Evaluation of the Chondromalacia Patella Using a Microscopy Coil: Comparison of the Two-Dimensional Fast Spin Echo Techniques and the Three-Dimensional Fast Field Echo Techniques

Abstract

ObjectiveWe wanted to compare the two-dimensional (2D) fast spin echo (FSE) techniques and the three-dimensional (3D) fast field echo techniques for the evaluation of the chondromalacia patella using a microscopy coil.Materials and MethodsTwenty five patients who underwent total knee arthroplasty were included in this study. Preoperative MRI evaluation of the patella was performed using a microscopy coil (47 mm). The proton density-weighted fast spin echo images (PD), the fat-suppressed PD images (FS-PD), the intermediate weighted-fat suppressed fast spin echo images (iw-FS-FSE), the 3D balanced-fast field echo images (B-FFE), the 3D water selective cartilage scan (WATS-c) and the 3D water selective fluid scan (WATS-f) were obtained on a 1.5T MRI scanner. The patellar cartilage was evaluated in nine areas: the superior, middle and the inferior portions that were subdivided into the medial, central and lateral facets in a total of 215 areas. Employing the Noyes grading system, the MRI grade 0-I, II and III lesions were compared using the gross and microscopic findings. The sensitivity, specificity and accuracy were evaluated for each sequence. The significance of the differences for the individual sequences was calculated using the McNemar test.ResultsThe gross and microscopic findings demonstrated 167 grade 0-I lesions, 40 grade II lesions and eight grade III lesions. Iw-FS-FSE had the highest accuracy (sensitivity/specificity/accuracy = 88%/98%/96%), followed by FS-PD (78%/98%/93%, respectively), PD (76%/98%/93%, respectively), B-FFE (71%/100%/93%, respectively), WATS-c (67%/100%/92%, respectively) and WATS-f (58%/99%/89%, respectively). There were statistically significant differences for the iw-FS-FSE and WATS-f and for the PD-FS and WATS-f (p < 0.01).ConclusionThe iw-FS-FSE images obtained with a microscopy coil show best diagnostic performance among the 2D and 3D GRE images for evaluating the chondromalacia patella.

Knee Derangements: Comparison of Isotropic 3D Fast Spin-Echo, Isotropic 3D Balanced Fast Field-Echo, and Conventional 2D Fast Spin-Echo MR Imaging

“…However, the capability of this technique in the assessment of adjacent structures, such as the menisci and ligaments, has not been well validated. In comparison, balanced steady-state free precession MR imaging yields good image quality and contrast properties required for musculoskeletal imaging, including excellent synovial fluid-cartilage contrast and hypointense bone marrow, with an acquisition time of approximately 3 minutes (6,28,29). The trade name of the balanced steadystate free precession sequence depends on the manufacturer of the MR imager; for instance, this sequence is known as balanced FFE imaging (bFFE; Philips Medical Systems), fast imaging employing steady-state acquisition (FIESTA; GE Healthcare), and true fast imaging with steady-state precession (True FISP; Siemens Healthcare, Erlangen, Germany).…”

Accuracy of Preoperative MRI with Microscopy Coil in Evaluation of Primary Tumor Thickness of Malignant Melanoma of the Skin with Histopathologic Correlation

“…However, the introduction of microscopy surface coils has enabled its use in the evaluation of more superficial structures with better image quality and high resolution (1). Numerous studies have shown the usefulness of high-resolution MRI with microscopy coils (HR-MRI) in the evaluation of patellar cartilage, soft tissue tumors of the hand and foot, and ocular lesions including ocular melanomas (2-4). To meet the growing interest in the noninvasive imaging and characterization of benign and malignant dermatologic disorders, there have been efforts to further increase the signal-to-noise ratio (SNR) of MR images.…”

Intermediate Weighted Fast Spin Echo (IW FSE) MR Imaging of Hyaline Cartilage Defects of the Knee: Comparison with the Fat Suppressed Three Dimensional Gradient Echo (3D SPGR) Imaging and Arthroscopy

“…The incidences of cartilage lesions of different grades in our study were slightly lower than that of previous studies; however, these differences may be partly because of the relatively smaller sample size as patients with non traumatic knee pain and those with degenerative osteoarthritis were precluded from our research. As the T2 value of cartilage reflects its collagen content, tissue anisotropy and its water content 13,14 Iw-FSE imaging can detect early chondromalacia according to the T2 contrast 13,15 . The magnetization transfer effect is also one of the factors for cartilage contrast on the FSE imaging 13,16 .…”