Anatomical (static) magnetic resonance imaging (MRI) is the most useful imaging technique for the evaluation and assessment of internal derangement of the knee, but does not provide dynamic information and does not allow the study of the interaction of the different tissues during motion. As knee pain is often only experienced during dynamic tasks, the ability to obtain four-dimensional (4D) images of the knee during motion could improve the diagnosis and provide a deeper understanding of the knee joint. In this work, we present a novel approach for dynamic, high-resolution, 4D imaging of the freely moving knee without the need for external triggering. The dominant knee of five healthy volunteers was scanned during a flexion/extension task. To evaluate the effects of non-uniform motion and poor coordination skills on the quality of the reconstructed images, we performed a comparison between fully free movement and movement instructed by a visual cue. The trigger signal for self-gating was extracted using principal component analysis (PCA), and the images were reconstructed using a parallel imaging and compressed sensing reconstruction pipeline. The reconstructed 4D movies were scored for image quality and used to derive bone kinematics through image registration. Using our method, we were able to obtain 4D high-resolution movies of the knee without the need for external triggering hardware. The movies obtained with and without instruction did not differ significantly in terms of image scoring and quantitative values for tibiofemoral kinematics. Our method showed to be robust for the extraction of the self-gating signal even for uninstructed motion. This can make the technique suitable for patients who, as a result of pain, may find it difficult to comply exactly with instructions. Furthermore, bone kinematics can be derived from accelerated MRI without the need for additional hardware for triggering.

In this study, a multi-dimensional strain estimation method is presented to assess local relative deformation in three orthogonal directions in 3D space of skeletal muscles during voluntary contractions. A rigid translation and compressive deformation of a block phantom, that mimics muscle contraction, is used as experimental validation of the 3D technique and to compare its performance with respect to a 2D based technique. Axial, lateral and (in case of 3D) elevational displacements are estimated using a cross-correlation based displacement estimation algorithm. After transformation of the displacements to a Cartesian coordinate system, strain is derived using a least-squares strain estimator. The performance of both methods is compared by calculating the root-mean-squared error of the estimated displacements with the calculated theoretical displacements of the phantom experiments. We observe that the 3D technique delivers more accurate displacement estimations compared to the 2D technique, especially in the translation experiment where out-of-plane motion hampers the 2D technique. In vivo application of the 3D technique in the musculus vastus intermedius shows good resemblance between measured strain and the force pattern. Similarity of the strain curves of repetitive measurements indicates the reproducibility of voluntary contractions. These results indicate that 3D ultrasound is a valuable imaging tool to quantify complex tissue motion, especially when there is motion in three directions, which results in out-of-plane errors for 2D techniques.