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1 Department of Radiology, University Hospital Balgrist, Forchstrasse 340,
Zurich CH-8008, Switzerland.
2 Present address: Department of Radiology, Kantonsspital Baden, Daettwil
CH-5405, Switzerland.
3 Department of Orthopedics, University Hospital Balgrist, Zurich CH-8008,
Switzerland.
4 Present address: Department of Orthopedic Surgery, Zieglerspital Bern,
Morillonstrasse, Bern 3001, Switzerland.
5 MR Application Development, Siemens AG Medical Solutions, Karl Schall Strasse
4, Erlangen D-91050, Germany.
OBJECTIVE. The objective of our study was to compare the diagnostic performance of a dedicated cartilage MR sequence (water-excitation 3D double-echo steady-state) with a standard MR sequence (T1-weighted spin-echo) in detecting articular cartilage lesions of the hip after intraarticular injection of gadopentetate dimeglumine.
MATERIALS AND METHODS. In 50 MR arthrograms of the hip joint obtained in 47 consecutive patients, a sagittal 3D double-echo steady-state sequence (TR/TE, 24/6.5; flip angle, 25°) was compared with a sagittal T1-weighted spin-echo sequence (350/14). Two musculoskeletal radiologists independently evaluated articular cartilage. Sensitivity and specificity for detecting cartilage defects were calculated for those hips that underwent open surgery (n = 21). Lesion conspicuity was retrospectively reviewed and graded between 1 (not visible) and 5 (well defined).
RESULTS. At surgery, a total of 26 lesions of the acetabular
(n = 20) and femoral (n = 6) cartilage were found. For the
3D double-echo steady-state and T1-weighted spin-echo sequences, sensitivities
and specificities for cartilage lesion detection were 58% and 88% and 81% and
81% for reviewer 1 and 62% and 94% and 62% and 100% for reviewer 2,
respectively. Lesion conspicuity was significantly superior (p =
0.036) for the 3D double-echo steady-state sequence (mean grade, 3.4) compared
with the T1-weighted spin-echo sequence (mean grade, 3.0). The kappa value was
fair for the 3D double-echo steady-state sequence (
= 0.40) and
moderate for the T1-weighted spin-echo sequence ( = 0.55).
CONCLUSION. The 3D double-echo steady-state sequence optimized for cartilage imaging improves lesion conspicuity but does not improve diagnostic performance.
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