The role of diffusion based magnetic resonance imaging in the evaluation of bone bruising of the knee

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Title: The role of diffusion based magnetic resonance imaging in the evaluation of bone bruising of the knee
Authors: Alqattan, Abrar
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Date: 2022
Online since: 2022-11-07T13:28:40Z
Abstract: Purpose: To evaluate the use of diffusion-weighted magnetic resonance imaging (DW-MRI) in the evaluation of bone bruising associated with anterior cruciate ligament (ACL) injury. Materials and methods: The study was divided into three phases: phantom, volunteer, and patients scanning phases. The phantom phase was used to evaluate MR scanner performance and optimise the DW-MRI sequences. The volunteer phase was used for further optimisation of this sequence on (n=15) healthy subjects and to quantitatively analyse the diffusion characteristics of normal cancellous bone. The patient phase involved acquiring routine knee scans and optimised DWI sequences on patients with ACL injury-related bone bruises. Routine and DWI sequences were repeated for patients with ACL injury-related bone bruises at three, post-injury, time intervals (3-8 weeks, 3 months, and 6 months) to demonstrate temporal changes in bone marrow signal intensity and measured apparent diffusion coefficient (ADC) values. Quantitative analyses for both volunteer and patient phases involved selecting different regions-of-interest (ROIs) and measuring ADC values on locations associated with ACL-related bone bruising [anterior, medial and lateral ROIs in the medial and lateral femoral condyles (FC), medial and lateral tibial condyle (TC)] with different b-values of 50, 600 and 800s/mm2 and correlate finding with KOOS and Tegner scales. Results: The phantom phase demonstrated that the optimised DWI sequence was valid and could be employed in the clinical setting. DWI, in association with ADC maps, were able to detect differences between normal and abnormal cancellous bone marrow in healthy volunteers and patients. The ADC values of areas of bone bruising were significantly higher than those for normal bone marrow in healthy subjects. The mid-lateral femoral condyles (M-LFC) and the postero-lateral tibial condyles (P-LTC) regions in patients with ACL injury had the highest mean ADC values: 0.87 (±0.22), 0.73 (±0.24), respectively in the acute and chronic phase; however, these values decreased over time.
Type of material: Doctoral Thesis
Publisher: University College Dublin. School of Medicine
Qualification Name: Ph.D.
Copyright (published version): 2022 the Author
Keywords: Anterior cruciate ligament injuryMagnetic resonance imagingDiffusion weightedBone bruising
Language: en
Status of Item: Peer reviewed
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Appears in Collections:Medicine Theses

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