Functional MRI for evaluation of hyaline cartilage extracelullar matrix, a physiopathological-based approach

Author:

Martín Noguerol Teodoro1,Raya Jose G2,Wessell Daniel E3,Vilanova Joan C4,Rossi Ignacio5,Luna Antonio1

Affiliation:

1. MRI unit, Radiology department, Health Time, Jaén, Spain

2. Department of Radiology, NYU School of Medicine, NY, USA

3. Department of Radiology, Mayo Clinic. Jacksonville, FL, USA

4. Department of Radiology, Clínica Girona. Institute Diagnostic Imaging (IDI), University of Girona, Girona, Spain

5. Centro Rossi, Buenos Aires, Argentina

Abstract

MRI of articular cartilage (AC) integrity has potential to become a biomarker for osteoarthritis progression. Traditional MRI sequences evaluate AC morphology, allowing for the measurement of thickness and its change over time. In the last two decades, more advanced, dedicated MRI cartilage sequences have been developed aiming to assess AC matrix composition non-invasively and detect early changes in cartilage not captured on morphological sequences. T2-mapping and T1ρ sequences can be used to estimate the relaxation times of water inside the AC. These sequences have been introduced into clinical protocols and show promising results for cartilage assessment. Extracelullar matrix can also be assessed using diffusion-weighted imaging and diffusion tensor imaging as the movement of water is limited by the presence of extracellular matrix in AC. Specific techniques for glycosaminoglycans (GAG) evaluation, such as delayed gadolinium enhanced MRI of cartilage or Chemical Exchange Saturation Transfer imaging of GAG, as well as sodium imaging have also shown utility in the detection of AC damage. This manuscript provides an educational update on the physical principles behind advanced AC MRI techniques as well as a comprehensive review of the strengths and weaknesses of each approach. Current clinical applications and potential future applications of these techniques are also discussed.

Publisher

British Institute of Radiology

Subject

Radiology Nuclear Medicine and imaging,General Medicine

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