Quantitative Magnetic Resonance and Ultrasound Imaging of Human Rotator Cuff Muscle and Tendon

人体肩袖肌肉和肌腱的定量磁共振和超声成像

• 批准号: 10409689
• 负责人: Eric Y Chang
• 金额: --
• 依托单位: VA SAN DIEGO HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-07-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10409689
• 关键词: Acoustics; Adult; Affect; Age; Aging; Animal Model; Award; Bed rest; Biological Markers; Biopsy Specimen; Cachexia; Cadaver; Chronic; Clinic; Clinical; Collagen; Conflict (Psychology); Couples; Data; Deterioration; Development; Diffusion; Evaluation; Fatty acid glycerol esters; Fibrosis; Frequencies; Functional disorder; Gender; Goals; Histologic; Histology; Human; Image; Imaging Techniques; Individual; Infiltration; Injury; Joint structure of shoulder region; Joints; Lead; Least-Squares Analysis; Magic; Magnetic Resonance; Magnetic Resonance Imaging; Measurement; Measures; Methods; Modeling; Muscle; Muscular Atrophy; Myelin; Nerve; Nervous System Trauma; Operative Surgical Procedures; Pain; Pathology; Patient-Focused Outcomes; Patients; Physiologic pulse; Population; Property; Quantitative Evaluations; Rattus; Reference Standards; Relaxation; Reporting; Reproducibility; Resolution; Rotator Cuff; Shapes; Shoulder; Skeletal Muscle; Source; Specimen; Structure; Techniques; Tendinopathy; Tendon structure; Thick; Time; Tissues; Translating; Translations; Ultrasonography; Veterans; Water; active duty; arthropathies; attenuation; base; cartilage degradation; cohort; density; disability; elastography; experimental study; human imaging; imaging biomarker; imaging modality; in vivo; kinematics; novel; prognostic; quantitative ultrasound; radio frequency; repaired; rotator cuff tear; statistics; success; ultrasound; virtual

The rotator cuff (RC) is the primary dynamic stabilizer of the glenohumeral joint and dysfunction can lead to abnormal joint kinematics through loss of force couples, deterioration of shoulder function, and ultimately cartilage degeneration and cuff arthropathy. Full-thickness RC tendon tears are common, occurring in >20% of the adult population, and when non-operative management fails, surgical repair is often performed. Although muscle fibrosis and tendon degeneration are important variables that can increase surgical complexity and lead to lower patient outcome scores, they are difficult to evaluate non-invasively, including with conventional magnetic resonance imaging (MRI) and ultrasound (US), the two most widely used imaging modalities. Recently the novel ultrashort echo time magnetization transfer (UTE-MT) MRI technique has been developed to assess tendon quality, and preliminary results showed insensitivity to the magic angle effect, a strong correlation with collagen loss, and the capability to distinguish between tendinopathy groups. However, the variable presence of fat diminishes the accuracy of the technique when applied to degenerated muscle, for which several new fat-suppression methods have been proposed. Ultrasound quantification of muscle fat and fibrosis has also been attempted using routine B-mode images with limited success. The goal of this proposal is to develop, optimize, validate, and translate novel MRI and US techniques for comprehensive quantitative evaluation of RC muscle and tendon collagen abnormalities and fibrosis. In the first technical development aim, novel UTE-MT with various fat-suppression methods will be optimized and implemented, and the superior version with optimized parameters will be determined. In addition, quantitative US based on raw radiofrequency data will be implemented and novel tissue-specific scattering models will be created. The first hypothesis is that novel quantitative UTE-MT with fat-suppression and quantitative US incorporating tissue-specific models for tendon and muscle can be developed and optimized. In the second aim, a controlled rat model with unilateral massive RC tendon tear is used to induce muscle and tendon degeneration. The novel quantitative MRI and US techniques will be validated and compared alongside existing quantitative techniques. The second hypothesis is that these novel techniques can be implemented longitudinally, are reproducible, and will better correlate with reference standard histological measurements. The third human translational aim brings these new techniques to the clinic. Two age- and gender-matched cohorts of patients will be imaged, including individuals without full-thickness RC tears and individuals with full-thickness RC tears who will undergo surgical repair with acquisition of small biopsy samples. The third hypothesis is that the novel quantitative MRI and US techniques can be translated to the clinic for comprehensive, non-invasive assessment of RC muscle and tendon.

肩袖（RC）是Glenohumeral关节和功能障碍的主要动态稳定剂 通过丧失力夫妇，肩部功能恶化，最终通过丧失力量的关节运动学 软骨变性和袖口关节病。全厚度RC肌腱撕裂很常见，发生在> 20％以上 成年人口，当非手术管理失败时，经常进行手术修复。虽然 肌肉纤维化和肌腱变性是重要变量，可以增加手术复杂性并引导 为了降低患者的结局评分，它们很难非侵入性评估，包括常规 磁共振成像（MRI）和超声（US），这是两种最广泛的成像方式。 最近，新型的Ultrastort Echo时间磁化转移（UTE-MT）MRI技术已经 开发以评估肌腱质量，初步结果表现出对魔法角效应的不敏感性，一个 与胶原蛋白损失的密切相关性，以及区分肌腱病组的能力。然而， 脂肪的存在可变降低，当应用于退化的肌肉时，该技术的准确性 已经提出了几种新的脂肪抑制方法。超声量化肌肉脂肪和 还尝试使用常规B模式图像有限的成功。 该建议的目的是开发，优化，验证和翻译新颖的MRI和美国技术 为了全面评估RC肌肉和肌腱胶原蛋白异常和纤维化。在 第一个技术开发目的，具有各种脂肪抑制方法的新型UTE-MT将被优化，并且 实施，将确定具有优化参数的上级版本。另外，定量 将实施基于原始射频数据的美国，新的组织特异性散射模型将是 创建。第一个假设是具有脂肪抑制和定量美国的新型定量UTE-MT 可以开发和优化肌腱和肌肉的组织特异性模型。在第二个目标中 具有单侧巨大RC肌腱撕裂的受控大鼠模型用于诱导肌肉和肌腱变性。 新颖的定量MRI和美国技术将得到验证，并与现有的定量进行比较 技术。第二个假设是这些新技术可以纵向实施，是 可重现，并将更好地与参考标准组织学测量相关。第三人 翻译目标将这些新技术带到诊所。两个年龄和性别匹配的患者队列 将成像，包括没有全厚的RC眼泪的个人和带有全厚的RC眼泪的人 他们将通过获取小型活检样本进行手术修复。第三个假设是小说 定量MRI和US技术可以转化为诊所进行全面的，无创的评估 RC肌肉和肌腱。