Key result
The abbreviated 3D UTE MRI paradigm detected significant increases in T2*s (0.19 ms) and bound water signal fraction (4%) in the tibial intra-bone graft from 3 to 6 months post-ACL reconstruction.
Why the study?
Existing ultrashort echo time MRI methods require prohibitively long acquisition times to quantitatively assess the clinically relevant fast decay T 2 component in ligaments and tendons.
Does an abbreviated quantitative UTE MRI paradigm accurately assess graft remodeling in patients with ACL reconstruction?
Observational (n=8)
No
Does an abbreviated quantitative UTE MRI paradigm accurately assess graft remodeling in patients with ACL reconstruction?
An abbreviated 3D UTE MRI paradigm can assess ACL graft remodeling in a clinically translatable acquisition time.
Answers are grounded in this paper and cite their sources.
Abbreviated 3D UTE MRI may monitor tibial graft remodeling after ACL reconstruction; hypothesis-generating and requires prospective validation before clinical use.
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 T 2 * 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 T 2 * for fast decay component ( T₂ₛ T 2 s ∗ ) and bound water signal fraction ( f bw ) 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 T₂ₛ T 2 s ∗ and f bw over a range of clinically relevant values for ACL grafts. A decrease in T₂ₛ T 2 s ∗ 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 T₂ₛ T 2 s ∗ and f bw from 3- to 6-months were observed in the tibial intra-bone graft ( T₂ₛ ΔT 2 s ∗ : 0.19 ± 0.18 ms, P < 0.05; Δf bw : 4% ± 4%, P < 0.05). Lower T₂ₛ T 2 s ∗ (− 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 T₂ₛ T 2 s ∗ (− 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 T₂ₛ T 2 s ∗ and f bw of the ACL graft were observed.
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Fukuda et al. (2019) conducted an observational in Anterior cruciate ligament (ACL) tear (n=8). Abbreviated quantitative 3D UTE MRI vs. 3-month baseline was evaluated on Change in T2*s of the tibial intra-bone graft from 3 to 6 months (MD 0.19 ms, p=<0.05). The abbreviated 3D UTE MRI paradigm detected significant increases in T2*s (0.19 ms) and bound water signal fraction (4%) in the tibial intra-bone graft from 3 to 6 months post-ACL reconstruction.
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