Journal Article

Real-time three-dimensional MRI for the assessment of dynamic carpal instability

Bateni, Cyrus, Borgese, Marissa, Boonsri, Pattira, Szabo, Robert M., Chaudhari, Abhijit J., Foster, Brent H., Shaw, Calvin B., Boutin, Robert D., Nayak, Krishna S., Bayne, Christopher O.

2019

Overview

Carpal instability is defined as a condition where wrist motion and/or loading creates mechanical dysfunction, resulting in weakness, pain and decreased function. When conventional methods do not identify the instability patterns, yet clinical signs of instability exist, the diagnosis of dynamic instability is often suggested to describe carpal derangement manifested only during the wrist's active motion or stress. We addressed the question: can advanced MRI techniques provide quantitative means to evaluate dynamic carpal instability and supplement standard static MRI acquisition? Our objectives were to (i) develop a real-time, three-dimensional MRI method to image the carpal joints during their active, uninterrupted motion; and (ii) demonstrate feasibility of the method for assessing metrics relevant to dynamic carpal instability, thus overcoming limitations of standard MRI. Twenty wrists (bilateral wrists of ten healthy participants) were scanned during radial-ulnar deviation and clenched-fist maneuvers. Images resulting from two real-time MRI pulse sequences, four sparse data-acquisition schemes, and three constrained image reconstruction techniques were compared. Image quality was assessed via blinded scoring by three radiologists and quantitative imaging metrics. Real-time MRI data-acquisition employing sparse radial sampling with a gradient-recalled-echo acquisition and constrained iterative reconstruction appeared to provide a practical tradeoff between imaging speed (temporal resolution up to 135 ms per slice) and image quality. The method effectively reduced streaking artifacts arising from data undersampling and enabled the derivation of quantitative measures pertinent to evaluating dynamic carpal instability. This study demonstrates that real-time, three-dimensional MRI of the moving wrist is feasible and may be useful for the evaluation of dynamic carpal instability.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adult / Arthritis / Biology and Life Sciences / Bones / Care and treatment / Carpal bones / Carpal Bones - diagnostic imaging / Carpal Bones - physiology / Carpal Joints - diagnostic imaging / Carpal Joints - physiology / Dynamic instability / Dynamic stability / Feasibility / Hand surgery / Health aspects / Humans / Identification methods / Image acquisition / Image Interpretation, Computer-Assisted - methods / Image processing / Image quality / Image reconstruction / Injuries / Instability / Joint Instability - physiopathology / Kinematics / Ligaments / Magnetic resonance imaging / Magnetic Resonance Imaging - methods / Male / Maneuvers / Medical imaging / Medicine and Health Sciences / Methods / Motion / Motion stability / NMR / Nuclear magnetic resonance / Pain / People and Places / Quality assessment / Real time / Reproducibility of Results / Research and Analysis Methods / Scanners / Stability analysis / Surgery / Temporal resolution / Wrist