UTE MRI of Tissue Response in Meniscal Repair

半月板修复中组织反应的 UTE MRI

• 批准号: 8630177
• 负责人: CHRISTINE B CHUNG
• 金额: $ 46.85万
• 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/8630177
• 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; Metric; 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（申请人提供）：半月板在膝关节中发挥着重要的机械作用，包括负荷传递、能量耗散、关节一致性和稳定性。现在人们普遍认识到半月板完整性的丧失是退行性变化和骨关节病发展的重要因素。这导致在半月板修复以及用于促进半月板愈合的增强技术中强调半月板组织的保存。半月板修复的临床评估和术后管理显然具有挑战性，并且因患者而异。本申请拟开展一项研究，实施新型 MR 脉冲序列（超短回波时间 (UTE) 技术），能够从半月板组织获取信号强度，这在标准临床 MR 序列上是不可能的。在此过程中，我们的第一个目标是，我们将比较新型和传统 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，新型超短回波时间（UTE）序列在评估半月板结构时将更加准确。过去几年文献中已经介绍了定量磁共振技术，据报道可以反映组织的生化含量。其中包括 T2 映射（胶原蛋白的反射）和 T1 rho 映射（蛋白多糖的反射）。在我们的第二个目标中，我们建议使用生化、生物力学和组织病理学参考标准，比较标准临床定量 T2 和 T1 rho 技术与 UTE 技术之间的关系。我们的假设是，能够从半月板组织获取信号的 MR 序列（UTE 技术）将与胶原蛋白和蛋白聚糖完整性的变化密切相关。在我们的第三个目标中，我们将在体外人类半月板和体内绵羊半月板修复模型中应用上述技术，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 序列将允许对半月板修复中的愈合反应（结构和生物力学）进行非侵入性组织表征。在我们的最终目标中，我们将把新颖的 MR 脉冲序列转化为一组接受过初次半月板修复的患者，并在半月板修复后 1、3 和 4 个月进行询问。我们还将在手术前进行预 MRI 检查。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，在临床环境中它们可以监测半月板修复环境中的组织反应。