MRI of the cartilage

Abstract

With the introduction of fat-suppressed gradient-echo and fast spin-echo (FSE) sequences in clinical routine MR visualization of the hyaline articular cartilage is routinely possible in the larger joints. While 3D gradient-echo with fat suppression allows exact depiction of the thickness and surface of cartilage, FSE outlines the normal and abnormal internal structures of the hyaline cartilage; therefore, both sequences seem to be necessary in a standard MRI protocol for cartilage visualization. In diagnostically ambiguous cases, in which important therapeutic decisions are required, direct MR arthrography is the established imag-ing standard as an add-on procedure. Despite the social impact and prevalence, until recent years there was a paucity of knowledge about the pathogenesis of cartilage damage. With the introduction of high-resolution MRI with powerful surface coils and fat-suppression techniques, visualization of the articular cartilage is now routinely possible in many joints. After a short summary of the anatomy and physiology of the hyaline cartilage, the different MR imaging methods are discussed and recommended standards are suggested.

Multiscale X-ray phase contrast imaging of human cartilage for investigating osteoarthritis formation

“…Clinical computed tomography (CT), as well as standard laboratory-based micro-CT set-ups, lack the contrast resolution to sufficiently visualize cartilage composition and its pathological alterations due to poor X-ray absorption of the tissue. The current clinical method of choice for direct cartilage depiction is Magnetic Resonance Imaging (MRI), which provides anatomical information about tissue volume and height [ 5 ], structural matrix changes and defects [ 6 ] and quantitative biochemical properties such as collagen or proteoglycan content [ 7 – 9 ], but the depiction varies strongly depending on the MRI sequence used [ 6 ]. Cautious interpretation is necessary as for a given lesion the estimated size differs depending on the chosen sequence parameters, which signifies that the application of a standardized protocol is very important to achieve meaningful consistent lesion size estimation.…”

The Role of Magnetic Resonance Imaging in Autologous Matrix-Induced Chondrogenesis for Osteochondral Lesions of the Talus: Analyzing MOCART 1 and 2.0

“…7-9 Native hyaline cartilage is rich in collagen type II and maintains nutrition through physiologic loading and unloading. 10 Once joint congruency is disturbed, however, successive joint degeneration results in osteoarthritis (OA) as adult cartilage has limited regenerative potential. 2 To prevent further degeneration and to improve clinical symptoms, numerous surgical treatment options for cartilage repair have been proposed.…”

“…Postoperative magnetic resonance imaging (MRI) is the most important noninvasive method for evaluation of surgical procedures for cartilage repair. 10,31-33 In 2004, Marlovits et al . 31 introduced the MOCART score (Magnetic Resonance Observation of Cartilage Repair Tissue) based on a standard knee MRI protocol including intermediate-weighted sequences for cartilage evaluation.…”

Characterization of Heterotopic Ossification Using Radiographic Imaging: Evidence for a Paradigm Shift

“…While quantification of HO growth is important for outcome evaluation of experiments, it is important to note that other advanced imaging techniques may also improve our understanding of HO development. For example, magnetic resonance imaging (MRI) allows for identification of soft tissues with high water content, a key identifying factor for cartilage[ 20 ]. In fact, MRI is used in the clinical setting to identify cartilage defects and may be used to identify HO, a lesion that forms through endochondral ossification, prior to ossification[ 3 , 21 , 22 ].…”