Published in:
Open Access 01-12-2019 | Research article
Abbreviated quantitative UTE imaging in anterior cruciate ligament reconstruction
Published in: BMC Musculoskeletal Disorders | Issue 1/2019
Login to get accessAbstract
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.