FUNCTIONAL MAGNETIC RESONANCE IMAGING IN ASSESSING THE BIOMECHANICS OF THE ANTERIOR CRUCIATE LIGAMENT OF THE KNEE JOINT:

METHODOLOGY AND STUDY PROTOCOL

 

Filisteev P.A.¹, Ternovoy S.K. ^2,3, Serova N.S. ², Semenov A.I ¹, Zarov A.Y.¹

 

1 - St. Alexius Hospital.

2 - Sechenov University

3 - National Cardiology Research Center. Moscow, Russia.

P

urpose. To develop a scanning protocol and evaluate the capabilities of functional magnetic resonance imaging (fMRI) of the knee in assessing the anatomy and biomechanics of the anterior cruciate ligament (ACL).

Materials and methods. A total of 32 volunteers from 21 to 81 years old without active complaints and signs of ACL rupture according to clinical examination were examined. A multicenter study of knee joints was carried out using standard magnetic resonance imaging (MRI) and functional MRI with assessment of anatomy and ACL function during joint movement in real time. The research methodology and protocol were developed using MRI scanners from different manufacturers with magnetic field strengths of 1.5 and 3 Tesla and different gantry aperture widths.

Results. A technique and protocol for fMRI of the knee joint in the prone position were developed based on a sequence of ultrafast short single-pulse spin echo with half Fourier transform (SS-FSE/SS-TSE/HASTE) on tomographs from different manufacturers with magnetic field strengths of 1.5 and 3 Tesla. On fMRI, the anterior cruciate ligament was visualized in all volunteers (n=32, 100%) who took part in the study, and patterns of its normal visualization in motion were assessed. On real-time MRI the dynamic range of flexion-extension of the knee joint was about 45-55° on an MRI scanner with a gantry aperture of 60 cm (n=15), and 50-65° (n=17) on an MRI scanner with a gantry aperture 70 cm.

Discussion. MRI has high soft tissue contrast for diagnosing the internal structures of the knee joint. Current imaging modalities such as fluoroscopy, ultrasound (US), or multislice computed tomography (MSCT) provide real-time imaging of the knee to assess bone motion, but are ineffective in assessing the cruciate ligaments. fMRI using the developed technique visualizes the anatomy and function of the anterior cruciate ligament in motion, opening up new opportunities for diagnosing its pathology.

Conclusion. Functional magnetic resonance imaging can be used to visualize normal and pathological biomechanics of the knee joint and diagnose complex injuries of the anterior cruciate ligament. In 50% of cases (n=16), fMRI was able to better assess the structure of the ACL and separately characterize the state of the anteromedial and posterolateral bundles than standard MRI. fMRI of the knee joint can be performed on any MRI scanner with a magnetic field strength of 1.5-3 Tesla and a gantry aperture of 60 or 70 cm, and takes about 3-5 minutes.

 

Keywords: fMRI, knee instability, ACL, ACL rupture, ACL biomechanics, knee joint, anterior cruciate ligament.

 

Corresponding author: Filisteev P.A., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Filisteev P.A., Ternovoy S.K., Serova N.S. , Semenov A.I., Zarov A.Y. Functional magnetic resonance imaging in assessing the biomechanics of the anterior cruciate ligament of the knee joint:

methodology and study protocol. REJR 2024; 14(4):167-178. DOI: 10.21569/2222-7415-2024-14-4-167-178.

Received:        05.10.24 Accepted:       20.11.24