Update on MRI Pulse Sequences for the Knee: Imaging of Cartilage, Meniscus, Tendon, and Hardware

Ariyachaipanich, Aticha; Bae, Won C.; Statum, Sheronda; Chung, Christine B.

doi:10.1055/s-0037-1599209

Cited by 6 publications

(6 citation statements)

References 131 publications

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“…The modality is unparalleled in the evaluation of non-osseous knee structure derangement, being well suited for high-resolution assessment of the musculoskeletal (MSK) system, including muscle, tendon, ligament and occult bone injuries. 9,10,11 Arthroscopy is considered the gold standard in terms of definitive diagnosis of internal derangements of the knee. It is both sensitive and specific, furthermore being both diagnostic and therapeutic.…”

Section: Introductionmentioning

confidence: 99%

The accuracy of magnetic resonance imaging diagnosis of non-osseous knee injury at Steve Biko Academic Hospital

2019

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BackgroundPreoperative magnetic resonance imaging (MRI) has internationally been proven to reduce unnecessary knee arthroscopies and assist with surgical planning. This has the advantage of avoiding unnecessary surgery and the associated anaesthetic risk, as well as reducing costs. No data were found in the recently published literature assessing the accuracy of MRI interpretation of knee ligament injury in the public sector locally.ObjectivesThis pilot study aimed to determine the accuracy of MRI in detecting non-osseous knee injury in a resource-limited tertiary-level academic hospital in Pretoria, South Africa, compared to the gold standard arthroscopy findings.MethodThis was an exploratory retrospective analysis of 39 patients who had MRI and arthroscopy at Steve Biko Academic Hospital (SBAH). True positive, true negative, false positive and false negative results were extrapolated from findings in both modalities and translated into sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for each structure.ResultsNegative predictive values were recorded as 97%, 81%, 90% and 100% (anterior cruciate ligament [ACL], medial meniscus [MM], lateral meniscus [LM] and posterior cruciate ligament [PCL], respectively), which were comparative to recently published international literature. The PPV results were lower than those previously evaluated at 55%, 58%, 55% and not applicable. The sensitivities and specificities of the ligaments were 83%, 58%, 83% and not applicable; and 87%, 81%, 70% and not applicable, respectively.ConclusionMagnetic resonance imaging was found to be sensitive and specific, with a high NPV noted in all structures evaluated. Negative results can therefore be used to avoid unnecessary surgery to the benefit of the patient and state. The study reiterates that high accuracy can be obtained from MRI on a 1.5-tesla non-dedicated scanner, with interpretation by generalist radiologists.

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Section: Introductionmentioning

confidence: 99%

The accuracy of magnetic resonance imaging diagnosis of non-osseous knee injury at Steve Biko Academic Hospital

2019

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“…Contrast is often useful in the setting of infection and mass lesions; MR angiographic sequences provide detailed analysis of vascular structures. [2][3][4]…”

Section: Magnetic Resonance Imaging Techniques Standardmentioning

confidence: 99%

“…Although diffusion techniques are commonly applied clinically in neuroimaging settings, diffusion imaging of articular cartilage is technically challenging, requiring high field strengths and long scan times to generate technically adequate images. 3,13,15 Short TE Sequences UTE imaging is a technique that may be used to assess the signal characteristics of highly ordered tissues with limited mobile water, which generally generate limited signal on conventional pulse sequences due to their extremely short T2 relaxation times. These tissues include structures such as normal ligaments, tendons, and menisci.…”

Section: Parametric Mapping Of Articular Cartilagementioning

confidence: 99%

“…Modifications in pulse acquisition parameters may be used to compensate for hardware shortcomings to a certain extent, although the technique still requires a system possessing high-performance gradients. 3,16,17 Normal cortical bone, much like ligaments and tendons, typically appears as signal void on routine clinical imaging sequences, due to an extremely short relaxation time. ZTE imaging allows capture of the minimal signal available from bone, and via postprocessing, it results in images displaying contrast like CT.…”

Section: Parametric Mapping Of Articular Cartilagementioning

confidence: 99%

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Advanced Magnetic Resonance Imaging in Osteoarthritis

Burge

Jawetz

2020

Semin Musculoskelet Radiol

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Osteoarthritis (OA) is one of the most common causes of disability throughout the world. Current therapeutic strategies are aimed at preventing the development and delaying the progression of OA, as well as repairing or replacing worn articular surfaces, because the regeneration of lost hyaline articular cartilage is not currently a clinically feasible option. Imaging is useful in formulating treatment strategies in patients at risk for OA, allowing assessment of risk factors, the degree of preexisting tissue damage, and posttreatment monitoring. Magnetic resonance imaging (MRI), in particular, provides in-depth evaluation of these patients, with optimal clinical sequencing allowing sensitive assessment of chondral signal and morphology, and the addition of advanced MRI techniques facilitating comprehensive evaluation of joint health, with increased sensitivity for changes in articular cartilage and surrounding joint tissues.

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“…Dedicated sequences have been designed to help reduce metal artifact, such as WARP, SEMAC, and MAVRIC, and these can be used in addition to the more conventionally used (fast) spin-echo sequences and simple modification of existing sequences. 19,20 The vendor-specific sequences just cited use a combination of factors to reduce the susceptibility effect of the metal, such as increased radiofrequency bandwidth, increased frequency encoding gradient, increased image matrix, increased echo train length, decreased echo spacing, and thinner slices. 21 Newer sequences use a combination of these different factors, with metal artifact reduction a key research area for MR physicists.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Imaging of the Knee and Surrounding Structures Following Tumor Surgery

Winn

Lalam

2018

Semin Musculoskelet Radiol

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Limb salvage is a key goal of tumor management around the knee, with surgical, medical, and radiologic treatment options. Primary bone and soft tissue sarcomas are optimally treated in specialist tertiary centers; however, metastatic disease is encountered in all aspects of radiologic practice, with overlap in the management strategies. Both specialist and generalist radiologists therefore need to be familiar with the expected normal appearances following these therapies and be able to recognize potential complications. This review article describes the techniques available for imaging the knee following treatment of bone and soft tissue tumors, with particular reference to artifact reduction. The therapeutic options for managing bone and soft tissue lesion are discussed, with emphasis on imaging appearances. Surgical, medical, and radiologic treatments are described. Complications and their imaging appearances are reviewed including local recurrence of tumor, infection, complications related to metallic implants, postradiation changes, and amputation. Normal imaging appearances and complications following radiologic treatment (namely radiofrequency ablation) of bone and soft tissue tumors are presented.

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Update on MRI Pulse Sequences for the Knee: Imaging of Cartilage, Meniscus, Tendon, and Hardware

Cited by 6 publications

References 131 publications

The accuracy of magnetic resonance imaging diagnosis of non-osseous knee injury at Steve Biko Academic Hospital

The accuracy of magnetic resonance imaging diagnosis of non-osseous knee injury at Steve Biko Academic Hospital

Advanced Magnetic Resonance Imaging in Osteoarthritis

Imaging of the Knee and Surrounding Structures Following Tumor Surgery

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