3-T T2 mapping magnetic resonance imaging for biochemical assessment of normal and damaged glenoid cartilage: a prospective arthroscopy-controlled study

Abstract

This study evaluated the ability of T2 mapping to assess the glenoid cartilage using arthroscopy as the gold standard. Eighteen consecutive patients (mean age: 52.4 ± 14.72 years, including 12 men) with shoulder pain underwent T2 mapping at 3-T with subsequent shoulder arthroscopy. With correlation to cartilage-sensitive morphologic sequences regions-of-interest were placed in the corresponding T2 maps both in normal-appearing cartilage and focal cartilage lesions using a quadrant-wise approach. Inter-reader and intra-reader correlation coefficients (ICCs) between two independent radiologists as well as cutoff values with their sensitivities/specificities for the detection of cartilage damage were calculated. The mean T2 value for healthy cartilage was 23.0 ± 3 ms with significantly higher values in the superior quadrants compared to the inferior quadrants (p < 0.0001). In 5 patients with focal cartilage damage significantly higher T2 values of 44.7 ± 3.7 ms (P < 0.01) were observed. The maximum T2 value in normal cartilage (27.3 ms) was lower than the minimum value in damaged cartilage (40.8 ms) resulting in perfect sensitivities/specificities of 100% (95% confidence-interval 47.8-100.0) for all cutoff values between 27.3-40.8 ms. ICCs ranged between 0.63 and 0.99. In conclusion, T2 mapping can evaluate biochemical cartilage integrity and discriminates arthroscopyproven healthy and damaged glenoid cartilage with high diagnostic performance. Osteoarthritis (OA) is a degenerative condition affecting the articulating facet joints. It is the most commonly encountered orthopaedic disorder and a leading cause of morbidity in elderly patients 1-3. Although OA predominantly affects the weight-bearing joints, glenoid OA is a well-known cause of shoulder disability with an increasing incidence and prevalence and ultimately leads to endoprosthetic joint replacement 4, 5. Cartilage defects are an important risk factor for development of OA 6, 7. Therefore, timely diagnosis of early and potentially reversible disruption of the chondral architecture is desirable to delay the onset and progression of OA. Magnetic resonance imaging (MRI) is the non-invasive gold standard for morphological evaluation of the articular cartilage 8. However, early degenerative changes in the cartilage, such as loss of glycosaminoglycans

Quantitative analysis of triangular fibrocartilage complex injury by 3.0T MR 3D VIBE and T2 mapping techniques

“…Felix et al and Mittal et al got the same conclusion and showed that the T2 value of fibrocartilage injury was higher than that of normal fibrocartilage. [ 12 , 13 ] The increase of T2 value is related to the decrease of collagen fibers and proteoglycans and the increase of water content. Both human and animal experiments showed that the T2 value of fibrocartilage had a direct correlation with proteoglycans and water content.…”

Quantitative T2 mapping of the glenohumeral joint cartilage in asymptomatic shoulders and shoulders with increasing severity of rotator cuff pathology

“…Lee et al [ 14 ] compared the median T2 values of patients with glenohumeral osteoarthritis to patients with normal macroscopic cartilage and demonstrated significantly higher total (glenoid and humeral head combined) T2 values for patients with osteoarthritis (median 37.52 ms; range 36.84–39.11 ms) compared to patients without (median 36.00 ms; range 33.89–37.31 ms). Wuennemann et al [ 21 ] examined the ability of T2 mapping MRI to detect focal changes in glenohumeral cartilage, with validation performed by arthroscopy in 18 patients (5 with cartilage lesions). They found that T2 mapping mean values were significantly higher in the locations of the Outerbridge grades 1–3 lesions (44.7 ± 3.7 ms) than in regions of cartilage that appeared healthy on arthroscopic examination (23.0 ± 3 ms).…”

“…Lastly, due to the thick-slice images and lack of precise shoulder landmarks visible on the T2 mapping images evaluation of additional, smaller subregions of the humeral head and glenoid cartilage was not performed as part of this work. Smaller subregions have been used previously in the study of focal glenoid cartilage defects and would be beneficial for detecting more localized changes [ 21 ]. Use of high-resolution sequences along with the T2 mapping sequence could address this challenge in future studies.…”

“…Although T2 mapping has been studied extensively in knee cartilage [ 16 , [18] , [19] , [20] ], few studies exist on T2 mapping of the glenohumeral cartilage [ 12 , 14 , 15 , 21 ]. Recently, Lee et al [ 13 ] have published a study on the T2 values of the glenohumeral cartilage in patients with rotator cuff disease.…”

The Cartilage Wear Index: a new evaluation method to improve patient selection in surgical treatment of recurrent posterior glenohumeral instability

“…Based on anatomical studies, we assumed that normality is a CWI 1, indicating that thickness of anterior and posterior glenoid cartilage in healthy individuals is equal. 37 …”