Effect of surface coating on water migration into resin-modified glass ionomer cements: a magnetic resonance micro-imaging study.

Magnetic resonance micro-imaging was applied to study water diffusion into resin-modified glass ionomer cement restoration and to evaluate the effect of surface coating over restoration. Two cavities were prepared on the labial surface of extracted teeth and restored with resin-modified glass ionomer cement; one was protected with surface coating and the other was not. Immediately after restoration, the teeth were immersed in water. Progress of water diffusion into restorations was monitored by T(1) weighted spin-echo MRI at one-day intervals after the start of immersion. To quantify the water diffusion, a model was developed and compared with imaging data. Best fit yielded an effective water diffusion coefficient D = (2.3 +/- 0.4) 10(-12) m(2)/sec. Experimental results demonstrated that surface coating protects the dental cement against water intrusion from the surface of the restoration which faces the oral cavity. Such coating, however, does not prevent water penetration from the dentine side.

Contrast enhanced Gd-DTPA magnetic resonance imaging in the evaluation of rheumatoid arthritis during a clinical trial with DMARDs. A prospective two-year follow-up study on hand joints in 31 patients.

OBJECTIVE: The aim of this prospective 24-month follow-up study was to compare clinical features with radiological and magnetic resonance imaging (MRI) findings in evaluating synovial proliferation in the hand joints of 31 patients with rheumatoid arthritis (RA). A single joint was used for the follow-up of each patient. METHODS: Thirty-one small hand joints were examined by conventional radiography and MRI before and after 24 months of treatment. MRI assessment of disease progression (volume and/or signal intensity of the synovial proliferation on T1 weighted precontrast, T1 weighted postcontrast and T2 weighted images) was compared with a clinical assessment of the chosen joints, and with a plain x-ray film evaluation (Larsen's score). RESULTS: Of 26 joints which clinically improved (14 markedly and 14 slightly) during the study, on MRI 16 showed improvement, 8 showed no change, and 2 showed deterioration. Four clinically unchanged joints appeared improved on MRI. One joint deteriorated clinically and on MRI. Overall, there was a 58% congruence between clinical and MRI findings. On x-ray 23 joints showed no change; nine of these were also unchanged on MRI, while 13 showed improvement and one deterioration. Only in 2 out of 8 joints showing deterioration on x-ray were the MRI findings in accordance. In the remaining six joints MRI showed improvement. The congruence between x-ray and MRI was therefore 36%. CONCLUSION: The long-term follow-up of rheumatoid synovial proliferation of the small joints in the hand using contrast enhanced MRI is feasible and may provide additional information regarding disease activity. Important advantages over conventional radiography methods are its ability to demonstrate qualitative differences of synovial proliferation within bone erosions, and demonstrate not only deterioration, but also the improvement of inflammatory disease.

Micro magnetic resonance imaging of water uptake by glass ionomer cements.

OBJECTIVES: The purpose of the present study was: 1) to visualize the water penetration into glass ionomer cement samples prepared in two different setting modes as a function of time, and 2) to assess the potential use of micro magnetic resonance imaging by studying penetration processes. METHODS: An encapsulated form of resin-modified glass ionomer cement (Fuji II LC, GC) was used in this study. The mixed cement was syringed into quartz tubes (4 mm ID x 10 mm long). Half of the samples were radially exposed to a light source for 120 s; the other half were allowed to set chemically in a photographic darkroom. One hour after the start of mixing, samples were extruded from the quartz tubes, immediately immersed in distilled water, and stored at 37 degrees C. Eight specimens were prepared with each setting mode and imaged at different times. Micro magnetic resonance imaging was performed on a Bruker Biospec System equipped with micro-imaging utilities. A spin echo technique was used. A small tube containing a mixture of normal and deuterated water was added as a standard to which the signals from the samples were normalized. The average signal, as calculated by the image processing software from each region, was divided by the signal from the standard sample to obtain the normalized intensity. The results were analyzed by a Student's t-test. RESULTS: After 24 h of immersion, water diffused 1 mm into the chemical-cured material and approximately 0.5 mm in the light-cured samples. After 96 h, the water had reached the center of all chemical-cured samples but not of the light-cured samples. After 192 h, water had reached the center of the cylinders of both groups of samples. SIGNIFICANCE: MRI microscopy is a good method for monitoring the water permeability of glass ionomer cements. The technique is nondestructive thus, the process can be followed on the same sample without destroying it. By using some special imaging techniques, refinement of the method will be possible.

Prognostic value of contrast enhanced Gd-DTPA MRI for development of bone erosive changes in rheumatoid arthritis.

Conventional radiograms have been used to quantitate the progression of rheumatoid arthritis, mainly through the assessment of bone erosions, but this approach has many limitations. It has been suggested that an advantage of contrast-enhanced Gd-DTPA MRI over radiography may be its prognostic value due to its ability to show the natural history of active destructive to inactive fibrous pannus. The aim of this study was to evaluate the possible prognostic value of MRI for future development of bone erosive changes in small hand joints in patients with RA. The results of the study confirm that in joints in which inflammatory active pannus is shown by contrast-enhanced MRI, progression of bone-destructive changes can be expected.

A method for generating magnetic resonance microimaging T2 maps with low sensitivity to diffusion.

Generating T2 maps in magnetic resonance microimaging is often complicated by the self-diffusion of water molecules. A modification of the standard spin-echo pulse sequence is proposed which minimizes this effect. Experiments with doped water confirmed that the T2 values obtained with the modified sequence were equal within the experimental error to the value obtained by the spectroscopic Carr-Purcell-Meiboom-Gill method. The applicability of the technique is demonstrated by generating T2 maps of porcine articular cartilage.

Distinctive radiological features of small hand joints in rheumatoid arthritis and seronegative spondyloarthritis demonstrated by contrast-enhanced (Gd-DTPA) magnetic resonance imaging.

A series of patients with clinically early inflammatory joint disease due to rheumatoid arthritis, psoriatic arthritis and Reiter's syndrome were examined by plain film radiography and magnetic resonance imaging (MRI). The spin echo T1-weighted precontrast, T2-weighted, and, especially, T1-weighted postcontrast images demonstrated distinct differences in the distribution of inflammatory changes, both within and adjacent to involved small hand joints. Two major subtypes of inflammatory arthritis were shown, thus providing a specific differential diagnosis between rheumatoid arthritis and some patients with seronegative spondyloarthritis. In particular, all the patients with Reiter's syndrome who were studied, and half of those with psoriatic arthritis, had a distinctive pattern of extra-articular disease involvement. The need for a new classification of clinical subsets in psoriatic arthritis has been recently suggested. The present findings suggest that magnetic resonance imaging could be useful in such a reclassification of seronegative spondyloarthritis, as well as offering considerable potential for a reappraisal of pathogenesis and therapy. In this series, it was also noted that juxta-articular osteoporosis on plain film did not correlate with bone marrow oedema on MRI. Hence the aetiology of this common radiographic finding also merits further consideration.

Precontrast and postcontrast (Gd-DTPA) magnetic resonance imaging of hand joints in patients with rheumatoid arthritis.

In an attempt to demonstrate whether clinically selected joints of the hand in active rheumatoid disease had consistent MRI findings, 45 patients were examined, in whom one joint in each was selected by both the referring clinician and patient as being active and symptomatic. Such joints, in order to be included in the study, were required to conform to ARA criteria of activity and usually mild to moderate X-ray changes. The joints were imaged using spin-echo sequences with T1W and T2W precontrast images, followed by T1W images after intravenous administration of Gd-DTPA. Different patterns of joint abnormalities were found. In 27 joints MRI findings suggested highly active synovitis and/or destructive pannus. In four, crescentic enhancement was thought to be compatible with simple synovitis, but in 23 rounded masses of synovial proliferation were characterized by marked, diffuse contrast enhancement on T1W postcontrast images, which corresponded well with high signal intensity on T2W images. Synovial proliferation in a further 12 joints was shown by only moderate stippled contrast enhancement and nonhomogeneous intermediate to high signal intensity on T2W images. These findings were thought to represent less active synovitis and pannus. MRI did not demonstrate inflammatory activity in six joints. In two of these pannus was of low signal intensity on T2W images, without contrast enhancement after Gd-DTPA infection presumed fibrotic and inert, and four were normal on all pulse sequences. These results suggest that clinical features of synovitis, even in carefully selected joints clinically, do not produce a homogeneous group when examined by MRI imaging. Indeed, a spectrum exists from presumed marked, active synovitis to total normality. If MRI is to be used as a clinical and research tool in the assessment of rheumatoid disease, and its therapeutic manipulation, these results are of some importance, since the variable findings indicate an appreciable heterogeneity of appearances in joints thought clinically to be of relatively uniform severity.

Prolonged T1 values of the crushed nerve are not exclusively attributable to Wallerian degeneration or endoneurial edema.

Axonotmesis of the left sciatic nerve was performed on adult male Wistar rats. T1 values of the crushed nerve samples were determined with proton magnetic resonance spectroscopy. Denervation changes of the dependent hind plantar flexor muscles were assessed with proton magnetic resonance imaging of their cross-sectional area and muscle force measurements. However, Tl relaxation time of the crushed nerve samples remained prolonged implying the absence of nerve regeneration. This would be in contradiction with what is known about regeneration after simple crash and the muscle force and magnetic resonance imaging measurements of the dependent plantar flexor muscles. These studies indicated that sufficient nerve regeneration had taken place to restore their muscle force and volume. A model is suggested to explain the persistence of prolonged Tl values in the presence of muscle force recovery.

Dependence of blood clot lysis on the mode of transport of urokinase into the clot--a magnetic resonance imaging study in vitro.

Magnetic resonance imaging was employed to study the dependence of clot lysing patterns on two different modes of transport of urokinase into whole blood clots. In one group of clots (nonperfused clots, n1 = 10), access of urokinase to the fibrin network was possible by diffusion only, whereas in the other group (perfused clots, n2 = 10) bulk flow of plasma containing urokinase was instituted through occlusive clots by a pressure difference of 3.7 kPa (37 cm H2O) across 3 cm long clots with a diameter of 4 mm. It was determined separately that this pressure difference resulted in a volume flow rate of 5.05 +/- 2.4 x 10(-2) ml/min through occlusive clots. Perfused clots diminished in size significantly in comparison to nonperfused ones already after 20 min (p less than 0.005). Linear regression analysis of two-dimensional clot sizes measured by MRI showed that the rate of lysis was more than 50-times faster in the perfused group in comparison to the nonperfused group. It was concluded that penetration of the thrombolytic agent into clots by perfusion is much more effective than by diffusion. Our results might have some implications for understanding the differences in lysis of arterial and venous thrombi.