Cartilage Imaging of the Hand and Wrist Using 3-T MRI

Abstract

The prevalence of osteoarthritis of the hand and wrist is high, and a thorough assessment of even subtle cartilage injuries is necessary before surgical interventions. Although magnetic resonance imaging (MRI) has been established as an important diagnostic tool for the evaluation of hand and wrist disorders, the focus has been on the assessment of the triangular fibrocartilage complex, tendons, ligaments, and the detection of avascular necrosis or occult fractures rather than on cartilage imaging. 3-T MR systems have become more and more widely available and yield an improved signal-to-noise ratio and thus a higher spatial resolution than 1.5-T systems. In principle, this should be especially beneficial for depicting the thin cartilage layers of the hand and wrist. This review focuses on cartilage imaging of the hand and wrist with 3-T MRI and addresses these four topics: (1) the advantages of 3-T versus 1.5- and 1-T MRI, (2) dedicated sequence protocols at 3 T including novel three-dimensional sequences, (3) imaging findings in common cases of overuse or sports injury, and (4) functional cartilage imaging techniques of the hand and wrist, for instance, delayed gadolinium-enhanced MRI of the cartilage.

Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) andT2mapping at 3T MRI of the wrist: Feasibility and clinical application

“…In the patient group, the morphological sequences were evaluated regarding the presence of visible cartilage damage. Cartilage damage was defined as a focal superficial or deep defect, substantial thinning of the entire layer, or focal swelling with irregularity and edema corresponding to modified Noyes grades 1–3 cartilage damage . Full thickness Noyes grade 4 lesions were not analyzed due to lack of cartilage.…”

Feasibility of gadoteric acid for delayed gadolinium‐enhanced MRI of cartilage (dGEMRIC) at the wrist and knee and comparison with Gd‐DTPA

“…We used a sequence protocol similar to that already implemented in the knee and wrist . Besides the study sequences for dGEMRIC, the routine imaging protocol included a cartilage‐sensitive, proton density‐weighted turbo spin‐echo sequence with fat saturation (PDfs) for morphological correlation and exclusion of cartilage defects. Imaging parameters for the PDfs at the wrist were echo time / repetition time (TE/TR) 26/2,370 msec, slice thickness (ST) 2 mm, and acquisition time (TA) 2:06 min, and at the knee were TE/TR 25/3,310 msec, ST 3 mm, and TA 2:56 min.…”

“…Normal cartilage was defined as a visually normal cartilage signal on all sequences as well as preserved cartilage thickness with an intact surface and absence of intrachondral signal alterations . Cartilage damage was defined as a focal superficial or deep defect, substantial thinning of the entire layer, or focal swelling with irregularity and edema corresponding to the modified Noyes score . All MRI examinations were randomized, and identifying variables, such as the patient's name, were removed.…”

Standardized quantitative measurements of wrist cartilage in healthy humans using 3T magnetic resonance imaging

“…It is noteworthy that most of the MRI studies reported so far have been conducted using a conventional magnetic field, i.e., 1.5T but a few studies have clearly indicated that MRI investigations at higher field, e.g., 3T could provide a better signal/noise ratio and a more accurate identification of certain anatomical structures [16][17][18][19] .…”