Angle-sensitive MRI for quantitative analysis of fiber-network deformations in compressed cartilage.

PURPOSE: To demonstrate the feasibility of a novel experimental method to quantitatively analyze fiber-network deformation in compressed cartilage by angle-sensitive magnetic resonance imaging (MRI) of cartilage. METHODS: Three knee cartilage samples of an adult sheep were imaged in a high-resolution MRI scanner at 7 T. Main fiber orientation and its "offset" from the direction perpendicular to the bone-cartilage boundary were derived from MR images taken at different orientations with respect to B0. Bending of the collagen fibers was determined from weight-bearing MRI with the load (up to 1.0 MPa) applied over the whole sample surface. A "fascicle" model of the cartilage ultrastructure was assumed to analyze characteristic intensity variations in T2-weighted images under load. RESULTS: T2-weighted MR images showed a strong variation of the signal intensities with sample orientation. In the T2-weighted weight-bearing series, regions of high signal intensity underwent shifts from the lateral to the central parts in all three cartilage samples. The bending of the collagen fibers was determined to be 27.2°, 35.4°, and 40.0° per MPa, respectively. CONCLUSION: Assuming a "fascicle" model, the presented MRI method provides quantitative measures of structural adjustments in compressed cartilage. Our preliminary analysis suggests that cartilage fiber deformation includes both bending and crimping.

In vivo MRI analysis of depth-dependent ultrastructure in human knee cartilage at 7 T.

Signal intensities of T2-weighted magnetic resonance images depend on the local fiber arrangement in hyaline cartilage. The aims of this study were to determine whether angle-sensitive MRI at 7 T can be used to quantify the cartilage ultrastructure of the knee in vivo and to assess potential differences with age. Ten younger (21-30) and ten older (55-76 years old) healthy volunteers were imaged with a T2-weighted spin-echo sequence in a 7 T whole-body MRI. A "fascicle" model was assumed to describe the depth-dependent fiber arrangement of cartilage. The R/T boundary positions between radial and transitional zones were assessed from intensity profiles in small regions of interest in the femur and tibia, and normalized to cartilage thickness using logistic curve fits. The quality of our highly resolved (0.3 × 0.3 × 1.0 mm(3)) MR cartilage images were high enough for quantitative analysis (goodness of fit R(2) = 0.91 ± 0.09). Between younger and older subjects, normalized positions of the R/T boundary, with value 0 at the bone-cartilage interface and 1 at the cartilage surface, were significantly (p < 0.05) different in femoral (0.51 ± 0.12 versus 0.41 ± 0.10), but not in tibial cartilage (0.65 ± 0.11 versus 0.57 ± 0.09, p = 0.119). Within both age groups, differences between femoral and tibial R/T boundaries were significant. Using a fascicle model and angle-sensitive MRI, the depth-dependent anisotropic fiber arrangement of knee cartilage could be assessed in vivo from a single 7 T MR image. The derived quantitative parameter, thickness of the radial zone, may serve as an indicator of the structural integrity of cartilage. This method may potentially be suitable to detect and monitor early osteoarthritis because the progressive disintegration of the anisotropic network is also indicative of arthritic changes in cartilage.

31P and 13C solid-state NMR spectroscopy to study collagen synthesis and biomineralization in polymer-based bone implants.

A combination of solid-state NMR spectroscopy and MRI was used to evaluate the formation of extracellular matrix in poly(D,L-lactide-co-glycolide) (PLGA) bone implants. Porous PLGA scaffolds were implanted into rat tibiae and analysed after 2, 4 or 8 weeks. MRI clearly delineated the implants within the cancellous bone. Differences in the trabecular structure of the implanted material and native bone were demonstrated. In addition, implants were analyzed by solid-state NMR spectroscopy under magic angle spinning. (13)C NMR spectra showed the unambiguous signature of collagen formed in the scaffolds, but also the characteristic signals of the PLGA matrix, indicating that resorption was not complete after 8 weeks. Furthermore, (31)P NMR spectroscopy detected the inorganic component of the matrix, which is composed of bioapatite. (31)P NMR spectra were quantified and this analysis revealed that the amount of inorganic extracellular matrix formed de novo was significantly lower than in native bone. This demonstrates that solid-state NMR spectroscopy, in particular in combination with MRI, can provide useful information on the composition and structure of the extracellular matrix, and serve as a tool to evaluate the quality of tissue engineering strategies.

Suitability of miniature inductively coupled RF coils as MR-visible markers for clinical purposes.

PURPOSE: MR-visible markers have already been used for various purposes such as image registration, motion detection, and device tracking. Inductively coupled RF (ICRF) coils, in particular, provide a high contrast and do not require connecting wires to the scanner, which makes their application highly flexible and safe. This work aims to thoroughly characterize the MR signals of such ICRF markers under various conditions with a special emphasis on fully automatic detection. METHODS: The small markers consisted of a solenoid coil that was wound around a glass tube containing the MR signal source and tuned to the resonance frequency of a 1.5 T MRI. Marker imaging was performed with a spoiled gradient echo sequence (FLASH) and a balanced steady-state free precession (SSFP) sequence (TrueFISP) in three standard projections. The signal intensities of the markers were recorded for both pulse sequences, three source materials (tap water, distilled water, and contrast agent solution), different flip angles and coil alignments with respect to the B(0) direction as well as for different marker positions in the entire imaging volume (field of view, FOV). Heating of the ICRF coils was measured during 10-min RF expositions to three conventional pulse sequences. Clinical utility of the markers was assessed from their performance in computer-aided detection and in defining double oblique scan planes. RESULTS: For almost the entire FOV (±215 mm) and an estimated 82% of all possible RF coil alignments with respect to B(0), the ICRF markers generated clearly visible MR signals and could be reliably localized over a large range of flip angles, in particular with the TrueFISP sequence (0.3°-4.0°). Generally, TrueFISP provided a higher marker contrast than FLASH. RF exposition caused a moderate heating (≤5 °C) of the ICRF coils only. CONCLUSIONS: Small ICRF coils, imaged at low flip angles with a balanced SSFP sequence showed an excellent performance under a variety of experimental conditions and therefore make for a reliable, compact, flexible, and relatively safe marker for clinical use.

Flexible add-on solution for MR image-guided interventions in a closed-bore scanner environment.

MRI is of great clinical utility for the guidance of various diagnostic and therapeutic procedures. In a standard closed-bore scanner, the simplest approach is to manipulate the instrument outside the bore and move the patient into the bore for reference and control imaging only. Without navigational assistance, however, such an approach can be difficult, inaccurate, and time consuming. Therefore, an add-on navigation solution is described that addresses these limitations. Patient registration is established by an automatic, robust, and fast (<30 sec) localization of table-mounted MR reference markers and the instrument is tracked optically. Good hand-eye coordination is provided by following the virtual instrument on MR images that are reconstructed in real time from the reference data. Needle displacements of 2.2 +/- 0.6 mm and 3.9 +/- 2.4 mm were determined in a phantom (P < 0.05), depending on whether the reference markers were placed at smaller (98-139 mm) or larger (147-188 mm) distances from the isocenter. Clinical functionality of the navigation concept is demonstrated by a double oblique, subscapular hook-wire insertion in a patient with a body mass index of 30.1 kg/m(2). Ease of use, compactness, and flexibility of this technique suggest that it can be used for many other procedures in different body regions. More patient cases are needed to evaluate clinical performance and workflow.

Collagene order of articular cartilage by clinical magnetic resonance images and its age dependency.

The present paper describes a novel method to obtain information on the degree of order of the collagen network of the knee meniscal cartilage by means of a single clinical MRI. Images were obtained from 34 healthy volunteers aged between 6 and 76 years as well as from one patient with clinically-diagnosed arthrosis at the age of 32 and 37 years. A Siemens Vision (1.5 T) MRT with TR=750 ms, TE=50 ms, FoV=160 mm, and Matrix 512x512 was used for this purpose. The MR signal intensities of the cartilage were read out along slices with constant height above the subchondral bone and plotted versus the actual angle to the external magnetic field. The obtained intensity curves were fitted by a model distribution, and the degree of order of the collagen fibers was calculated. For the knee meniscal cartilage, there was an age-dependency of the degree of order and a significant deviation of the volunteer with arthrosis from the normal curve. The results are discussed in view of the arcade model and of a possible use of non-invasive clinical MRT for the detection of early arthrotic changes of cartilage.

Load distribution of articular cartilage from MR-images by neural nets.

Artificial neural nets were used to determine the Young's modulus and spatial load distribution in articular cartilage by means of T2-weighted MR imaging. MR images were obtained in vitro (ex vivo?) from the joints of sheep of different ages (3 months, 9 months, 15 months, 1.5 years, 5 years, 5.5 years) and pigs (4 and 6 months) with a Bruker AMX 300 (7 T) spectrometer equipped with a micro-imaging unit. The knee of a 29-year-old male volunteer was studied in vivo under mechanical load using a clinical Siemens Vision MRT (1.5 T). The load of the cartilage is understood as a non-linear image transformation of loaded versus unloaded images. The artificial neural net was used to recognize given reference pixels of the unloaded cartilage within the image of the loaded cartilage. The Young's modulus was calculated from the local strain and the external pressure using the Hooke's law. With this method, the average Young's modulus was obtained in relationship to the biological age of the cartilage. The investigated age interval showed a progressive increase of 0.5 +/- 0.3 MPa per year. These results are consistent with published results. As shown in this pilot study, the method of neural nets allows the visualization of the spatial load distribution within the articular cartilage.

[Cryotherapy of the brain--a new methodologic approach]. / Kryotherapie am Hirn--ein neuer methodischer Ansatz.

Cryodestruction of tissue is influenced by cooling and thawing rates, absolute tissue temperature, number of freeze-thaw cycles, and type of tissue. However, under clinical conditions a MRT visualization of the temperature distribution during cryo-procedures is not possible. Thus, the extent of necrotic areas within the cryo-influenced regions are not precisely predictable. This limitation is particularly relevant for the application of cryoablation in the brain. The present paper proposes the concept of a local, cryo-induced ischemic necrosis. The basic concept is that the MRT-observable and surgically well-manageable frozen region is ischemic. This cryo-induced ischemia causes a necrosis. The extent of the necrotic region is exclusively determined by the ischemia tolerance of the tissue. The effectiveness of this method is demonstrated on sheep brain in vivo. Compared to the freeze-thaw method, histological examinations show a sharper demarcation between regions of necrosis and healthy tissue. In conclusion, the method of MR-controlled local, cryo-induced ischemia enables an exact definition of the region of necrosis in the brain.

Method for automatic localization of MR-visible markers using morphological image processing and conventional pulse sequences: feasibility for image-guided procedures.

PURPOSE: To evaluate the feasibility and accuracy of an automated method to determine the 3D position of MR-visible markers. MATERIALS AND METHODS: Inductively coupled RF coils were imaged in a whole-body 1.5T scanner using the body coil and two conventional gradient echo sequences (FLASH and TrueFISP) and large imaging volumes up to (300 mm(3)). To minimize background signals, a flip angle of approximately 1 degrees was used. Morphological 2D image processing in orthogonal scan planes was used to determine the 3D positions of a configuration of three fiducial markers (FMC). The accuracies of the marker positions and of the orientation of the plane defined by the FMC were evaluated at various distances r(M) from the isocenter. RESULTS: Fiducial marker detection with conventional equipment (pulse sequences, imaging coils) was very reliable and highly reproducible over a wide range of experimental conditions. For r(M)

MRI assessment of cartilage ultrastructure.

In T2-weighted MRI images joint cartilage can appear laminated. The multilaminar appearance is visualized as zones of different intensity. This appearance is based on the dipolar interaction of water molecules within cartilage zones of different collageneous network structures. Therefore, the MR visualization of zones of anisotropic arrangement of the collagen fibers depends upon their orientation to the static magnetic field (magic-angle effect). The aim of this article is to demonstrate the potential of high-resolution MRI for characterizing cartilage network structuring and biomechanical properties. Information equivalent to that from polarization light microscopy can be derived noninvasively. Based on NMR microscopic (microMRI) data, potential new possibilities of MRI for quantitative assessment of collagen structuring and intracartilagenous load distribution are presented. These methods use MR intensity angle dependence and load influence on cartilage visualization. Alternatively to the determination of mechanical parameters from cartilage deformation, it is demonstrated that stress distribution and biomechanical properties can be derived in principle from the local intensity variation of anisotropic fiber orientation zones. The limitations with respect to a clinical application of the proposed methods are discussed.