Longitudinal T2 Mapping and Texture Feature Analysis in the Detection and Monitoring of Experimental Post-Traumatic Cartilage Degeneration.

Marc Sebastian Huppertz,Manuel Post,Sven Nebelung,Karl Ludger Radke,Justus Schock,Daniel Truhn,Christiane Kuhl,Daniel Benjamin Abrar

doi:10.3390/life11030201

Marc Sebastian Huppertz, Manuel Post + Show 6 more

Open Access

https://doi.org/10.3390/life11030201

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Abstract

Background: Traumatic cartilage injuries predispose articulating joints to focal cartilage defects and, eventually, posttraumatic osteoarthritis. Current clinical-standard imaging modalities such as morphologic MRI fail to reliably detect cartilage trauma and to monitor associated posttraumatic degenerative changes with oftentimes severe prognostic implications. Quantitative MRI techniques such as T2 mapping are promising in detecting and monitoring such changes yet lack sufficient validation in controlled basic research contexts. Material and Methods: 35 macroscopically intact cartilage samples obtained from total joint replacements were exposed to standardized injurious impaction with low (0.49 J, n = 14) or high (0.98 J, n = 14) energy levels and imaged before and immediately, 24 h, and 72 h after impaction by T2 mapping. Contrast, homogeneity, energy, and variance were quantified as features of texture on each T2 map. Unimpacted controls (n = 7) and histologic assessment served as reference. Results: As a function of impaction energy and time, absolute T2 values, contrast, and variance were significantly increased, while homogeneity and energy were significantly decreased. Conclusion: T2 mapping and texture feature analysis are sensitive diagnostic means to detect and monitor traumatic impaction injuries of cartilage and associated posttraumatic degenerative changes and may be used to assess cartilage after trauma to identify “cartilage at risk”.

Highlights

Associated with knee symptoms and dysfunction, focal cartilage lesions are common in the general population
While the aetiology of focal cartilage lesions is multifactorial, focal cartilage lesions are often the result of trauma [5,6]: Meniscus and anterior cruciate ligament (ACL) injuries bring about instability and predispose the joint to cartilage lesions [5]
Considerable dents corresponding to the metallic tip’s geometry Life 2021, 11, x FOR PEER REVIEW were observed at the impaction site following HIMP exposure (11/14 samples) (Figur8eo3fa1)7, while no such marks were observed after LIMP exposure or in controls

Summary

Introduction

Associated with knee symptoms and dysfunction, focal cartilage lesions are common in the general population. Hjelle et al reported (osteo)chondral lesions (of any type) in 61% of their patients undergoing knee arthroscopy [1]. Other aetiologic factors are fractures, soft-tissue injuries, and repetitive microtraumatizations that result in surface incongruity, altered joint kinematics, and chronic degenerative changes, thereby predisposing to cartilage lesions, too. Traumatic cartilage injuries predispose articulating joints to focal cartilage defects and, eventually, posttraumatic osteoarthritis. Current clinical-standard imaging modalities such as morphologic MRI fail to reliably detect cartilage trauma and to monitor associated posttraumatic degenerative changes with oftentimes severe prognostic implications. Conclusion: T2 mapping and texture feature analysis are sensitive diagnostic means to detect and monitor traumatic impaction injuries of cartilage and associated posttraumatic degenerative changes and may be used to assess cartilage after trauma to identify “cartilage at risk”

Methods

Results

Conclusion