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Biomedical subjects

Garry E Gold

Publications and source records attributed to Garry E Gold.

At least 37 records · Page 2Linked to original sources
PubMed2005

Patellofemoral joint contact area increases with knee flexion and weight-bearing.

Patellofemoral pain is a common and debilitating disorder. Elevated cartilage stress of the patellofemoral joint is hypothesized to play a role in the onset of pain. Estimating cartilage stress requires accurate measurements of contact area. The purpose of this study was to estimate patellofemoral joint contact areas in a group of healthy, pain-free subjects during upright, weight-bearing conditions. Sixteen subjects (8 female, 8 male) were scanned in a GE Signa SP open configuration MRI scanner, which allowed subjects to stand or squat while reclining 25 degrees from vertical with the knee positioned at 0 degrees , 30 degrees , or 60 degrees of flexion. A custom-built backrest enabled subjects to be scanned without motion artifact in both weight-bearing (0.45 body weight per leg) and reduced loading conditions ('unloaded' at 0.15 body weight) at each knee flexion posture. Male subjects displayed mean unloaded patellofemoral joint contact areas of 210, 414, and 520 mm(2) at 0 degrees , 30 degrees and 60 degrees of knee flexion, respectively. Female subjects' unloaded contact areas were similar at full extension (0 degrees ), but significantly smaller at 30 degrees and 60 degrees (p<0.01), with mean values of 269 and 396 mm(2), respectively. When normalized by patellar dimensions (heightxwidth), contact areas were not different between genders. Under weight-bearing conditions, contact areas increased by an average of 24% (p<0.05). This study highlights the differences in patellofemoral joint contact area between gender, knee flexion postures, and physiologic loading conditions.

Adult↗
PubMed2005

Controversies in protocol selection in the imaging of articular cartilage.

Magnetic resonance (MR) imaging, with its unique ability to noninvasively image and characterize soft tissue, has shown promise in assessment of cartilage. The development of new, fast imaging methods with high contrast will improve the MR evaluation of cartilage morphology. In addition to morphological MR imaging methods, MR imaging contrast mechanisms under development may reveal detailed information regarding the physiology of cartilage. However, many of these methods remain to be tested in the clinical setting. Protocol selection for cartilage imaging requires understanding of the patient population and the advantages and limitations of these techniques.

Cartilage Diseases↗
PubMed2005

A modeling framework to estimate patellofemoral joint cartilage stress in vivo.

PURPOSE: Patellofemoral (PF) pain is common among athletes and may be caused by increased subchondral bone stress as a result of increased stress in the cartilage of the femur or patella. This article presents a modeling pipeline to estimate in vivo cartilage stress in the PF joint. METHODS: The modeling pipeline uses the finite element method to calculate stresses and strains in the PF joint cartilage. Model inputs include an accurate geometrical representation of the bones and cartilage from magnetic resonance imaging (MRI), cartilage material properties, and an estimate of muscle forces from an EMG-driven musculoskeletal model. Validation is performed using PF joint contact area and patellar orientation measured from upright, weight-bearing MRI. Preliminary data from an active, pain-free subject illustrate the modeling pipeline to calculate cartilage stress during a static squat. RESULTS: The quasistatic finite element simulation reproduced the orientation of the patella to within 2.1 mm and predicted the PF joint contact area to within 2.3%. Octahedral shear stresses were highest in the central, lateral aspect of the patella cartilage with a peak of 2.5 MPa. The corresponding stresses in the femoral cartilage reached only 2.0 MPa. However, peak hydrostatic pressures were higher within the femoral cartilage (3.5 MPa) than the patellar cartilage (2.3 MPa). CONCLUSION: The methods presented in this article offer a novel approach to calculate PF joint cartilage stress in vivo. Future efforts will use this modeling pipeline to further our knowledge of PF pain and potential rehabilitation strategies.

Cartilage↗
PubMed2004

Weight-bearing MRI of patellofemoral joint cartilage contact area.

PURPOSE: To measure contact area of cartilage in the patellofemoral joint during weight bearing using an open MRI scanner. MATERIALS AND METHODS: We developed an MR-compatible back support that allows three-dimensional imaging of the patellofemoral cartilage under physiologic weight-bearing conditions with negligible motion artifact in an open MRI scanner. To measure contact areas, we trained observers using a phantom of known area and tested intra- and interobserver variability. We measured in vivo contact areas between the patella and femoral cartilage with the knee in 30 degrees of flexion, loaded and unloaded, in six volunteers. RESULTS: We were able to measure the contact area of the patellofemoral cartilage with small interobserver (CV 7.0%) and intraobserver (CV 3.0%) variation. At 30 degrees of knee flexion, mean contact area increased from 400 mm2 (unloaded) to 522 mm2(loaded to 0.45 times body weight per leg). CONCLUSION: Using an open magnet and specially designed apparatus, it is possible to image the patellar cartilage during physiologic loading. Knowledge of patellar cartilage contact area is needed to assess patellofemoral stress, which may be increased in patients with patellofemoral pain syndrome.

Cartilage, Articular↗
PubMed2004

Multicoil Dixon chemical species separation with an iterative least-squares estimation method.

This work describes a new approach to multipoint Dixon fat-water separation that is amenable to pulse sequences that require short echo time (TE) increments, such as steady-state free precession (SSFP) and fast spin-echo (FSE) imaging. Using an iterative linear least-squares method that decomposes water and fat images from source images acquired at short TE increments, images with a high signal-to-noise ratio (SNR) and uniform separation of water and fat are obtained. This algorithm extends to multicoil reconstruction with minimal additional complexity. Examples of single- and multicoil fat-water decompositions are shown from source images acquired at both 1.5T and 3.0T. Examples in the knee, ankle, pelvis, abdomen, and heart are shown, using FSE, SSFP, and spoiled gradient-echo (SPGR) pulse sequences. The algorithm was applied to systems with multiple chemical species, and an example of water-fat-silicone separation is shown. An analysis of the noise performance of this method is described, and methods to improve noise performance through multicoil acquisition and field map smoothing are discussed.

Adipose Tissue↗
PubMed2004

Steady-state diffusion-weighted imaging of in vivo knee cartilage.

Diffusion-weighted imaging (DWI) has strong potential as a diagnostic for early cartilage damage, with clinical impact for diseases such as osteoarthritis. However, in vivo DWI of cartilage has proven difficult with conventional methods due to the short T2. This work presents a 3D steady-state DWI sequence that is able to image short-T2 species with high SNR. When combined with 2D navigator correction of motion-induced phase artifacts, this method enables high resolution in vivo DWI of cartilage. In vivo knee images in healthy subjects are presented with high SNR (SNR = 110) and submillimeter in-plane resolution (0.5 x 0.7 x 3.0 mm(3)). A method for fitting the diffusion coefficient is presented which produces fits within 10% of literature values. This method should be applicable to other short-T2 tissues, such as muscle, which are difficult to image using traditional DWI methods.

Artifacts↗
PubMed2004

Analysis of multiple-acquisition SSFP.

Refocused steady-state free precession (SSFP) is limited by its high sensitivity to local field variation, particularly at high field strengths or the long repetition times (TRs) necessary for high resolution. Several methods have been proposed to reduce SSFP banding artifact by combining multiple phase-cycled SSFP acquisitions, each differing in how individual signal magnitudes and phases are combined. These include maximum-intensity SSFP (MI-SSFP) and complex-sum SSFP (CS-SSFP). The reduction in SSFP banding is accompanied by a loss in signal-to-noise ratio (SNR) efficiency. In this work a general framework for analyzing banding artifact reduction, contrast, and SNR of any multiple-acquisition SSFP combination method is presented. A new sum-of-squares method is proposed, and a comparison is performed between each of the combination schemes. The sum-of-squares SSFP technique (SOS-SSFP) delivers both robust banding artifact reduction and higher SNR efficiency than other multiple-acquisition techniques, while preserving SSFP contrast.

Artifacts↗
PubMed2004

Musculoskeletal MRI at 3.0 T: relaxation times and image contrast.

OBJECTIVE: The purpose of our study was to measure relaxation times in musculoskeletal tissues at 1.5 and 3.0 T to optimize musculoskeletal MRI methods at 3.0 T. MATERIALS AND METHODS: In the knees of five healthy volunteers, we measured the T1 and T2 relaxation times of cartilage, synovial fluid, muscle, marrow, and fat at 1.5 and 3.0 T. The T1 relaxation times were measured using a spiral Look-Locker sequence with eight samples along the T1 recovery curve. The T2 relaxation times were measured using a spiral T2 preparation sequence with six echoes. Accuracy and repeatability of the T1 and T2 measurement sequences were verified in phantoms. RESULTS: T1 relaxation times in cartilage, muscle, synovial fluid, marrow, and subcutaneous fat at 3.0 T were consistently higher than those measured at 1.5 T. Measured T2 relaxation times were reduced at 3.0 T compared with 1.5 T. Relaxation time measurements in vivo were verified using calculated and measured signal-to-noise results. Relaxation times were used to develop a high-resolution protocol for T2-weighted imaging of the knee at 3.0 T. CONCLUSION: MRI at 3.0 T can improve resolution and speed in musculoskeletal imaging; however, interactions between field strength and relaxation times need to be considered for optimal image contrast and signal-to-noise ratio. Scanning can be performed in shorter times at 3.0 T using single-average acquisitions. Efficient higher-resolution imaging at 3.0 T can be done by increasing the TR to account for increased T1 relaxation times and acquiring thinner slices than at 1.5 T.

Adult↗
PubMed2003

Magnetic resonance imaging findings after rectus femoris transfer surgery.

We describe the magnetic resonance (MR) imaging appearance of the knee flexor and extensor tendons after bilateral rectus femoris transfer and hamstring lengthening surgery in five patients (10 limbs) with cerebral palsy. Three-dimensional models of the path of the transferred tendon were constructed in all cases. MR images of the transferred and lengthened tendons were examined and compared with images from ten non-surgical subjects. The models showed that the path of the transferred rectus femoris tendon had a marked angular deviation near the transfer site in all cases. MR imaging demonstrated irregular areas of low signal intensity near the transferred rectus femoris and around the hamstrings in all subjects. Eight of the ten post-surgical limbs showed evidence of fluid near or around the transferred or lengthened tendons. This was not observed in the non-surgical subjects. Thus, MR imaging of patients with cerebral palsy after rectus femoris transfer and hamstring-lengthening surgery shows evidence of signal intensity and contour changes, even several years after surgery.

Adolescent↗
PubMed2003

Real-time imaging of skeletal muscle velocity.

PURPOSE: To test the feasibility of using real-time phase contrast (PC) magnetic resonance imaging (MRI) to track velocities (1-20 cm/second) of skeletal muscle motion. MATERIALS AND METHODS: To do this we modified a fast real-time spiral PC pulse sequence to accommodate through-plane velocity encoding in the range of -20 to +20 cm/second. We successfully imaged motion of the biceps brachii and triceps brachii muscles during elbow flexion and extension in seven unimpaired adult subjects using real-time PC MRI. RESULTS: The velocity data demonstrate that the biceps brachii and the triceps brachii, antagonistic muscles, move in opposite directions during elbow flexion and extension with velocity values in the muscle tissue ranging from -10 to +10 cm/second. CONCLUSION: With further development, real-time PC MRI may provide a means to analyze muscle function in individuals with neurologic or movement disorders who cannot actively complete the repeated motions required for dynamic MRI techniques, such as cine PC MRI, that are more commonly used in musculoskeletal biomechanics applications.

Adult↗
PubMed2003

Comparison of new sequences for high-resolution cartilage imaging.

The high prevalence of osteoarthritis continues to demand improved accuracy in detecting cartilage injury and monitoring its response to different treatments. MRI is the most accurate noninvasive method of diagnosing cartilage lesions. However, MR imaging of cartilage is limited by scan time, signal-to-noise ratio (SNR), and image contrast. Recently, there has been renewed interest in SNR-efficient imaging sequences for imaging cartilage, including various forms of steady-state free-precession as well as driven-equilibrium imaging. This work compares several of these sequences with existing methods, both theoretically and in normal volunteers. Results show that the new steady-state methods increase SNR-efficiency by as much as 30% and improve cartilage-synovial fluid contrast by a factor of three. Additionally, these methods markedly decrease minimum scan times, while providing 3D coverage without the characteristic blurring seen in fast spin-echo images.

Cartilage↗
PubMed2003

Dynamic and functional imaging of the musculoskeletal system.

Conventional magnetic resonance imaging (MRI) examination of the musculoskeletal system is limited to static evaluation of muscle, spine, and joint morphology. However, using the variety of contrast mechanisms available with MRI, it is possible to obtain functional and biomechanical data about the musculoskeletal system. The function of joints and muscles are for motion and weight bearing, so pathology that only occurs during activity can be missed on static MRI examination. Similarly, important information about muscle biomechanics, muscle energetics, and joint function can be obtained with unique MRI contrast such as T(2)-mapping, spectroscopy, blood-oxygenation-level-dependent (BOLD) imaging, and molecular imaging. These new techniques hold the promise for a more complete and useful joint examination.

Biomechanical Phenomena↗
PubMed2003

Protocols in sports magnetic resonance imaging.

Magnetic resonance imaging, with its multiplanar imaging capability and superior soft-tissue contrast, has become the preferred method for imaging sports-related injuries. Advances in gradient technology, receiver coils, and imaging software have allowed the imaging of the injured athlete to take place quickly and at high resolution. Understanding the tissues being imaged, the underlying anatomy, and the capabilities of today's scanners is crucial to the design of intelligent and efficient protocols.

Athletic Injuries↗
PubMed2003

Interactive and interventional sports medicine imaging.

The concepts and clinical potential of interactive magnetic resonance imaging (MRI) in which an examiner manipulates the joint of interest during MRI, and of interventional sports medicine imaging in which radiological guidance is used for targeted therapy of injuries and masses are described. As illustrated by a series of clinical cases, we believe that with further development, interactive MRI will play an important role in the comprehensive evaluation of patients with shoulder pain or dysfunction as well as other joint derangements. Interventional sports medicine takes advantage of the increasingly sophisticated diagnostic value of MRI and the radiologist's ability to use imaging to guide percutaneous therapy. We review our recent experience treating a wide variety of disorders such as cysts, hematomas, and inflammatory disorders, focusing on techniques utilizing ultrasound and MR guidance.

Adolescent↗