American Journal of Roentgenology, Vol 172, 1073-1080, Copyright © 1999 by American Roentgen Ray Society

ARTICLES

Accuracy of T2-weighted fast spin-echo MR imaging with fat saturation in detecting cartilage defects in the knee: comparison with arthroscopy in 130 patients

MA Bredella, PF Tirman, CG Peterfy, M Zarlingo, JF Feller, FW Bost, JP Belzer, TK Wischer and HK Genant
Department of Radiology, University of California, San Francisco 94143- 0628, USA.

OBJECTIVE: The purpose of this study was to assess the accuracy of routine T2-weighted MR imaging in detecting and grading articular cartilage lesions in the knee compared with arthroscopy. SUBJECTS AND METHODS: We examined 130 consecutive patients who underwent MR imaging and arthroscopy of the knee for suspected internal derangement. MR imaging consisted of axial and coronal T2-weighted fast spin-echo sequences with fat saturation and sagittal T2-weighted spin-echo sequences. Each single plane was evaluated and graded for the presence and appearance of articular cartilage defects using a standard arthroscopic grading scheme adapted to MR imaging. RESULTS: Of the 86 arthroscopically proven abnormalities, 81 were detected on MR imaging. Sensitivity of the T2-weighted fast spin-echo sequence with fat saturation was 61% for the coronal plane alone and 59% for the axial plane alone. Specificity for each plane was 99%. Sensitivity for the sagittal T2-weighted spin-echo sequence was 40%, and specificity was 100%. Sensitivity of the combination of axial and coronal T2-weighted fast spin-echo sequences with fat saturation and sagittal T2-weighted spin-echo sequence compared with arthroscopy for revealing cartilage lesions was 94%, specificity was 99%, and accuracy was 98%. Sensitivity of coronal and axial T2-weighted fast spin-echo sequences with fat saturation was 93%, and specificity was 99%. Fifty-five lesions (64%) were identically graded on MR imaging and arthroscopy. Seventy-eight lesions (90%) were within one grade using MR imaging and arthroscopy, and 84 lesions (97%) were within two grades using MR imaging and arthroscopy. CONCLUSION: T2-weighted fast spin-echo MR imaging with fat saturation is an accurate and fast technique for detecting and grading articular cartilage defects in the knee. The combination of the axial and coronal planes offers sufficient coverage of articular surfaces to provide a high sensitivity and specificity for chondral defects.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				G. E. Gold, C. A. Chen, S. Koo, B. A. Hargreaves, and N. K. Bangerter Recent Advances in MRI of Articular Cartilage Am. J. Roentgenol., September 1, 2009; 193(3): 628 - 638. [Abstract] [Full Text] [PDF]

				R. Kijowski, K. W. Davis, M. A. Woods, M. J. Lindstrom, A. A. De Smet, G. E. Gold, and R. F. Busse Knee Joint: Comprehensive Assessment with 3D Isotropic Resolution Fast Spin-Echo MR Imaging--Diagnostic Performance Compared with That of Conventional MR Imaging at 3.0 T Radiology, August 1, 2009; 252(2): 486 - 495. [Abstract] [Full Text] [PDF]

				R. Kijowski, D. G. Blankenbaker, J. L. Klaers, K. Shinki, A. A. De Smet, and W. F. Block Vastly Undersampled Isotropic Projection Steady-State Free Precession Imaging of the Knee: Diagnostic Performance Compared with Conventional MR Radiology, April 1, 2009; 251(1): 185 - 194. [Abstract] [Full Text] [PDF]

				R. Kijowski, D. G. Blankenbaker, K. W. Davis, K. Shinki, L. D. Kaplan, and A. A. De Smet Comparison of 1.5- and 3.0-T MR Imaging for Evaluating the Articular Cartilage of the Knee Joint Radiology, March 1, 2009; 250(3): 839 - 848. [Abstract] [Full Text] [PDF]

				H. G. Potter and L. R. Chong Magnetic Resonance Imaging Assessment of Chondral Lesions and Repair J. Bone Joint Surg. Am., February 1, 2009; 91(Supplement_1): 126 - 131. [Abstract] [Full Text] [PDF]

				P. J. Sillanpaa, H. M. Maenpaa, V. M. Mattila, T. Visuri, and H. Pihlajamaki Arthroscopic Surgery for Primary Traumatic Patellar Dislocation: A Prospective, Nonrandomized Study Comparing Patients Treated With and Without Acute Arthroscopic Stabilization With a Median 7-Year Follow-up Am. J. Sports Med., December 1, 2008; 36(12): 2301 - 2309. [Abstract] [Full Text] [PDF]

				G. E. Gold, R. F. Busse, C. Beehler, E. Han, A. C. S. Brau, P. J. Beatty, and C. F. Beaulieu Isotropic MRI of the Knee with 3D Fast Spin-Echo Extended Echo-Train Acquisition (XETA): Initial Experience Am. J. Roentgenol., May 1, 2007; 188(5): 1287 - 1293. [Abstract] [Full Text] [PDF]

				S. R. Duc, P. Koch, M. R. Schmid, W. Horger, J. Hodler, and C. W. A. Pfirrmann Diagnosis of Articular Cartilage Abnormalities of the Knee: Prospective Clinical Evaluation of a 3D Water-Excitation True FISP Sequence Radiology, May 1, 2007; 243(2): 475 - 482. [Abstract] [Full Text] [PDF]

				N. Saupe, C. W. A. Pfirrmann, M. R. Schmid, T. Schertler, M. Manestar, and D. Weishaupt MR Imaging of Cartilage in Cadaveric Wrists: Comparison between Imaging at 1.5 and 3.0 T and Gross Pathologic Inspection Radiology, April 1, 2007; 243(1): 180 - 187. [Abstract] [Full Text] [PDF]

				D. G. Disler, Y. Y. Ho, A. J. Stanley, J. H.-P. Hui, and S.-C. Wang Invited Commentary * Authors' Response RadioGraphics, January 1, 2007; 27(1): 221 - 222. [Full Text] [PDF]

				A. Farber, L. Fayad, T. Johnson, B. Cascio, M. Shindle, P. Neubauer, and A. J. Khanna Magnetic Resonance Imaging of the Shoulder. Current Techniques and Spectrum of Disease J. Bone Joint Surg. Am., December 1, 2006; 88(suppl_4): 64 - 79. [Full Text] [PDF]

				L. M. White, M. S. Sussman, M. Hurtig, L. Probyn, G. Tomlinson, and R. Kandel Cartilage T2 Assessment: Differentiation of Normal Hyaline Cartilage and Reparative Tissue after Arthroscopic Cartilage Repair in Equine Subjects. Radiology, November 1, 2006; 241(2): 407 - 414. [Abstract] [Full Text] [PDF]

				K.-P. Jungius, M. R. Schmid, M. Zanetti, J. Hodler, P. Koch, and C. W. A. Pfirrmann Cartilaginous Defects of the Femorotibial Joint: Accuracy of Coronal Short Inversion Time Inversion-Recovery MR Sequence Radiology, August 1, 2006; 240(2): 482 - 488. [Abstract] [Full Text] [PDF]

				G. E. Gold, S. B. Reeder, H. Yu, P. Kornaat, A. S. Shimakawa, J. W. Johnson, N. J. Pelc, C. F. Beaulieu, and J. H. Brittain Articular Cartilage of the Knee: Rapid Three-dimensional MR Imaging at 3.0 T with IDEAL Balanced Steady-State Free Precession--Initial Experience Radiology, August 1, 2006; 240(2): 546 - 551. [Abstract] [Full Text] [PDF]

				P. R. Kornaat, J. L. Bloem, R. Y. T. Ceulemans, N. Riyazi, F. R. Rosendaal, R. G. Nelissen, W. O. Carter, M.-P. Hellio Le Graverand, and M. Kloppenburg Osteoarthritis of the Knee: Association between Clinical Features and MR Imaging Findings. Radiology, June 1, 2006; 239(3): 811 - 817. [Abstract] [Full Text] [PDF]

				H. G. Potter and L. F. Foo Magnetic Resonance Imaging of Articular Cartilage: Trauma, Degeneration, and Repair Am. J. Sports Med., April 1, 2006; 34(4): 661 - 677. [Abstract] [Full Text] [PDF]

				R. Kijowski, P. Stanton, J. Fine, and A. De Smet Subchondral Bone Marrow Edema in Patients with Degeneration of the Articular Cartilage of the Knee Joint Radiology, March 1, 2006; 238(3): 943 - 949. [Abstract] [Full Text] [PDF]

				C. W. Hayes, D. A. Jamadar, G. W. Welch, M. L. Jannausch, L. L. Lachance, D. C. Capul, and M. R. Sowers Osteoarthritis of the Knee: Comparison of MR Imaging Findings with Radiographic Severity Measurements and Pain in Middle-aged Women Radiology, December 1, 2005; 237(3): 998 - 1007. [Abstract] [Full Text] [PDF]

				M. P. Recht, D. W. Goodwin, C. S. Winalski, and L. M. White MRI of Articular Cartilage: Revisiting Current Status and Future Directions Am. J. Roentgenol., October 1, 2005; 185(4): 899 - 914. [Abstract] [Full Text] [PDF]

				J. N. Masi, C. A. Sell, C. Phan, E. Han, D. Newitt, L. Steinbach, S. Majumdar, and T. M. Link Cartilage MR Imaging at 3.0 versus That at 1.5 T: Preliminary Results in a Porcine Model Radiology, July 1, 2005; 236(1): 140 - 150. [Abstract] [Full Text] [PDF]

				M. R. Schmid, C. W. A. Pfirrmann, P. Koch, M. Zanetti, B. Kuehn, and J. Hodler Imaging of Patellar Cartilage with a 2D Multiple-Echo Data Image Combination Sequence Am. J. Roentgenol., June 1, 2005; 184(6): 1744 - 1748. [Abstract] [Full Text] [PDF]

				S. S. Vasanawala, B. A. Hargreaves, J. M. Pauly, D. G. Nishimura, C. F. Beaulieu, and G. E. Gold Rapid Musculoskeletal MRI with Phase-Sensitive Steady-State Free Precession: Comparison with Routine Knee MRI Am. J. Roentgenol., May 1, 2005; 184(5): 1450 - 1455. [Abstract] [Full Text] [PDF]

				P. R. Knuesel, C. W. A. Pfirrmann, H. P. Noetzli, C. Dora, M. Zanetti, J. Hodler, B. Kuehn, and M. R. Schmid MR Arthrography of the Hip: Diagnostic Performance of a Dedicated Water-Excitation 3D Double-Echo Steady-State Sequence to Detect Cartilage Lesions Am. J. Roentgenol., December 1, 2004; 183(6): 1729 - 1735. [Abstract] [Full Text] [PDF]

				G. Y. El-Khoury, K. J. Alliman, H. J. Lundberg, M. J. Rudert, T. D. Brown, and C. L. Saltzman Cartilage Thickness in Cadaveric Ankles: Measurement with Double-Contrast Multi-Detector Row CT Arthrography versus MR Imaging Radiology, December 1, 2004; 233(3): 768 - 773. [Abstract] [Full Text] [PDF]

				T. Magee and D. Williams Detection of Meniscal Tears and Marrow Lesions Using Coronal MRI Am. J. Roentgenol., November 1, 2004; 183(5): 1469 - 1473. [Abstract] [Full Text] [PDF]

				A. H. Haims, A. E. Moore, M. E. Schweitzer, W. B. Morrison, D. Deely, R. W. Culp, and H. P. Forman MRI in the Diagnosis of Cartilage Injury in the Wrist Am. J. Roentgenol., May 1, 2004; 182(5): 1267 - 1270. [Abstract] [Full Text] [PDF]

				C G Peterfy MRI of the wrist in early rheumatoid arthritis Ann Rheum Dis, May 1, 2004; 63(5): 473 - 477. [Full Text] [PDF]

				H. Yoshioka, K. Stevens, M. Genovese, M. F. Dillingham, and P. Lang Articular Cartilage of Knee: Normal Patterns at MR Imaging That Mimic Disease in Healthy Subjects and Patients with Osteoarthritis Radiology, April 1, 2004; 231(1): 31 - 38. [Abstract] [Full Text] [PDF]

				D R Jeffrey and I Watt Imaging hyaline cartilage Br. J. Radiol., November 1, 2003; 76(911): 777 - 787. [Full Text] [PDF]

				J-P Pelletier and J Martel-Pelletier Therapeutic targets in osteoarthritis: from today to tomorrow with new imaging technology Ann Rheum Dis, November 1, 2003; 62(90002): ii79 - 82. [Full Text] [PDF]

				G. E. Gold, T. R. McCauley, M. L. Gray, and D. G. Disler Special Focus Session: What's New in Cartilage? RadioGraphics, September 1, 2003; 23(5): 1227 - 1242. [Abstract] [Full Text] [PDF]

				A. Mohr, F. W. Roemer, H. K. Genant, C. Liess, and A. Sonin Using Fat-Saturated Proton Density-Weighted MR Imaging to Evaluate Articular Cartilage Am. J. Roentgenol., July 1, 2003; 181(1): 280 - 282. [Full Text] [PDF]

				M. Brittberg and C. S. Winalski Evaluation of Cartilage Injuries and Repair J. Bone Joint Surg. Am., April 28, 2003; 85(90002): 58 - 69. [Full Text]

				R. D. Boutin, J. A. Januario, A. H. Newberg, C. R. Gundry, and J. S. Newman MR Imaging Features of Osteochondritis Dissecans of the Femoral Sulcus Am. J. Roentgenol., March 1, 2003; 180(3): 641 - 645. [Abstract] [Full Text] [PDF]

				S. B. Reeder, N. J. Pelc, M. T. Alley, and G. E. Gold Rapid MR Imaging of Articular Cartilage with Steady-State Free Precession and Multipoint Fat-Water Separation Am. J. Roentgenol., February 1, 2003; 180(2): 357 - 362. [Abstract] [Full Text] [PDF]

				M. R. Schmid, H. P. Notzli, M. Zanetti, T. F. Wyss, and J. Hodler Cartilage Lesions in the Hip: Diagnostic Effectiveness of MR Arthrography Radiology, February 1, 2003; 226(2): 382 - 386. [Abstract] [Full Text] [PDF]

				C. A. Helms The Meniscus: Recent Advances in MR Imaging of the Knee Am. J. Roentgenol., November 1, 2002; 179(5): 1115 - 1122. [Full Text] [PDF]

				A. H. Sonin, R. A. Pensy, M. E. Mulligan, and S. Hatem Grading Articular Cartilage of the Knee Using Fast Spin-Echo Proton Density-Weighted MR Imaging Without Fat Suppression Am. J. Roentgenol., November 1, 2002; 179(5): 1159 - 1166. [Abstract] [Full Text] [PDF]

				M. A. Bredella, C. Losasso, S. C. Moelleken, R. W. Huegli, H. K. Genant, and P. F. J. Tirman Three-Point Dixon Chemical-Shift Imaging for Evaluating Articular Cartilage Defects in the Knee Joint on a Low-Field-Strength Open Magnet Am. J. Roentgenol., December 1, 2001; 177(6): 1371 - 1375. [Abstract] [Full Text] [PDF]

				A. J. Khanna, A. J. Cosgarea, M. A. Mont, B. M. Andres, B. G. Domb, P. J. Evans, D. A. Bluemke, and F. J. Frassica Magnetic Resonance Imaging of the Knee : Current Techniques and Spectrum of Disease J. Bone Joint Surg. Am., November 1, 2001; 83(90022): S128 - 141. [Full Text] [PDF]

				T. R. McCauley and D. G. Disler Magnetic Resonance Imaging of Articular Cartilage of the Knee J. Am. Acad. Ortho. Surg., January 1, 2001; 9(1): 2 - 8. [Abstract] [Full Text] [PDF]

				D. A. Turner, D. A. Rubin, and J. M. Costello Subchondral Bone Marrow Edema in Degenerative Chondrosis Am. J. Roentgenol., December 1, 2000; 175 (6): 1749 - 1750. [Full Text] [PDF]

				D. G. Disler, E. Raymond, D. A. May, J. S. Wayne, and T. R. McCauley Articular Cartilage Defects: In Vitro Evaluation of Accuracy and Interobserver Reliability for Detection and Grading with US Radiology, June 1, 2000; 215(3): 846 - 851. [Abstract] [Full Text]

				D. A. Rubin, C. D. Harner, and J. M. Costello Treatable Chondral Injuries in the Knee: Frequency of Associated Focal Subchondral Edema Am. J. Roentgenol., April 1, 2000; 174(4): 1099 - 1106. [Abstract] [Full Text] [PDF]

				B. C. Vande Berg, F. E. Lecouvet, P. Poilvache, J. Jamart, R. Materne, B. Lengele, B. Maldague, and J. Malghem Assessment of Knee Cartilage in Cadavers with Dual-Detector Spiral CT Arthrography and MR Imaging Radiology, February 1, 2002; 222(2): 430 - 436. [Abstract] [Full Text] [PDF]