tibial intra-bone graft (\( {\varDelta T}_{2s}^{\ast } \): 0.19 ± 0.18 ms, P < 0.05; Δfbw: 4% ± 4%, P < 0.05). Lower \( {T}_{2s}^{\ast } \) (− 0.09 ± 0.11 ms, P < 0.05) was observed at 3-months when comparing the intra-bone graft to the graft/bone interface in the femoral tunnel. The same comparisons at the 6-months also yielded relatively lower \( {T}_{2s}^{\ast } \) (− 0.09 ± 0.12 ms, P < 0.05).

Conclusion

The proposed abbreviated 3D UTE MRI paradigm is capable of assessing the ACL graft remodeling process in a clinically translatable acquisition time. Longitudinal changes in \( {T}_{2s}^{\ast } \) and fbw of the ACL graft were observed.
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