Seeing Beyond Morphology-Standardized Stress MRI to Assess Human Knee Joint Instability

While providing the reference imaging modality for joint pathologies, MRI is focused on morphology and static configurations, thereby not fully exploiting the modality’s diagnostic capabilities. This study aimed to assess the diagnostic value of stress MRI combining imaging and loading in differenti...

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Bibliographic Details
Main Authors: Eva-Maria Winkelmeyer, Justus Schock, Lena Marie Wollschläger, Philipp Schad, Marc Sebastian Huppertz, Niklas Kotowski, Andreas Prescher, Christiane Kuhl, Daniel Truhn, Sven Nebelung
Format: Article
Language:English
Published: MDPI AG 2021-06-01
Series:Diagnostics
Subjects:
Online Access:https://www.mdpi.com/2075-4418/11/6/1035
Description
Summary:While providing the reference imaging modality for joint pathologies, MRI is focused on morphology and static configurations, thereby not fully exploiting the modality’s diagnostic capabilities. This study aimed to assess the diagnostic value of stress MRI combining imaging and loading in differentiating partial versus complete anterior cruciate ligament (ACL)-injury. Ten human cadaveric knee joint specimens were subjected to serial imaging using a 3.0T MRI scanner and a custom-made pressure-controlled loading device. Emulating the anterior-drawer test, joints were imaged before and after arthroscopic partial and complete ACL transection in the unloaded and loaded configurations using morphologic sequences. Following manual segmentations and registration of anatomic landmarks, two 3D vectors were computed between anatomic landmarks and registered coordinates. Loading-induced changes were quantified as vector lengths, angles, and projections on the x-, y-, and z-axis, related to the intact unloaded configuration, and referenced to manual measurements. Vector lengths and projections significantly increased with loading and increasing ACL injury and indicated multidimensional changes. Manual measurements confirmed gradually increasing anterior tibial translation. Beyond imaging of ligament structure and functionality, stress MRI techniques can quantify joint stability to differentiate partial and complete ACL injury and, possibly, compare surgical procedures and monitor treatment outcomes.
ISSN:2075-4418