Abnormalities of articular cartilage in the knee: analysis of available MR techniques.

Recht, Michael P.; Kramer, Jan; Marcelis, Stefaan; Pathria, Mini N.; Trudell, Debra; Haghighi, Parviz; Sartoris, D J; Resnick, Donald

doi:10.1148/radiology.187.2.8475293

Cited by 334 publications

(182 citation statements)

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“…Because MRI detects subchondral changes, more superficial lesions are less likely to be imaged [25]. Other MRI factors that may affect accuracy include the type of sequence [5,16,17,27], power of the magnet [11,12,26], and positioning [21]. The articular cartilage in the ankle is thinner than in the knee [23], there is close tibiotalar apposition, and the bony anatomy is more complex, all of which could complicate accurate observation of chondral lesions by MRI in the ankle as compared with the knee.…”

Section: Discussionmentioning

confidence: 99%

Is MRI Adequate to Detect Lesions in Patients with Ankle Instability?

O’Neill

Aman

Guyton

2010

Clinical Orthopaedics &Amp; Related Research

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Background Chondral lesions, peroneal tendon tears, and other disorders in patients with chronic ankle instability may not be detected by preoperative MRI. Also, MRI often is obtained and interpreted at the referring institution, leading to variability in reading. Questions/PurposesWe assessed the accuracy of the radiologists' and orthopaedic surgeon's reading of preoperative MRI for diagnosing ankle lesions in patients with ankle instability warranting surgery. Patients and Methods We retrospectively reviewed 133 patients who underwent 135 surgeries for lateral ankle ligament reconstruction with concomitant ankle arthroscopy and who had preoperative MRI. Results We found 72 associated lesions in 66 of the 135 surgeries, including 38 chondral injuries, 18 peroneus brevis tears, seven loose bodies, and nine other miscellaneous abnormalities. Eliminating eight lesions for which the decision to operate was not based on operative findings, there were 127 surgeries with 64 associated lesions that required intraoperative confirmation or were detected intraoperatively. In the original reports, the radiologists identified 39% (15) of the chondral injuries, 56% (10) of the peroneal tears, and 57% (four) of the loose bodies. Radiologists' MRI sensitivity for detecting lesions was 45%. The attending surgeon identified 47% (18) of the chondral injuries, 89% (16) of the loose bodies, 71% (five) of the peroneus brevis tears, and the posterior talus process lesion, with a sensitivity of 63%. ConclusionsOur data suggest orthopaedic surgeons should review preoperative MRIs and also suggest the sensitivity of MRI may not be adequate to detect lesions in these patients before surgery.

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Section: Discussionmentioning

confidence: 99%

Is MRI Adequate to Detect Lesions in Patients with Ankle Instability?

O’Neill

Aman

Guyton

2010

Clinical Orthopaedics &Amp; Related Research

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“…MR sequences used for semiquantitative scoring of cartilage lesions involve T 1 -weighted spoiled gradient recalled acquisition at steady state (SPGR ¼ spoiled gradient echo or FLASH ¼ fast low-angle shot) with fat suppression (38,(40)(41)(42)(43)(44)(45)(46)(47) the internal structure of the cartilage displays a more heterogeneous signal and 'internal' pathological changes may be more readily displayed. Also, cartilage surface lesions are well depicted with these sequences, because of the steep gradient of signal intensity between the cartilage and the synovial fluid, in particular when effusion is present [ Fig.…”

Section: Semiquantitative Scoring Of Articular Tissues In Oa Hardwarementioning

confidence: 99%

“…Satisfactory specificity and sensitivity for detecting chondral lesions has been demonstrated in cadaveric knees and in vivo with arthroscopic verification (40)(41)(42)(48)(49)(50)53). Bredella et al (51) reported a sensitivity of 93% and a specificity of 99% in detecting chondral lesions versus athroscopy when axial and coronal images were combined, and values of 94/99% when images in all three planes were combined.…”

Section: Technical Accuracy and Precision Of Measurementsmentioning

confidence: 99%

“…MR sequences used for semiquantitative scoring of cartilage lesions involve T 1 -weighted spoiled gradient recalled acquisition at steady state (SPGR ¼ spoiled gradient echo or FLASH ¼ fast low-angle shot) with fat suppression (38,(40)(41)(42)(43)(44)(45)(46)(47) or selective water excitation (we) (48) [Figs 1, 2 and 3(a)], fat-suppressed T 2 -or intermediate (IM) weighted fast spin-echo (FSE) (38,43,(49)(50)(51)(52) [ Fig. 3(b) and (c)] and fat-suppressed driven equilibrium Fourier transform (DEFT) imaging (53).…”

Section: Semiquantitative Scoring Of Articular Tissues In Oa Hardwarementioning

confidence: 99%

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Quantitative MRI of cartilage and bone: degenerative changes in osteoarthritis

2006

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Magnetic resonance imaging (MRI) and quantitative image analysis technology has recently started to generate a great wealth of quantitative information on articular cartilage and bone physiology, pathophysiology and degenerative changes in osteoarthritis. This paper reviews semiquantitative scoring of changes of articular tissues (e.g. WORMS ¼ whole-organ MRI scoring or KOSS ¼ knee osteoarthritis scoring system), quantification of cartilage morphology (e.g. volume and thickness), quantitative measurements of cartilage composition (e.g. T 2 , T 1rho , T 1Gd ¼ dGEMRIC index) and quantitative measurement of bone structure (e.g. app. BV/TV, app. TbTh, app. Tb.N, app. Tb.Sp) in osteoarthritis. For each of these fields we describe the hardware and MRI sequences available, the image analysis systems and techniques used to derive semiquantitative and quantitative parameters, the technical accuracy and precision of the measurements reported to date and current results from cross-sectional and longitudinal studies in osteoarthritis. Moreover, the paper summarizes studies that have compared MRI-based measurements with radiography and discusses future perspectives of quantitative MRI in osteoarthritis. In summary, the above methodologies show great promise for elucidating the pathophysiology of various tissues and identifying risk factors of osteoarthritis, for developing structure modifying drugs (DMOADs) and for combating osteoarthritis with new and better therapy. Copyright # 2006 John Wiley & Sons, Ltd.KEYWORDS: osteoarthritis; joint; cartilage; bone; magnetic resonance imaging; knee; image analysis; disease-modifying drugs RATIONALE FOR QUANTITATIVE MRI OF CARTILAGE AND BONE IN OSTEOARTHRITISThe health and integrity of diarthrodial (synovial) joints are prerequisites for pain-free movement and have a major impact on the quality of life. However, the population of individuals above the age of 65 years is rapidly growing and 70% of the women and 60% of the men aged 65 years or older suffer from degenerative joint disease [¼ osteoarthritis (OA)] (1-7). OA has been defined by the American College of Rheumatology (ACR) as a 'heterogeneous group of conditions that leads to joint symptoms and signs which are associated with defective integrity of articular cartilage, in addition to related changes in the underlying bone at the joint margins'. It remains an open question whether the initial changes take place in cartilage or bone or other articular tissues and, more importantly, what the causal relationship between these changes is (5-19). Also, within each NMR IN BIOMEDICINE NMR Biomed. 2006; 19: 822-854 Published online in Wiley InterScience (www.interscience.wiley.com). DOI:10.1002/nbm.1063 narrowing; JSW, joint space width; K, knee; KLG, Kellgren Lawrence grade; KOSS, knee osteoarthritis scoring system; LF, lateral femoral condyle; LT, lateral tibia; MRI, magnetic resonance imaging; MF, medial femoral condyle; MT, medial tibia; OA, osteoarthritis; OAI, Osteoarthritis Initiative; P, patella; PGs, proteoglycans;...

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“…The development of magnetic resonance imaging (MRI) has made it possible to delineate articular cartilage in vivo (Recht et al, 1993;Peterfy et al, 1994;Eckstein et al, 1996). In conjunction with state-of-the-art three-dimensional (3D) postprocessing tools (qMRI) the technique has been shown to produce accurate and precise data on the cartilage morphology (volume, thickness, and surface area) of the knee in healthy individuals (Stammberger et al, 1999a;Hohe et al, 2002), and in patients with femorotibial osteoarthritis (OA) (Burgkart et al, 2001).…”

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confidence: 99%

Correlation of knee‐joint cartilage morphology with muscle cross‐sectional areas vs. anthropometric variables

Hudelmaier

Gläser

Englmeier³

et al. 2003

Anat. Rec.

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We tested the hypothesis that muscle cross-sectional areas (MCSAs) are more highly (and independently) correlated with cartilage morphology than are body height and weight, and that the physiological reduction of cartilage thickness with aging is associated with a proportional, age-dependent decrease in MCSAs. In 59 asymptomatic individuals (23-75 years old), morphological parameters of the knee cartilages (volume, thickness, and bonecartilage interface area), and MCSAs were determined from magnetic resonance imaging (MRI) data. Multiple regression models were used to calculate which proportion of the variability of the normal cartilage morphology can be predicted based on independent variables. MCSAs and body height and weight showed correlation coefficients of ϩ0.66, ϩ0.60, and ϩ0.25, respectively, with knee-joint cartilage volume. The correlation coefficients with cartilage thickness were ϩ0.44, ϩ0.35, and ϩ0.24, respectively. Age accounted for a significant (P Ͻ 0.01) reduction in cartilage thickness, but there was no proportional change of MCSAs. Approximately 76% of the variability of the knee cartilage volume could be predicted from independent variables in a multiple regression model with MCSAs contributing significant, independent information. In conclusion, we find that MCSAs are more highly correlated with cartilage morphology than are body height and weight. The significant decrease in cartilage volume and thickness with age is not associated with a proportional decrease in MCSAs. Anat Rec Part A 270A: 175-184, 2003.

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Abnormalities of articular cartilage in the knee: analysis of available MR techniques.

Cited by 334 publications

References 0 publications

Is MRI Adequate to Detect Lesions in Patients with Ankle Instability?

Is MRI Adequate to Detect Lesions in Patients with Ankle Instability?

Quantitative MRI of cartilage and bone: degenerative changes in osteoarthritis

Correlation of knee‐joint cartilage morphology with muscle cross‐sectional areas vs. anthropometric variables

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