3.0-Tesla MRI and Arthroscopy for Assessment of Knee Articular Cartilage Lesions

Abstract

The purpose of this study was to evaluate the ability of 3.0-Tesla magnetic resonance imaging (MRI) to accurately assess knee articular cartilage lesions. Sixteen patients who had knee 3.0-T MRI and underwent knee arthroscopy for partial meniscectomy were included. Three fellowship-trained sports medicine orthopedic surgeons reviewed all images. Articular lesions on MRI were graded from I to IV and compared with arthroscopic grading using the Outerbridge and the International Cartilage Repair Society (ICRS) classifications. The articular surface was divided into 6 regions. Based on MRI findings, of the 288 articular surface evaluations, 113 (39%) surface evaluations were classified as disease-positive (grade 2 to 4). Kappa interrater reliability scores for MRI evaluation, Outerbridge classification, and ICRS classification were 0.13, 0.54, and 0.41, respectively. Using the Outerbridge classification as a reference standard, the sensitivity, specificity, and accuracy were 57%, 71%, and 63%, respectively. Using the ICRS classification, sensitivity, specificity, and accuracy were 59%, 71%, and 69%, respectively. When isolating the articular grading to the senior author on MRI evaluation vs Outerbridge classification, the sensitivity, specificity, and accuracy were 54%, 92%, and 75%, respectively. Based on the current findings, 3.0-T MRI is as an invaluable noninvasive tool with good diagnostic value for assessing articular cartilage lesions of the knee, although it may not be as sensitive and accurate as previously reported.

Combined 5‐minute double‐echo in steady‐state with separated echoes and 2‐minute proton‐density‐weighted 2D FSE sequence for comprehensive whole‐joint knee MRI assessment

“…The arthroscopic correlations in the small subset of patients showed relatively comparable accuracy with previous studies, albeit with slightly lower sensitivities . This was promising, because the goal of this study was not to compare the DESS and DESS+PDFS findings with arthroscopy.…”

“…Consequently, the readers were not provided with patient history, reason for referral, and previous imaging and surgical findings. The specificities of diagnosing injuries of the meniscus, ligaments, and tendons were high, whereas the sensitivities of diagnosing such lesions were lower (especially in cartilage), which has been chronicled in previous studies . Of the two ACL tears observed in the nine patients, one was correctly identified by all readers, while a subtle tear was missed by all readers, leading to the lower 50% sensitivity.…”

“…The arthroscopic correlations in the small subset of patients showed relatively comparable accuracy with previous studies, albeit with slightly lower sensitivities. 37,38 This was promising, because the goal of this study was not to compare the DESS and DESS+PDFS findings with arthroscopy. Consequently, the readers were not provided with patient history, reason for referral, and previous imaging and surgical findings.…”

Tibial ACL insertion site length: correlation between preoperative MRI and intra-operative measurements

“…Regarding the agreement of MRI reading, the inter-rater reliability between the two MRI measurements, which was performed by two blinded physicians, showed a high ICC of 0.812 (95 % CI 0.747; 0.862; p < 0.0005). Compared with other studies using the MRI for detecting pathology in the knee joint, such as evaluation of cartilage lesions [32] or predicting the reparability of meniscus tears [6], the inter-rater reliability was reported from 0.13 to 0.434, respectively. Camp et al [8] showed inter-rater reliability values of 0.843 for determining the tibial tubercle-trochlear groove (TT-TG) distance by MRI, which is comparable to our results.…”

Three-Dimensional Isotropic Fat-Suppressed Proton Density-Weighted MRI at 3 Tesla Using a T/R-Coil Can Replace Multiple Plane Two-Dimensional Sequences in Knee Imaging

“…Kernaussagen: was 2 pixels (220 Hz/pixel) for 2D-PDwFS and 1.3 pixels (340 Hz/ pixel) for 3D-PDwFS. [14].…”