UTE MRI of Tissue Response in Meniscal Repair

描述（由申请人提供）：半月板在膝关节中起着重要的力学作用，包括载荷传递、能量耗散、关节一致性和稳定性。现在人们普遍认识到，椎骨完整性的丧失是退行性变化和骨关节病发展的重要因素。这导致在尿道修复的情况下强调保留尿道组织以及用于促进尿道愈合的增强技术。尿道修复术的临床评价和术后管理显然具有挑战性，并且因患者而异。本申请拟进行一项研究，该研究将实施新型MR脉冲序列（超短回波时间（UTE）技术），能够从血管组织中采集信号强度，这在标准临床MR序列中是不可能的。在这样做时，在我们的第一个目标，我们将比较新的和传统的MR脉冲序列的准确性，用于表征组织结构，使用组织病理学参考标准。我们的假设是，新的超短时间回波（UTE）序列将更准确地评估动脉结构。在过去的几年里，定量MR技术已经被引入文献中，据报道，该技术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（蛋白聚糖的反射）。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，MR序列，可以获得信号从尿道组织（UTE技术）将更强烈地与胶原蛋白和蛋白多糖的完整性的变化。在我们的第三个目标中，我们将应用上述技术在体外人尿道和体内绵羊尿道修复模型中，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序列将允许非侵入性组织表征的愈合反应（结构和生物力学）的设置中的神经修复。在我们的最终目标中，我们将把新的MR脉冲序列转化为一组接受了初次尿道修复的患者，并在尿道修复后1、3和4个月进行询问。我们也会在手术前做核磁共振检查.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，在那里他们可以监测组织的反应，在设置修复。

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.