Keywords: Whole Joint, Multimodal, FRACTURE, CT, shoulder

Motivation: It is highly desirable to evaluate both soft tissue and bone in a single examination. FRACTURE could be used as a viable auxiliary method of conventional MRI to allow evaluating soft tissue injury and quantifying bone defect simultaneously.

Goal(s): To evaluate the equivalence of FRACTURE and 3D-CT in quantifying bone loss in patients with shoulder dislocation and measuring the morphological parameters of the shoulder.

Approach: Fifty-six patients with shoulder dislocation underwent both MRI (including FRACTURE) and CT scanning. Paired t-test was utilized to assess the difference between them.

Results: There was no statistical difference between the measurements of 3D-CT and FRACTURE. 

Impact: FRACTURE, a radiation-free and reliable examination, could serve as an effective auxiliary method to conventional MRI. It allows for simultaneous evaluation of soft tissue injury and accurate quantification of bone defect.

Keywords: Tendon/Ligament, Bone, Magnetic resonance imaging

Motivation: The use of ZTE-MRI and Synthetic MRI technologies is increasing in musculoskeletal MRI, showing significant clinical symptoms in patients with limited shoulder joint mobility caused by supraspinatus tendon injuries

Goal(s): ZTE technology offers superior bone display capabilities, making it ideal for studying the relationship between CSA and AI and rotator cuff injuries

Approach: Prospective clinical study on the combined application of novel magnetic resonance technology for assessing supraspinatus tendon injuries

Results: The PLCC indicated a positive correlation between ZTE-MRI and T1WI measurements, with high consistency within and between groups. Boxplot statistics revealed a significant difference in the PD value of Synthetic-MRI quantitative values.

Impact: We used advanced magnetic resonance technology and relevant parameters to assess rotator cuff injury, employing a quantitative approach for classification and providing precise reference indicators for clinical imaging diagnosis and surgical treatment.

Keywords: Cartilage, MSK

Motivation: The study validated a non-invasive quantitative MR imaging for evaluating cartilage prognostic status after anterior cruciate ligament reconstruction (ACLR) as a technique against arthroscopic and histological measures.

Goal(s): To find the non-invasive biomarkers that can guide treatments and limit post-traumatic osteoarthritis (PTOA) in ACLR patients via quantitative cartilage morphometry analysis and biochemical assessments using GRAPPATINI T2 mapping.

Approach: This was a retrospective cohort study with level II evidence.

Results: Most knee cartilage subregions were thicker, larger in volume, and had higher T2 values in ACLR patients than in healthy controls. Partial cartilage parameters were significantly correlated with clinical scores. 

Impact: Quantitative MRI parameters of cartilage could significantly advance non-invasive diagnosis, prognostication, and personalized management of cartilage degeneration. 

Keywords: Synthetic MR, Quantitative Imaging, MSK

Motivation: Post-surgical imaging evaluation of the meniscus is essential for clinicians to formulate personalized rehabilitation programs.

Goal(s): SyMRI can simultaneously quantify the T1, T2 relaxation time and PD of tissues, providing an objective method to reflect meniscus change. 

Approach: The conventional MRI and SyMRI were performed before surgery, at 6 months, and 1 year after a surgery of meniscus repair, along with the Lysholm scores, to evaluate the postoperative recovery status.

Results:  Compared with the conventional MRI, T2 values presented a significant correlation with Lysholm scores and enabled to reflect follow-up postoperative function status of the meniscus.

Impact: The post-surgery abnormal meniscus signals fail to accurately distinguish the recurrent meniscus tears from postoperative changes during recovery period using conventional MRI. SyMRI can simultaneously provide contrast weighted MRI and quantification, giving an objective assessment of meniscus changes.

Keywords: New Devices, New Devices

Motivation: Wheelchair basketball players have a high risk of TFCC injury, necessitating the development of a portable MRI for wheelchair users.

Goal(s):  To demonstrate that the portable MRI is clinically feasible for the diagnosis of TFCC injuries in wheelchair basketball players.

Approach: We modified an existing portable MRI system for wheelchair use and imaged both wrists of seven players who had been selected for the Japanese women's wheelchair basketball team. We measured the signal-to-noise ratio of the wrist images and performed a clinical evaluation by two radiologists.

Results: Our portable MRI provided images of clinically detectable quality for TFCC injury.
 

Impact: The portable MRI system for wheelchair users improved in this study enables wheelchair users to assume the examination posture themselves and diagnose TFCC injuries. This is expected to expand the opportunities for MRI examinations of the wrists of wheelchair users.

Keywords: Large Animals, Nonhuman Primates, Spinal Cord, Multiple Linear Regression

Motivation: Diffusion MRI provides several quantitative parameters for evaluating structural alterations in spinal cord resulting from injuries.

Goal(s): Our primary objective is to comprehensively assess the sensitivity and specificity of measures derived from both the spherical mean technique and diffusion tensor imaging for assessing regional damage in the cervical spine of non-human primates after a targeted injury to a unilateral dorsal column.

Approach: We acquired diffusion MRI data and obtained silver-stained histological sections for validation.

Results: Our results suggest that diffusion MRI can detect and characterize axonal and cell body damage and assess the severity of spinal cord injury from multiple linear regression.

Impact: SMT and DTI offer sensitive and specific metrics to spinal cord injury (SCI). V_ax correlates strongly with histologic assessments of SCI, independent of axonal orientation. Multiple linear regression provides better estimates of tissue damage after SCI than single linear regression.

Keywords: Neuro, Trauma

Motivation: Are the different prognosis of pediatric spinal cord injury (SCI) patients related to differences in brain structure and function? The research on this project has a good guiding significance for prognosis prediction and advanced intervention treatment.

Goal(s): To search for sensitive imaging indicators that can predict neurological outcomes in pediatric SCI patients.

Approach: Voxel-based morphometry (VBM) and fractional amplitude of low-frequency fluctuations (fALFF) were used to analyze the differences of brain structure and function in children with and without neurological improvement.

Results: The medial temporal gyrus may be used as neuroimaging biomarker to predict the prognosis of pediatric SCI.

Impact: MTG can be used as neuroimaging biomarker to predict the prognosis of children with SCI , providing imaging support for clinical stimulation of related brain regions to improve the probability of neurological improvement.

Keywords: Other Musculoskeletal, MSK

Motivation: Anterior cruciate ligament (ACL) injury is associated with development of posttraumatic osteoarthritis and infrapatellar fat pad (IPFP) abnormalities.

Goal(s): Our goal was to quantify texture features of the IPFP in patients with ACL injury (pre- and post-ACLR) and compare to healthy contralateral knees. 

Approach: Image texture features were calculated from bilateral knee MRIs acquired at baseline (TP0), 6-months post-ACLR (TP1), and 1-year post-ACLR (TP2) from patients with acute, unilateral ACL tears. 

Results: The IPFP of ACL-injured knees had greater texture variability as compared to healthy contralateral knees up to 1-year post-ACLR. 

Impact: Texture heterogeneity of the IPFP of ACL-injured knees were higher up to 1-year post-ACLR compared to intact contralateral knees. MRI-based texture analysis can be used to differentiate between injured and contralateral knees.  

Keywords: Bone, Normal development, Fracture

Motivation: Stress fractures are common in athletic populations causing significant time-lost and potential future complications. Quantitative MRI thresholds have gained popularity but indiscriminate use without careful validation may cause error.

Goal(s): Evaluate impact of imaging sequence, age and gender on diagnosis of traumatic bone oedema.

Approach: Lumbar MRI from high risk screening and symptomatic injuries were imaged using multiple fat-suppressed sequences. A modified water-fat phantom was built mimicking normal and abnormal bone composition.

Results: Up to two-fold variation was evident in signal intensity of oedema between different fat-suppressed sequences, even when normalised. Female athletes showed higher signal intensities but age was not significant.

Impact: Sequence and gender-dependence on bone signal have important clinical implications for the use of absolute intensity or ratios to quantify oedema. Clinical adoption requires more attention to standardisation, calibration or locally derived thresholds to avoid misdiagnosis.

Keywords: Muscle, Muscle, Multi parametric MRI; Quantitative MRI; Rehabilitation

Motivation: Our research is driven by the need for advanced, non-invasive tools to assess the rehabilitation effectiveness in people with Spinal Cord Injury (SCI).

Goal(s): To determine the effects of Functional Electrical Stimulation (FES)-bike exercise training on muscle health in SCI patients using multiparametric MRI (mpMRI).

Approach: Four males with SCI conducted a 12-week FES-bike exercise training program. mpMRI was used to assess muscle health comprehensively considering muscle volume, fat fraction, diffusion parameters.

Results: Our study demonstrated significant increase in muscle volume and decrease in fat infiltration in the thigh muscles of people with SCI after 12-weeks of FES-bike training.

Impact: Our study highlights the potential of mpMRI for assessing the effectiveness of FES-bike training in people with SCI. This paves the way for more comprehensive evaluation methods, fostering precise monitoring of muscle health during rehabilitation and promoting tailored treatment strategies.

Keywords: Cartilage, MSK

Motivation: Cartilage degeneration can be evaluated non-invasively by quantitative T2 mapping MRI. However, clinical knee joint MRI requires multiple contrasts to diagnose various diseases, and T2 mapping for quantitative evaluation must be additionally performed.

Goal(s): To evaluate the lesion detection performance between 2D-TSE and 3D MIXTURE in clinical knee MRI.

Approach: MIXTURE is a 3D TSE that can set arbitrary echo times using the T2 preparation pulses, and enables several image contrasts and T2 mapping by acquiring at least two echo time images.

Results: With regard to the lesion depiction, 3D MIXTURE and conventional 2D TSE were considered comparable with equivalent diagnostic confidence.

Impact: MIXTURE can acquire morphological and quantitative images in a single scan. We evaluated the diagnostic accuracy of the morphological images. We will clarify the diagnostic accuracy of MIXTURE by comparing it with the conventional 2D-TSE method for knee joints.

Keywords: Other Musculoskeletal, Machine Learning/Artificial Intelligence, Meniscus

Motivation: Making an accurate diagnosis of meniscus tears from knee magnetic resonance imaging (MRI) is difficult.

Goal(s): To evaluate the accuracy of the 3D/2D deeply supervised U-net model for meniscus tears detection on knee MRI.

Approach: A total of 391 adult knee MRI scans were annotated in the tear regions of the menisci in coronal and sagittal images as ground truth. Tear detection was performed as a segmentation within the exam in the 679 test dataset.

Results: The accuracy of the coronal model and sagittal model were 0.76 and 0.74, respectively.

Impact: The diagnostic model for meniscus tears on knee magnetic resonance imaging might be useful as a screening tool and diagnostic aid for radiologists but further improvement is required for more accurate detection.

Keywords: Whole Joint, Bone, deep learning; knee joint; image quality; meniscus injury; MRI

Motivation: The need for accurate meniscus injury diagnosis and the limitations of traditional MRI.

Goal(s): To enhance knee MRI through deep learning algorithms.

Approach: A cohort of 46 patients underwent MRI with and without deep learning reconstruction (DLR). Radiologists subjectively assessed image quality and evaluated meniscus damage.

Results: DLR improved image quality, reducing noise and artifacts. Radiologists consistently rated DLR images higher. DLR excelled in detecting subtle meniscus injuries compared to traditional MRI.

Impact: This study demonstrates that deep learning-based MRI reconstruction substantially improves image quality and the detection of subtle meniscus injuries, offering enhanced diagnostic accuracy in knee joint assessments.

Keywords: Tendon/Ligament, Tendon/Ligament

Motivation: We analyzed magnetic resonance imaging (MRI) features of the elbow tendons to provide information for early diagnosis and treatment.

Goal(s): To analyze the injury classification of the common extensor tendon (CET) and common flexor tendon (CFT) tendinopathy by MRI.

Approach:  62 patients with elbow tendinopathy as the case group and 20 healthy subject as the control group. All subjects underwent elbow MR examination. The MRI of tendinopathy were read by 2 senior radiologists independently, and the consistency was tested by the κ test. The MRI manifestations for injury classification were discussed.

Results: MRI can be used to diagnose tendinopathies and classify injuries.

Impact: Tendinopathy of CFT and CET of elbow joint has its characteristic MRI manifestations, indicating that MRI can be used for the diagnosis injury classification of tendinopathy. In addition, MRI can also be used for the injury classification.