MR imaging of knee hyaline cartilage: Evaluation of two‐ and three‐dimensional sequences

Abstract

Magnetic resonance (MR) imaging of cadaveric knees was performed to determine optimal sequences for visualization of hyaline cartilage. Full-thickness cartilage lesions ranging in diameter from 1 to 5 mm and a partial-thickness cartilage lesion 15 mm in diameter were created in the femoral articular surfaces of three cadaveric knees. The knees were then imaged with a 1.5-T imager with various two-dimensional and high-resolution three-dimensional (3D) techniques. After imaging, the knee specimens were sectioned for evaluation. Measurements of cartilage thickness in fast spin-echo images correlated best with those in the gross specimen. Diffuse areas of cartilage thinning were also most accurately identified with fast spin-echo images. Small, focal cartilage defects were best delineated in 3D SPGR (spoiled GRASS [gradient-recalled acquisition in the steady state]) images.

Saline versus gadolinium-enhanced magnetic resonance arthrography of porcine cartilage

“…Disler et al [4] optimized the contrast-to-noise ratio of knee cartilage to saline for a fat-saturated 3D SPGR sequence and found similar sequence parameters (60/5, 40 ° flip angle) to be best. Tervonen et al [6] also found 3D SPGR (30/9, 30 ° flip angle) to be superior to 3D GRASS and steady stat e free precession (SSFP) techniques in the detection of cartilage lesions created in human cadaver knees. Van der Linden [10] deemed a SPGR sequence (65/11.5; 30o-45 ° flip angle) preferable to other spoiled and steady-state GRE sequences at 0.5 T in the depiction of lesions created in pig cartilage.…”

“…We used a dark fluid sequence for 3D saline imaging, whereas a bright fluid sequence was used for 3D gadolinium-enhanced imaging. Our choice of MR pulse sequences was based on prevailing recommendations in the literature [4][5][6] and on our o w n clinical experience.…”

“…Chandnani et al [7] deemed fatsaturated Tl-weighted SE images better than protondensity-weighted, T2-weighted, or non-fat-saturated Tl-weighted SE images for the visualization of cartilage in cadaver knees after intraarticular saline injection. Tervonen et al [6], however, also evaluated cartilage lesions created in cadaver knees after intraarticular saline injection and found fast SE images to be far superior to conventional SE images, with or without spectral fat saturation. Fast SE sequences are time-efficient, and incidental magnetization transfer contrast in fast SE imaging of cartilage confers a potential advantage over GRE and conventional SE techniques [8,9].…”

Measurement of cartilage thickness in the human knee-joint by magnetic resonance imaging using a three-dimensional gradient-echo sequence

“…Calcified cartilage makes up to 10% of the total cartilage thickness [1,16]. With this in mind, the limiting factor is not the calcified tissue, which is difficult to delineate by MRI in commonly used sequences [21], but the resolution in plane.…”

“…So far there has been no clear consensus on which technique is best for cartilage imaging. Three-dimensional sequences [21] with thin slices [15] provide better results in the assessment of hyaline cartilage thickness and hyaline cartilage volume. Fat-suppressed sequences may improve the discrimination of cartilage [20,21].…”