Development and Translation of Novel UTE-MuSIC MR Sequence to Image Around Metal

新型 UTE-MuSIC MR 序列的开发和转化为金属周围的图像

• 批准号: 9188779
• 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: 2014
• 资助国家: 美国
• 起止时间: 2014-01-01 至 2017-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9188779
• 关键词: Aging; Area; Biochemical; Biological Assay; Cadaver; Characteristics; Chromium; Clinical; Clinical Research; Cobalt; Collagen; Collection; Complication; Degenerative polyarthritis; Development; Diagnosis; Disease; Eligibility Determination; Evaluation; Failure; Grant; Hip Prosthesis; Histologic; Image; Imagery; Implant; In Vitro; Injury; Ions; Joints; Liquid substance; Magnetic Resonance; Magnetic Resonance Imaging; Metals; Methods; Modeling; Morphologic artifacts; Motion; Musculoskeletal; Musculoskeletal System; Music; Needles; Orthopedics; Pathogenesis; Pathologic; Pathology; Patient Care; Patients; Physiologic pulse; Population; Predisposition; Prosthesis; Protons; Publishing; Recruitment Activity; Reference Standards; Replacement Arthroplasty; Research; Sepharose; Serum; Signal Transduction; Site; Structure; System; Techniques; Tendon structure; Testing; Time; Tissues; Translations; Veterans; Visit; cohort; collagenase; hip replacement arthroplasty; imaging approach; improved; in vivo; insight; magnetic field; metallicity; noninvasive diagnosis; novel; public health relevance; reconstruction; soft tissue; spectrograph; standard of care

DESCRIPTION (provided by applicant): The aim of the study is to develop and implement novel MR sequences that decrease metallic susceptibility artifact about orthopedic hardware, specifically, total hip arthroplasties (THA). TH metal distorts magnetic field and leads to areas in MR images that are black, and obscure underlying tissue. Other areas appear bright (signal pile up), and are difficult to distinguish fro pathology. In Aim 1, we develop a novel pulse sequence that decreases metallic artifact and allows signal acquisition from short T2 tissues (those black on all clinical MR images). They are black because protons relax before the MR can switch from transmit (proton excitation), to receive (signal collection). Short T2 tissue signal can be accessed with a pulse sequence allowing near immediate signal acquisition after proton excitation (Ultrashort echo time (UTE) MRI). We developed UTE-MSI (Ultrashort Echo Time - Multi-spectral Imaging) with a single published article describing it. It uses a 3D acquisition to allow multiplanar reconstruction, a technique called Multi-spectral imaging to decrease metal artifact, and UTE to visualize short T2 tissues. This sequence suffers from long imaging time. In aim 1, we further develop UTE-MSI sequence, optimize it for improved suppression of metal artifact, better contrast and use a technique called compressed sensing to decrease imaging times. This sequence is UTE-MuSIC (Ultrashort Time to Echo - Multi-Spectral Imaging with Compressed Sensing). Also in aim 1, we compare UTE-MuSIC to a clinical sequence and a well-accepted research sequence (limited distribution to test sites only) that decrease metal artifact. This allows evalution of UTE-MuSIC as compared to standard of care, and best case scenario in research setting. We have developed both qualitative and quantitative methods to compare sequences and will do so in phantoms with metal. In Aim 2, UTE-MuSIC will be compared to clinical and research sequences to quantitatively evaluate fluid collections with varying concentrations of metal ion using techniques from Aim 1. If successful, fluid collections with metal ion could be identified non-invasively. A well-described complication of Metal-on-Metal (MoM) THA is pseudotumor development that contains metal ions and is destructive to soft tissues (tendon). Also in Aim 2, we will compare the ability of UTE-MuSIC sequence to characterize normal and pathologic tendon in phantoms with metal, simulating potential tendon damage in vivo in the setting of pseudotumor. In Aim 3, MRI of patients with MoM THA will be done. The San Diego VA Department of Orthopedics sees 30 to 50 MoM patients/year. Patients will be screened for MR eligibility (standard practice), and patients being followed for MoM THA (n=30) will be recruited for longitudinal MR studies in years 2-4 of the grant. In the MoM cohort, at yearly visits, serum ion levels will be checked. In the presence of peri-prosthetic fluid collections, fluid analysis wil be performed. If revision arthroplasty is indicated from a clinical standpoint, joint tissue and prostheses will be evaluated. Tissue will undergo histological evaluation and grading.

描述（由申请人提供）： 该研究的目的是开发和实施新型 MR 序列，以减少骨科硬件（特别是全髋关节置换术 (THA)）的金属敏感性伪影。 TH 金属会扭曲磁场，导致 MR 图像中的区域呈黑色，并且使下面的组织变得模糊。其他区域显得明亮（信号堆积），并且很难与病理区分开。 在目标 1 中，我们开发了一种新颖的脉冲序列，可以减少金属伪影并允许从短 T2 组织（所有临床 MR 图像上的黑色组织）采集信号。它们是黑色的，因为在 MR 可以从发射（质子激发）切换到接收（信号收集）之前，质子会松弛。短 T2 组织信号可以通过脉冲序列获取，允许在质子激发后立即采集信号（超短回波时间 (UTE) MRI）。我们开发了 UTE-MSI（超短回波时间 - 多光谱成像），并发表了一篇文章对其进行了描述。它使用 3D 采集来实现多平面重建，使用一种称为多光谱成像的技术来减少金属伪影，并使用 UTE 来可视化短 T2 组织。该序列的成像时间较长。在目标 1 中，我们进一步开发 UTE-MSI 序列，对其进行优化以改善对金属伪影的抑制，获得更好的对比度，并使用压缩传感技术来减少成像时间。该序列是 UTE-MuSIC（超短回波时间 - 压缩感知多光谱成像）。同样在目标 1 中，我们将 UTE-MuSIC 与减少金属伪影的临床序列和广泛接受的研究序列（仅有限分布到测试站点）进行比较。这允许与护理标准和研究环境中的最佳案例场景进行比较来评估 UTE-MuSIC。我们已经开发了定性和定量方法来比较序列，并将在模型与金属中进行比较。 在目标 2 中，UTE-MuSIC 将与临床和研究序列进行比较，以使用目标 1 中的技术定量评估具有不同浓度金属离子的液体收集。如果成功，可以非侵入性地识别具有金属离子的液体收集。金属对金属 (MoM) THA 的一个众所周知的并发症是假瘤发展，其中含有金属离子，对软组织（肌腱）有破坏性。同样在目标 2 中，我们将比较 UTE-MuSIC 序列在金属体模中表征正常肌腱和病理肌腱的能力，模拟假肿瘤环境中体内潜在的肌腱损伤。 在目标 3 中，将对 MoM THA 患者进行 MRI 检查。圣地亚哥 VA 骨科每年接诊 30 至 50 名患者。将对患者进行 MR 资格筛查（标准做法），并在资助的第 2-4 年招募接受 MoMTHA 随访的患者 (n=30) 进行纵向 MR 研究。在 MoM 队列中，每年都会检查血清离子水平。在存在假体周围液体收集的情况下，将进行液体分析。如果从临床角度来看需要进行关节翻修术，则将对关节组织和假体进行评估。组织将接受组织学评估和分级。