Ultrashort TE MR Imaging of Femorotibial Cartilage

股胫软骨超短 TE MR 成像

• 批准号: 10038791
• 负责人: CHRISTINE B CHUNG
• 金额: --
• 依托单位: VA SAN DIEGO HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-10-01 至 2021-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10038791
• 关键词: 3-Dimensional; Acute; Affect; Aftercare; Biochemical; Biological; Biological Markers; Biomechanics; Bone Marrow; Bone plates; Bone remodeling; Bone structure; Cadaver; Cartilage; Chronic; Clinical; Clinical Protocols; Complex; Computer software; Consensus; Contralateral; Degenerative polyarthritis; Development; Evaluation; Failure; Fatty acid glycerol esters; Goals; Histologic; Image Analysis; Joints; Knee; Knee Osteoarthritis; Lead; Location; Magnetic Resonance Imaging; Marrow; Measures; Mechanics; Meniscus structure of joint; Monitor; Morphology; Operative Surgical Procedures; Outcome; Pathologic; Pathology; Pathway interactions; Patients; Pattern; Phenotype; Physiologic pulse; Process; Property; Protocols documentation; Public Health; Reference Standards; Research; Resolution; Sampling; Severities; Structure; Surface; Techniques; Testing; Time; Tissues; Translating; Treatment Protocols; Weight-Bearing state; Work; arthropathies; articular cartilage; base; bone; cartilage degradation; cohort; experience; histological image; human subject; imaging biomarker; improved; injured; joint loading; meniscal tear; meniscus injury; microCT; novel; osteochondral tissue; overtreatment; predicting response; preservation; repaired; response; soft tissue; subchondral bone; substantia spongiosa; success; theories; tibia

The general purpose of this study is to establish, validate and translate to clinical protocol, MR imaging biomarkers that non-invasively reflect structure, function, and adaptive relationships between meniscus, cartilage and subchondral bone based upon structural, histologic, and biomechanical reference standards. This proposal incorporates our experience from past cartilage and meniscus research to develop a unified theory, that of the meniscal osteochondral unit (M-OCU). This theory emphasizes the dynamic relationship between meniscus, cartilage, subchondral bone and bone marrow. It is supported by structural and mechanical relationships in the meniscus covered and uncovered osteochondral surfaces of the tibia, as well as by pathologic phenotypes in knee OA. The development of a single study protocol that allows non-invasive evaluation of the components of the M-OCU will facilitate understanding the degree and type of adaptation that occurs in these tissues in the setting of an altered mechanical axis in meniscus-injured patients. The overall hypothesis is that the intact M-OCU preserves a normal mechanical axis in the knee, and further that the pattern of meniscal failure (acuity, location, character) will predict the response of the subjacent osteochondral surface (adaptive response versus failure). Four specific aims are proposed: 1) cadaveric knees, we will determine if high resolution 3D Cube MR measures of the subchondral bone and trabecular bone can serve as biomarkers for structure and biomechanical function of tissue, for characterizing the structures of the subchondral (SC) bone plate and SC trabecular bone using micro CT as a reference standard, 2) cadaveric knees, will determine if MR measures of bone marrow can serve as biomarkers for marrow composition, and together with bone structure, improve the prediction of biomechanical function of the surrounding trabecular bone, 3) to evaluate the M-OCU (meniscus, cartilage, SC bone plate, SC trabecular bone, and bone marrow) using morphologic and quantitative MR sequences with histologic, imaging, and biomechanical reference standards, and 4) to translate MR imaging evaluation of the M-OCU with a novel load-bearing technique, to 2 meniscal repair cohorts pre- and post-treatment over time to characterize degree and patterns of adaptive remodeling. Aims 1 and 2 will establish sensitivity of MR techniques, magnified by novel hardware and software optimization, to structure and function of SC bone plate and SC trabecular bone. Aim 3 will be a translational aim, to perform whole-joint MR analysis of M-OCU in normal vs. pathologic knees of cadavers. Aim 4 will apply all of the developed techniques to meniscus-deficient patient cohorts, one receiving traditional meniscectomy vs. another receiving meniscus-conserving treatments, which is hypothesized to better preserve mechanical axis, lead to gradual adaptation of M-OCU, and better clinical outcome.

本研究的总体目的是建立、验证 MR 成像并转化为临床方案 非侵入性地反映半月板之间的结构、功能和适应性关系的生物标志物， 基于结构、组织学和生物力学参考标准的软骨和软骨下骨。这 该提案结合了我们过去软骨和半月板研究的经验，开发了一个统一的理论，即 半月板骨软骨单位（M-OCU）。该理论强调了两者之间的动态关系。 半月板、软骨、软骨下骨和骨髓。它由结构和机械支撑 半月板覆盖和未覆盖的胫骨骨软骨表面的关系，以及 膝关节骨关节炎的病理表型。制定允许非侵入性的单一研究方案 对 M-OCU 组成部分的评估将有助于理解适应的程度和类型 在半月板损伤患者的机械轴改变的情况下，这些组织中会发生这种情况。整体 假设完整的 M-OCU 保留了膝关节的正常机械轴，并且进一步认为 半月板衰竭的模式（敏锐度、位置、特征）将预测下层的反应 骨软骨表面（适应性反应与失败）。提出了四个具体目标：1）尸体 膝盖，我们将确定高分辨率 3D Cube MR 是否测量软骨下骨和骨小梁 可作为组织结构和生物力学功能的生物标志物，用于表征组织的结构 使用显微 CT 作为参考标准的软骨下 (SC) 骨板和 SC 骨小梁，2) 尸体 膝盖，将确定骨髓的 MR 测量是否可以作为骨髓成分的生物标志物，以及 与骨骼结构一起，提高对周围小梁生物力学功能的预测 骨，3) 评估 M-OCU（半月板、软骨、SC 骨板、SC 小梁骨和骨髓） 使用形态学和定量 MR 序列以及组织学、成像和生物力学参考 标准，以及 4) 将采用新颖的承载技术的 M-OCU 的 MR 成像评估转化为 2 半月板修复队列在治疗前和治疗后随时间的推移来表征适应性的程度和模式 重塑。目标 1 和 2 将建立 MR 技术的敏感性，并通过新颖的硬件和 软件优化，对SC骨板和SC骨小梁的结构和功能进行优化。目标 3 将是 转化目标是对尸体正常膝关节与病理膝关节的 M-OCU 进行全关节 MR 分析。 目标 4 将把所有已开发的技术应用于半月板缺陷的患者群体，其中一个接受传统的治疗 半月板切除术与接受半月板保留治疗的另一种治疗（假设可以更好地保留半月板） 机械轴，导致M-OCU逐渐适应，并获得更好的临床结果。