Benign and malignant musculoskeletal lesions: dynamic contrast-enhanced MR imaging--parametric "first-pass" images depict tissue vascularization and perfusion.

Verstraete, Koenraad; Deene, Yves De; Roels, H; Dierick, A; Uyttendaele, Dirk; Kunnen, Marc

doi:10.1148/radiology.192.3.8058957

Cited by 280 publications

(161 citation statements)

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“…Since the sequences are performed during and immediately after a bolus injection of the contrast agent, they reflect the early contrast distribution in the capillaries and interstitial tissue. This technique thus provides information about tissue vascularity, perfusion and capillary permeability (Brasch et al, 1992, Verstraete et al, 1994. On the other hand, the standard static Gd-contrast agent enhancing MR images are performed several minutes after the injection of the contrast agent.…”

Section: Static and Dynamic Contrast Agent Enhancement (Studies 1-ii)mentioning

confidence: 99%

Magnetic resonance imaging in chronic achilles tendinopathy

Shalabi

2004

Acta Radiol

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The main objective of this thesis was to evaluate and monitor the morphological response following treatment interventions in patients with chronic Achilles tendinopathy by using different MRI-techniques. For this purpose, we investigated different types of sequences, including gadolinium contrast medium enhanced T1-WI images (CME T1-WI) and developed a precise method to measure tendon volume and mean intratendinous signal of the Achilles tendon. Study I aimed at evaluating 15 patients with chronic painful Achilles tendinosis, before -and two years after -surgical treatment. There was marked regression of the intratendinous signal postoperatively. The most sensitive sequence for depicting an intratendinous lesion in this study was CME T1-WI images. They showed a regression of the intratendinous signal abnormality from 13/15 patients preoperatively to 4/15 postoperatively. The clinical outcome was excellent in 8, good in 5, fair in 1 and poor in 1 patient. In study II, the early contrast agent enhancement in the dynamically enhanced MRI signal (DEMRI) was correlated to the histopathological findings in 15 patients with chronic Achilles tendinopathy. Early contrast enhancement (within the first 72 seconds) was seen in DEMRI in the symptomatic Achilles tendons with a significant difference compared to the asymptomatic contralateral tendons. Increased severity of tendon changes, including fiber structure abnormality, increased vascularity, rounding of nuclei and increased amount of glycosaminoglycans, correlated to CME. In study III, we developed a computerized 3-D seed growing MRI-technique to measure tendon volume and mean intratendinous signal. This technique showed an excellent inter-and intra-observer reliability. The technique was also used to prospectively follow up the tendon adaptation and healing described in studies IV-VI. In study IV, using serial MRI during a period of one year we evaluated the biological effect of tendon repair following iatrogenic tendon injury by five transversal ultrasound-guided core-biopsies employing a needle technique in chronic Achilles tendinopathy. Alterations found during healing, such as tendon volume and intratendinous reactive changes could be monitored by MR imaging, and subsided as noted in the seven and twelve months follow-up. In study V, we evaluated the effect of treatment with three months daily-performed heavy loaded calf muscle strength training program in 25 patients who had been suffering from chronic painful Achilles tendinopathy. The tendon volume decreased with 14%, and the mean intratendinous signal with 23%. The clinical outcome was improved. In study VI, we revealed tendon adaptation immediately following calf muscle strength training. An MRI examination within 30 minutes of the performed exercises resulted in increased total tendon volume (12%) and mean intratendinous signal (31%).In conclusion, MRI-techniques can be used as an adjunct to clinical evaluation by monitoring morphological effects following different treatment interventions, thereby ...

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Section: Static and Dynamic Contrast Agent Enhancement (Studies 1-ii)mentioning

confidence: 99%

Magnetic resonance imaging in chronic achilles tendinopathy

Shalabi

2004

Acta Radiol

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“…For example, DCE-MR imaging is able to differentiate between benign and malignant lesions in both vertebral and nonvertebral bone marrow. 5,8,9,[12][13][14][15][16] There is also evidence that perfusion studies can differentiate osteoporotic compression fractures from pathologic fractures. 8,9 Furthermore, the ability of DCE-MR imaging to monitor tumor response to chemotherapy and radiation, as well as to detect areas of viable tumor before resection, has also been described.…”

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confidence: 99%

Characterizing Hypervascular and Hypovascular Metastases and Normal Bone Marrow of the Spine Using Dynamic Contrast-Enhanced MR Imaging

Khadem¹,

Karimi²,

Peck³

et al. 2012

AJNR Am J Neuroradiol

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“…As previously suggested, the rapidly rising part of the TIC corresponds to contrast arrival in arterial capillaries and interstitial space; it mainly depends on tissue microvascularization and blood flow per unit of tissue mass. After this rise, capillary permeability and EES components contribute to TIC morphology (18)(19)(20)(21)29,30). Degenerative endplate marrow changes showed significantly diminished contrast inflow and outflow rate, but significantly higher and delayed contrast enhancement compared to normal marrow.…”

Section: Discussionmentioning

confidence: 99%

“…Degenerative endplate marrow changes showed significantly diminished contrast inflow and outflow rate, but significantly higher and delayed contrast enhancement compared to normal marrow. Considering reported data on contrast kinetics, reduced and delayed inflow may reflect diminished vascularization or blood flow (18)(19)(20)(21)(22). Increased but delayed maximum enhancement and decreased outflow may result from altered capillary permeability and surface area or increased EES volume (18)(19)(20)(21)(22).…”

Section: Discussionmentioning

confidence: 99%

Degenerative endplate changes of the lumbosacral spine: Dynamic contrast‐enhanced MRI profiles related to age, sex, and spinal level

Savvopoulou

Maris²,

Κουρέας

et al. 2011

Magnetic Resonance Imaging

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Purpose: To investigate differences in perfusion profiles between degenerative endplate marrow changes and normal vertebral marrow in relation to spinal level, age, and sex with dynamic contrast-enhanced magnetic resonance imaging (DCE MRI).Materials and Methods: Ninety-two consecutive patients referred for evaluation of low back pain or sciatica, without history of malignant or chronic disease, underwent conventional and DCE MRI of the lumbosacral spine. Fifty-two of them demonstrated degenerative endplate marrow changes. Regions of interest were placed on sites of normal marrow (group A) and degenerative changes (group B) on subtracted images. Fitted time-intensity curves (fTICs) were generated and evaluated for curve pattern. Both groups were stratified into upper (L1-L2) and lower (L3-I1) levels, males and females younger or older than 50 years. Perfusion parameters were calculated and statistically compared for both groups and subgroups. Receiver operator curve (ROC) analysis was also performed.Results: Two fTIC patterns were identified. Perfusion parameters of degenerative changes and normal marrow differed significantly, even when groups were stratified for spinal level, age, and sex (P < 0.05). A time to peak value >108 seconds was characteristic for degenerative changes with sensitivity 69.5% and specificity 84.6%.Conclusion: DCE MRI profiles of degenerative endplate marrow changes of the lumbosacral spine differ significantly from normal marrow regardless of spinal level, age, or sex.

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Benign and malignant musculoskeletal lesions: dynamic contrast-enhanced MR imaging--parametric "first-pass" images depict tissue vascularization and perfusion.

Abstract: FP images provide diagnostically useful information by depicting tissue vascularization and perfusion.

Cited by 280 publications

References 0 publications

Magnetic resonance imaging in chronic achilles tendinopathy

Magnetic resonance imaging in chronic achilles tendinopathy

Characterizing Hypervascular and Hypovascular Metastases and Normal Bone Marrow of the Spine Using Dynamic Contrast-Enhanced MR Imaging

Degenerative endplate changes of the lumbosacral spine: Dynamic contrast‐enhanced MRI profiles related to age, sex, and spinal level

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