3-Tesla-MRT vs. Arthroskopie bei der Diagnostik degenerativer Knorpelschäden des Kniegelenkes

Abstract

Regarding the high specificities and negative predictive values, 3-Tesla MRI is a reliable method for excluding even slight cartilage degeneration. In summary, in degenerative cartilage diseases, 3-Tesla MRI is a supportive, noninvasive method for clinical decision making regarding conservative or operative treatment possibilities. However, the value of diagnostic arthroscopy for a definitive assessment of the articular surfaces and for therapeutic planning currently cannot be replaced by 3-Tesla MRI. This applies especially to treatment options in which a differentiation between grade II and III cartilage lesions is of interest.

Accuracy of magnetic resonance imaging, magnetic resonance arthrography and computed tomography for the detection of chondral lesions of the knee

“…The 27 studies reported the diagnostic test accuracy of 2,592 knees in 2,509 patients. Mean age of the cohort was 37.7 years, ranging from 19 years [28] to 57 years [49]. The duration between radiological assessment and surgical comparison was reported in 14 studies.…”

“…The grading for chondral lesions was described as having been performed using two difference systems. Sixteen studies assessed chondral lesions using a 0–4 grading system as suggested by Shahriaree [43], where 0 equated homogenous intermediate signal intensity and cartilage normal; 1 focal thickening of cartilage with smooth surface or cartilage loss/softening of cartilage; 2 equating to focal bulging, fissuring, blister lesions or shallow ulceration with mild surface irregularities; grade 3 equates to surface irregularities with deep ulceration or fibrillation not extending to subchondral bone; and grade 4 equating to cartilage defect with exposure of subchondral bone [3, 4, 9, 10, 14, 15, 17, 21, 25, 28, 35, 42, 44, 48, 49, 52]. Nine studies assessed grade of lesion using a 0–3 point scale as recommended by Noyes and Stabler [31], where grade 0 was normal cartilage; grade 1 was assigned to cartilage with minor surface irregularities with early fissuring but no loss of thickness; grade 2 signified cartilage thinning with deep fissures but no full‐thickness loss; and grade 3 equated to cartilage with at least one area of full‐thickness loss [1, 16, 19, 22, 29, 37, 38, 45, 46].…”

The Clinical Utility and Diagnostic Performance of MRI for Identification and Classification of Knee Osteochondritis Dissecans

“…Four studies used a 1.5-T magnet or higher 13,[15][16][17] ; one study, a 1.0-T magnet 12 ; one study, a 0.5-T magnet 14 ; and one study, a 0. . Although they were not explicitly studied for osteochondritis dissecans, higher magnet strength and enhanced sequence techniques appear to improve MRI sensitivity for articular cartilage lesions [28][29][30][31][32] .…”

Diagnostic Performance of Multi-Detector Computed Tomography Arthrography and 3-Tesla Magnetic Resonance Imaging to Diagnose Experimentally Created Articular Cartilage Lesions in Equine Cadaver Stifles

“…The sensitivity of MRI ranges from 15-96% with a specificity above 90%, both being dependent on the scanning protocol and the magnet strength used. [23,24].…”