Comparison of reliability of magnetic resonance imaging using cartilage and T1-weighted sequences in the assessment of the closure of the growth plates at the knee

Abstract

Background Growth development is traditionally evaluated with plain radiographs of the hand and wrist to visualize bone structures using ionizing radiation. Meanwhile, MRI visualizes bone and cartilaginous tissue without radiation exposure. Purpose To determine the state of growth plate closure of the knee in healthy adolescents and young adults and compare the reliability of staging using cartilage sequences and T1-weighted (T1W) sequence between pediatric and general radiologists. Material and Methods A prospective, cross-sectional study of MRI of the knee with both cartilage and T1W sequences was performed in 395 male and female healthy subjects aged between 14.0 and 21.5 years old. The growth plate of the femur and the tibia were graded using a modified staging scale by two pediatric and two general radiologists. Femur and tibia were graded separately with both sequences. Results The intraclass correlation was overall excellent. The inter- and intra-observer agreement for pediatric radiologists on T1W was 82% (κ = 0.73) and 77% (κ = 0.65) for the femur and 90% (κ = 0.82) and 87% (κ = 0.75) for the tibia. The inter-observer agreement for general radiologists on T1W was 69% (κ = 0.56) for the femur and 56% (κ = 0.34) for the tibia. Cohen’s kappa coefficient showed a higher inter- and intra-observer agreement for cartilage sequences than for T1W: 93% (κ = 0.86) and 89% (κ = 0.79) for the femur and 95% (κ = 0.90) and 91% (κ = 0.81) for the tibia. Conclusion Cartilage sequences are more reliable than T1W sequence in the assessment of the growth plate in adolescents and young adults. Pediatric radiology experience is preferable.

Magnetic resonance and diffusion tensor imaging of the adolescent rabbit growth plate of the knee

“…The correlation between the modalities is of interest because previous MRI studies have shown different results in assessing the growth plate, depending on whether the assessment has been performed on a cartilage sequence or T1-weighted sequence. 28 Our study strengthens the hypothesis that the multi-gradient echo 3D sequence accurately reproduces the growth plate on MRI.…”

“…Similarly, the high‐resolution histological images showed a small chondrocyte remnant of the growth plate in the rabbits that was completely fused. A growth plate remnant has also been reported in human subjects 28–30 . Our findings indicate a difference between chronological and biological ages.…”

“…(The zero value is indicated by a black line) remnant has also been reported in human subjects. [28][29][30] Our findings indicate a difference between chronological and biological ages. Kaweblum et al 31 showed that the growth plate fused earlier in New Zealand white rabbits in the femur (radiograph: 20-23 wk; histology:19-24 wk) than in the tibia (radiograph: 22-27 wk; histology:…”

A cross‐sectional magnetic resonance imaging study of factors influencing growth plate closure in adolescents and young adults

“…Images were examined and rated according to a system based on Kellinghaus' modified version of Schmeling's developmental stages 6,7 , and the developmental stages by Dedouit et al 8 with minor alterations. Our scale was introduced in a previous study 21 in which we defined the scale as follows:…”

Magnetic resonance imaging of the knee for chronological age estimation—a systematic review

“…Two reviewers independently screened the titles and abstracts identified by the literature search strategy. All studies of potential relevance according to the inclusion criteria Kvist [18] were obtained in full text, and two reviewers independently assessed them for inclusion. In addition, the articles included in the systematic review by Ding et al [25] were screened for relevance.…”