UTE MRI of Tissue Response in Meniscal Repair

半月板修复中组织反应的 UTE MRI

• 批准号: 8846027
• 负责人: CHRISTINE B CHUNG
• 金额: $ 45.66万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-05-06 至 2019-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8846027
• 关键词: Acute; Animal Model; Arthrography; Arthroscopy; Biochemical; Biological Assay; Biological Markers; Biological Preservation; Biomechanics; Clinical; Clinical Assessment Tool; Collagen; Complement; Contralateral; Data; Degenerative polyarthritis; Development; Evaluation; Glycosaminoglycans; Goals; Healed; Health; Histology; Histopathologic Grade; Human; Image; In Vitro; Joints; Knee; Lead; Limb structure; Literature; Magnetic Resonance; Magnetic Resonance Imaging; Maps; Measures; Mechanics; Meniscus structure of joint; Modeling; Monitor; Morphology; Musculoskeletal System; Operative Surgical Procedures; Orthopedics; Outcome; Patients; Physiologic pulse; Play; Postoperative Period; Preparation; Property; Proteoglycan; Randomized; Reference Standards; Reporting; Role; Second Look Surgery; Signal Transduction; Structure; Surgeon; Techniques; Testing; Time; Tissues; Translating; cohort; healing; in vitro Model; in vivo; novel; operation; prevent; prospective; repaired; research clinical testing; response; rho; tissue repair; transmission process

DESCRIPTION (provided by applicant): Menisci play an important mechanical role in the knee, including load transmission, energy dissipation, joint congruity and stability. It is now widely recognized that loss of meniscal integrity is an important contributor to the development of degenerative changes and osteoarthrosis. This has lead to an emphasis on preservation of meniscal tissue in the setting of meniscal repair as well as augmentation techniques used to facilitate meniscal healing. Clinical evaluation and post-operative management in the setting of meniscal repair is clearly challenging and variable from patient to patient. This application proposes to perform a study that will implement novel MR pulse sequences (ultrashort time to echo (UTE) techniques) that are able to acquire signal intensity from meniscal tissue, not possible on standard clinical MR sequences. In so doing, in our first aim, we will compare the accuracy of novel and conventional MR pulse sequences for characterizing tissue structure using a histopathologic reference standard. Our hypothesis is that novel ultrashort time to echo (UTE) sequences will be more accurate in evaluating meniscal structure. Quantitative MR techniques have been introduced in the literature over the past several years that are reported to reflect the biochemical content of tissue. These include, among others, T2 mapping (reflection of collagen) and T1 rho mapping (reflection of proteoglycan). In our second aim, we propose to compare the relationship between standard clinical quantitative T2 and T1 rho techniques with those performed with the UTE technique, using biochemical, biomechanical and histopathologic reference standards. Our hypothesis is that MR sequences that can acquire signal from meniscal tissue (UTE technique) will correlate more strongly with changes in collagen and proteoglycan integrity. In our third aim, we will apply the aforementioned techniques in an in vitro human meniscal and in vivo ovine model of meniscal repair implementing histolopathologic and biomechanical reference standards. Our hypothesis is that quantitative MR sequences will allow non-invasive tissue characterization of the healing response (both structural and biomechanical) in the setting of meniscal repair. In our final aim, we will translate the novel MR pulse sequences to a cohort of patients that have undergone primary meniscal repair with interrogation at 1, 3 and 4 months post-meniscal repair. We will also get a pre- MRI prior to the surgical procedure. We will use a clinical assessment tool as a reference standard. Our hypothesis is that quantitative MR sequences can successfully be translated to the clinical setting where they can monitor tissue response in the setting of meniscal repair.

描述（由申请人提供）：半月板在膝盖中起重要的机械作用，包括负载传输，能量耗散，关节一致性和稳定性。现在，人们广泛认识到，半月板完整性的丧失是导致退化性变化和骨关节炎的重要促进者。这导致着重于半月板修复的半月板组织，以及用于促进半月板愈合的增强技术。半月板修复环境中的临床评估和术后管理显然具有挑战性，并且因患者而变化。该应用建议进行一项研究，该研究将实施能够从半月板组织中获取信号强度的新型MR脉冲序列（超短时间（UTE）技术），这是在标准临床MR序列上不可能的。在这样做的情况下，在我们的第一个目标中，我们将比较新颖和常规的MR脉冲序列使用组织病理学参考标准表征组织结构的准确性。我们的假设是，回声（UTE）序列的新型超短时间在评估半月板结构方面将更加准确。在过去几年中，文献中已经引入了定量MR技术，这些技术据报道反映了组织的生化含量。其中包括T2映射（胶原蛋白的反射）和T1 Rho映射（蛋白聚糖的反射）。在我们的第二个目标中，我们建议使用生物化学，生物力学和组织病理学参考标准将标准临床定量T2和T1 RHO技术与用UTE技术进行的关系进行比较。我们的假设是，可以从半月板组织（UTE技术）获取信号的MR序列将与胶原蛋白和蛋白聚糖完整性的变化更加密切相关。在我们的第三个目标中，我们将应用上述技术在半月板修复的体外半月板模型中，实施组织病理学和生物力学参考标准。我们的假设是，定量MR序列将允许在半月板修复中对愈合反应（结构和生物力学）的非侵入性组织表征。在我们的最终目标中，我们将新颖的MR脉冲序列转化为经过一级半月板修复的患者队列，并在体育后修复1、3和4个月进行询问。在手术程序之前，我们还将获得前MRI。我们将使用临床评估工具作为参考标准。我们的假设是，定量MR序列可以成功地转化为临床环境，在半月板修复中可以监测组织反应。