Zhenyu Cai1,2, Zhao Wei2, Mingxin Chen2, Saeed Jerban2, Hyungseok Jang2, Eric Chang2,3, Jiang Du2, and Yajun Ma2
1Radiology, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, shenzhen, China, 2Radiology, University of California San Diego, San Diego, CA, United States, 3VA San Diego Healthcare System, San Diego, CA, United States
Synopsis
The osteochondral junction (OCJ) is the region where
calcified cartilage meets subchondral bone (SCB), and is likely to be highly
related to osteoarthritis (OA). However, it is difficult to image OCJ tissues
due to their relatively short transverse relaxation times, which cause little
or no signal to appear with conventional imaging sequences. In this study, we developed a 3D T1-weighed fast ultrashort
echo time cones sequence with fat saturation (FS-UTE-Cones) to generate a high OCJ contrast image of
the human knee on a clinical 3T MRI scanner.
Introduction
Several studies have shown that the
region of the osteochondral junction (OCJ), which encompasses the tissues
between the uncalcified layers of cartilage and the marrow spaces of the
trabecular bone, is highly related to osteoarthritis (OA) (1-4). However,
magnetic resonance imaging (MRI) of the OCJ region is difficult due to the tissues’
short transverse relaxation times (i.e. short T2), which result in little or no
signal with conventional sequences. Ultrashort echo time (UTE) sequences have
been employed to overcome this limitation (5-11). However, most techniques are
based on 2D UTE sequences, which are unable to cover the whole knee joint due
to strong out-of-slice signal excitation, especially for off-center slices
(12). In this study, we developed a fast 3D T1-weighed UTE Cones sequence with
fat saturation (FS-UTE-Cones) to highlight OCJ tissues in human knee on a
clinical 3T MRI scanner. This study examined an ex vivo patellar cartilage
sample, cadaveric whole knee joint, and an in vivo knee joint.Methods
The
features of 3D FS-UTE-Cones sequence can be found in Figure 1 (13). A product FatSat module was used to suppress fat. To
improve the acquisition efficiency, a series of spokes (Nsp) was acquired
after each FatSat pulse (Figure 1A). For each spoke, a short
rectangular pulse (e.g., 100µs) was used for non-selective
signal excitation (Figure
1B), followed by a Cones
data acquisition (Figure 1C). To investigate the T1
values for the different layers of cartilage (i.e. superficial, middle, deep,
and calcified layers), a patellar cartilage sample was scanned in a homemade
birdcage coil with a 3D
UTE-Cones actual flip angle imaging and variable flip angle (3D UTE-Cones
AFI-VFA) sequence (14): 1) UTE-Cones AFI: TR=20/100ms, flip angle=45°; 2) UTE-Cones
VFA: TR=20ms; flip angle=4°, 7°, 10°, 15°, 20°, 25° and 30°. Other sequence
parameters were: FOV=7×7×6.4cm3, acquisition matrix=192×192×64, TE=0.032 ms,
receiver bandwidth=100 kHz, and a total
scan time of 45.5 min. In vivo knee imaging was
performed on five healthy volunteers (29-45
years of age, 3 males and 2 females) and five patients with OA (48-70 years of age, 4 males and 1female). Informed consent was obtained from all
subjects in accordance with guidelines of the institutional review board. A healthy knee joint from a
36-year-old volunteer was scanned with the FS-UTE-Cones sequence with
different flip angles (i.e. flip angle=5°, 10°, 15°, 20°, 25°, and 30°) to investigate the
contrast change of the OCJ tissues. A transmit and receive knee coil was used
for RF excitation and signal reception. Other sequence parameters were: FOV=13×13×8.4cm3, acquisition matrix=256×256×42, TR/TE=80/0.032 ms,
Nsp=5, τ=6ms,
receiver bandwidth=166 kHz, and a total scan time of 3 min. The clinical T2- and PD-weighted
sequences were used for comparison. Then, a high contrast image of the OCJ was obtained by
scanning a healthy knee joint from a 37-year-old volunteer with the optimized
T1-weighted FS-UTE-Cones sequence (flip angle=30°). Six abnormal cadaveric whole knee joints and five
OA patients were also scanned with the T1-weighted FS-UTE-Cones sequence and
compared with the clinical T2-weighted sequence.Results and Discussion
Figure 2
shows a 3D FS-UTE-Cones image of the patellar cartilage sample and
corresponding fitting curves and T1 values of different regions of cartilage.
The T1 values of uncalcified cartilage decrease from the superficial
layer (890±11 ms) to the middle
layer (847±4 ms), then the
deep layer (729±7 ms). The
calcified cartilage has a much lower T1 of 465±8 ms. The significantly lower T1 values of
the calcified cartilage make it possible to highlight the OCJ region with a
highly T1-weighted UTE sequence.
The OCJ tissues appear
dark in the clinical T2- and PD-FSE images (Figure 3A and 3B) due to the short
T2 relaxation. However, the signals in the OCJ region can be detected with the
PD-weighted FS-UTE-Cones sequence with low flip angles (Figure 3C and 3D), but
without OCJ contrast. In comparison, the OCJ region was highlighted with the
T1-weighed FS-UTE-Cones sequence with high flip angles (e.g. 25° and 30°) as a bright band. Figure 4 demonstrated a high OCJ contrast in whole knee joint
imaging with the proposed T1-weighted FS-UTE-Cones sequence. Continuous
bright bands can be found in the OCJ region of patellar, femoral, and tibial
cartilage.
Both the
abnormal knee joint specimen and knee joints of the OA patients show
morphological changes in the OCJ region (Figure 5), including regions with
ill-defined or focal absence of bright band adjacent and parallel to the SCB (arrows).Conclusion
The proposed 3D
T1-weighted FS-UTE-Cones sequence is a novel imaging method that can highlight
the OCJ region of human knee joint. This fast technique could be used to detect
signal changes in OCJ tissues which may be related to OA.Acknowledgements
The authors acknowledge grant support from NIH (R01AR075825, 2R01AR062581,
1R01 AR068987), and the VA Clinical Science and Rehabilitation R&DAwards (I01RX002604)References
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