Abnormalities of articular cartilage in the knee: analysis of available MR techniques.

Abstract

In an attempt to improve the detection of chondral abnormalities with magnetic resonance imaging, a fat-suppressed three-dimensional gradient-recalled acquisition in the steady state (GRASS) and spoiled GRASS (SPGR) sequence was optimized by study of five cadaveric knee specimens. Results with this optimized sequence then were compared with results with three spin-echo (T1-, proton-density-, and T2-weighted) and two three-dimensional gradient-recalled echo sequences (GRASS and non-fat-suppressed SPGR) in the assessment of naturally occurring abnormalities of the patellofemoral compartment in 10 cadaveric knees. Results with the optimized fat-suppressed SPGR sequence were significantly better (P < .02) than results with the other five sequences and had a sensitivity of 96%, a specificity of 95%, and an accuracy of 95%. In addition, normal cartilage consistently appeared as a trilaminar structure with the fat-suppressed SPGR sequence, a feature that appeared to help in identification of chondral lesions.

Is MRI Adequate to Detect Lesions in Patients with Ankle Instability?

“…Because MRI detects subchondral changes, more superficial lesions are less likely to be imaged [25]. Other MRI factors that may affect accuracy include the type of sequence [5,16,17,27], power of the magnet [11,12,26], and positioning [21]. The articular cartilage in the ankle is thinner than in the knee [23], there is close tibiotalar apposition, and the bony anatomy is more complex, all of which could complicate accurate observation of chondral lesions by MRI in the ankle as compared with the knee.…”

Quantitative MRI of cartilage and bone: degenerative changes in osteoarthritis

“…MR sequences used for semiquantitative scoring of cartilage lesions involve T 1 -weighted spoiled gradient recalled acquisition at steady state (SPGR ¼ spoiled gradient echo or FLASH ¼ fast low-angle shot) with fat suppression (38,(40)(41)(42)(43)(44)(45)(46)(47) the internal structure of the cartilage displays a more heterogeneous signal and 'internal' pathological changes may be more readily displayed. Also, cartilage surface lesions are well depicted with these sequences, because of the steep gradient of signal intensity between the cartilage and the synovial fluid, in particular when effusion is present [ Fig.…”

“…Satisfactory specificity and sensitivity for detecting chondral lesions has been demonstrated in cadaveric knees and in vivo with arthroscopic verification (40)(41)(42)(48)(49)(50)53). Bredella et al (51) reported a sensitivity of 93% and a specificity of 99% in detecting chondral lesions versus athroscopy when axial and coronal images were combined, and values of 94/99% when images in all three planes were combined.…”

“…MR sequences used for semiquantitative scoring of cartilage lesions involve T 1 -weighted spoiled gradient recalled acquisition at steady state (SPGR ¼ spoiled gradient echo or FLASH ¼ fast low-angle shot) with fat suppression (38,(40)(41)(42)(43)(44)(45)(46)(47) or selective water excitation (we) (48) [Figs 1, 2 and 3(a)], fat-suppressed T 2 -or intermediate (IM) weighted fast spin-echo (FSE) (38,43,(49)(50)(51)(52) [ Fig. 3(b) and (c)] and fat-suppressed driven equilibrium Fourier transform (DEFT) imaging (53).…”

Correlation of knee‐joint cartilage morphology with muscle cross‐sectional areas vs. anthropometric variables

“…The development of magnetic resonance imaging (MRI) has made it possible to delineate articular cartilage in vivo (Recht et al, 1993;Peterfy et al, 1994;Eckstein et al, 1996). In conjunction with state-of-the-art three-dimensional (3D) postprocessing tools (qMRI) the technique has been shown to produce accurate and precise data on the cartilage morphology (volume, thickness, and surface area) of the knee in healthy individuals (Stammberger et al, 1999a;Hohe et al, 2002), and in patients with femorotibial osteoarthritis (OA) (Burgkart et al, 2001).…”