利用扩散磁共振成像对人髌腱微观结构和微循环进行体内评估。
In vivo evaluation of human patellar tendon microstructure and microcirculation with diffusion MRI.
作者信息
Wengler Kenneth, Fukuda Takeshi, Tank Dharmesh, Komatsu David E, Paulus Megan, Huang Mingqian, Gould Elaine S, Schweitzer Mark E, He Xiang
机构信息
Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York, USA.
Department of Radiology, Stony Brook University, Stony Brook, New York, USA.
出版信息
J Magn Reson Imaging. 2020 Mar;51(3):780-790. doi: 10.1002/jmri.26898. Epub 2019 Aug 12.
BACKGROUND
Patellar tendon (PT) microstructure integrity and microcirculation status play a crucial role in the progression of tendinopathy and tendon repair.
PURPOSE
To assess the feasibility and robustness of stimulated-echo based diffusion-weighted MRI with readout-segmented echo-planar imaging (ste-RS-EPI) for noninvasive assessment of microstructure and microcirculation of human PT.
STUDY TYPE
Prospective.
SUBJECTS
Fifteen healthy volunteers.
FIELD STRENGTH/SEQUENCE: PT diffusion tensor imaging (DTI) and intravoxel incoherent motion (IVIM) were acquired with an ste-RS-EPI protocol on a 3T MRI scanner.
ASSESSMENT
Subjects were positioned with their PT at the magic angle. DTI-derived parameters including axial diffusivity (AD), radial diffusivity (RD), mean diffusivity (MD), and fractional anisotropy (FA) were estimated with b-values of 0 and 800 s/mm and 12 diffusion directions. IVIM-derived parameters, f , D* × f , V , and D* × V were assessed in the central-third and the outer-two thirds of the PT with b-values of 0, 20, 30, 60, 80, 120, 200, 400, and 600 s/mm in three orthogonal directions.
STATISTICAL TESTS
Paired t-tests were used to evaluate differences in IVIM parameters between the central-third and outer-two thirds regions of the patellar tendon. Paired t-tests and within-subject coefficient of variation were used to assess the intra- and intersession reproducibility of PT DTI and IVIM parameters.
RESULTS
DTI parameters for healthy PT were 1.54 ± 0.09 × 10 mm /s, 1.01 ± 0.05 × 10 mm /s, 1.18 ± 0.06 × 10 mm /s, and 0.30 ± 0.04 for AD, RD, MD, and FA, respectively. Significantly higher (P < 0.05) IVIM parameters f and D* × f were observed in the outer-two thirds (6.1% ± 2.4% and 95.2 ± 49.6, respectively) compared with the central-third (3.8% ± 2.3% and 48.6 ± 35.2, respectively) of the PT.
DATA CONCLUSION
Diffusion MRI of PT with an ste-RS-EPI protocol is clinically feasible. Both DTI- and IVIM-derived parameters of the PT demonstrated good test-retest reproducibility and interrater reliability.
LEVEL OF EVIDENCE
2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2020;51:780-790.
背景
髌腱（PT）的微观结构完整性和微循环状态在肌腱病进展和肌腱修复中起关键作用。
目的
评估基于刺激回波的扩散加权磁共振成像（MRI）结合读出分段回波平面成像（ste-RS-EPI）用于无创评估人髌腱微观结构和微循环的可行性及可靠性。
研究类型
前瞻性研究。
研究对象
15名健康志愿者。
场强/序列：在3T MRI扫描仪上采用ste-RS-EPI协议采集髌腱扩散张量成像（DTI）和体素内不相干运动（IVIM）数据。
评估
受试者将髌腱置于魔角位置。利用b值为0和800 s/mm²以及12个扩散方向估计DTI衍生参数，包括轴向扩散率（AD）、径向扩散率（RD）、平均扩散率（MD）和分数各向异性（FA）。在髌腱的中三分之一和外三分之二区域评估IVIM衍生参数f、D*×f、V和D*×V，b值分别为0、20、30、60、80、120、200、400和600 s/mm²，扩散方向为三个正交方向。
统计检验
采用配对t检验评估髌腱中三分之一和外三分之二区域之间IVIM参数的差异。采用配对t检验和受试者内变异系数评估髌腱DTI和IVIM参数的组内和组间重复性。
结果
健康髌腱的DTI参数中，AD、RD、MD和FA分别为1.54±0.09×10⁻³mm²/s、1.01±0.05×10⁻³mm²/s、1.18±0.06×10⁻³mm²/s和0.30±0.04。与髌腱中三分之一区域（分别为3.8%±2.3%和48.6±35.2）相比，外三分之二区域的IVIM参数f和D*×f显著更高（P<0.05）（分别为6.1%±2.4%和95.2±49.6）。
数据结论
采用ste-RS-EPI协议对髌腱进行扩散MRI检查在临床上是可行的。髌腱的DTI和IVIM衍生参数均显示出良好的重测重复性和评分者间可靠性。
证据水平
2级 技术效能：1级 《磁共振成像杂志》2020年；51:780-790。
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