Magnetic Resonance Imaging of Articular Cartilage

Abstract

The emergence of newer pharmacotherapeutic agents and surgical cartilage resurfacing techniques is driving the need for imaging modalities capable of early, accurate, and reproducible lesion detection. Magnetic resonance imaging (MRI) has emerged as a noninvasive tool for direct 2-dimensional (2D) and 3-dimensional (3D) assessment of the articular cartilage in both clinical and research settings. MRI has largely overcome the shortcomings of the current gold standard, radiography, by allowing for the detection of preclinical disease and subtle early abnormalities prior to the onset of radiographic disease, when damage is still reversible. Current MRI techniques are either morphological (2D/3D qualitative and quantitative techniques) or compositional (matrix-assessment techniques that detect macromolecular changes prior to morphological changes). MRI is evolving as a complete answer to our cartilage-imaging requirements of lesion description, treatment planning, and outcome measurement as well as in various research settings.

Trans-Posterior Cruciate Ligament All-Inside Root Repair Versus Partial Meniscectomy for Medial Meniscus Posterior Root Tears: Comparison of Semiquantitative and Quantitative MRI Outcomes in Cartilage Degeneration and Osteoarthritic Progression

“…Alterations in the ECM, such as destruction of the collagen network and proteoglycans, characterize the early stages of cartilage degeneration, so T2 mapping shows an increase in the T2 relaxation times of cartilage. 25 , 31 , 42 - 45 The medial femoral condyle (MFC) and MT were segmented manually into 5 and 3 subregions, respectively, according to the meniscus. Next, each subregion was assessed by further segmenting full-thickness cartilage into 2 approximately equal sections: a deep zone extending from the subchondral bone to the center of the tissue to encompass the bottom half of the tissue thickness, and a superficial zone extending from the center to the articular surface.…”

Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions Revision 2018

“…Clinicians should consider diagnostic classifications associated with serious pathological conditions or psychosocial factors when the patient's reported activity limitations or impair- • Isolated tenderness of patella (no bone tenderness of knee other than patella) • Tenderness of head of the fibula • Inability to flex knee to 90°• Inability to bear weight both immediately and in the emergency department for 4 steps regardless of limping Clinical examination by well-trained clinicians appears to be as accurate as MRI in regard to the diagnosis of meniscal lesions. 10,85,95 A lower threshold of suspicion of a meniscal tear is warranted in middle-aged and elderly patients. 59, 95 Magnetic resonance imaging may be reserved for more complicated or confusing cases 85 and may assist an orthopaedic surgeon in preoperative planning and prognosis.…”

Comparison of three dimensional gradient-echo sequences with conventional two dimensional sequences to assess the image quality of shoulder joint in magnetic resonance imaging

“…Several recent studies have investigated the effectiveness of 3D-GRE sequences in evaluating articular joints [22,23]. Commonly used clinical 3D-GRE-based methods, such as FLASH and DESS sequences, have been effective in assessing articular joints, but other 3D sequences like VIBE, TRUFISP, SPACE, and MEDIC have also demonstrated success [24][25][26]. TRUFISP imaging, in particular, has shown excellent synovial uid-cartilage contrast and utility in assessing various joint structures, including ligaments and cartilages [2,27].…”