Macroscopic Structure of Articular Cartilage of the Tibial Plateau: Influence of a Characteristic Matrix Architecture on MRI Appearance
Douglas W. Goodwin1,
Youssef Zaim Wadghiri2,
Haoqin Zhu3,
Christopher J. Vinton4,
Eric D. Smith5 and
Jeff F. Dunn1
1 Department of Radiology, Dartmouth Medical School, Dartmouth-Hitchcock Medical
Center, One Medical Center Dr., Lebanon, NH 03756.
2 Skirball Institute–NYU Medical Center, 540 First Ave., New York, NY
10016.
3 Millennium Technology Inc., 465-5600 Parkwood Way, Richmond, BC, Canada.
4 Department of Orthopaedic Surgery and Physical Rehabilitation, UMass Memorial
Medical Center, 55 Lake Ave. N, Worchester, MA 01655.
5 National Orthopedic Imaging Associates, 1260 S Eliseo Dr., Greenbrae, CA
94904.
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Fig. 1. —23-year-old man with knee pain. Typical appearance of
articular cartilage on routine clinical imaging is shown on this coronal
intermediate-weighted fast spin-echo 1.5-T image (TR/TEeff,
2,000/19). Thin low-signal-intensity surface layer (s),
higher-signal-intensity transitional layer (t), and low-signal-intensity deep
layer (d) with vertical striations are present. Relative thickness of these
three layers is significantly different in central region of lateral plateau
(cent) compared with submeniscal region (sm), in which transitional and
surface layers are much thicker. Image plane includes posterior portion of
medial plateau with larger submeniscal region (arrowheads).
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Fig. 2A. —Lateral tibial plateau of 35-year-old woman. B0 =
main magnetic field. On midcoronal spin-echo image (TR/TE, 1,000/14; field of
view, 45 mm; slice thickness, 1 mm; matrix size, 512 x 512), variations
in signal intensity produce characteristic three-layer appearance. In central
region of plateau (c), in which higher-signal-intensity transitional layer (t)
is thin and radial striations extend across thick deep layer (d), minor
fibrillation is seen at low-signal-intensity surface (s). In submeniscal
region (sm) and at tibial eminence (e), transitional layer is much thicker.
Chemical shift produces low-signal-intensity interface at subchondral bone
(arrowheads). Surface of tibial eminence (short arrows) does
not interface with saline and cannot be clearly visualized because of contact
of wax enclosure with joint surface.
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Fig. 2B. —Lateral tibial plateau of 35-year-old woman. B0 =
main magnetic field. On corresponding T2 map, changes in T2 parallel changes
in signal intensity. Peak T2 values are located in middle of transitional
layer. e = tibial eminence, c = central region of plateau, sm = submeniscal
region.
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Fig. 3A. —78-year-old man with lateral tibial plateau removed at
arthroplasty. B0 = main magnetic field. Sagittal spin-echo image
(TR/TE, 1,000/14; field of view, 45 mm; slice thickness, 1 mm; matrix size,
512 x 512) of submeniscal region scanned with surface perpendicular to
B0 shows relatively high-signal-intensity transitional layer
(black arrow) and lower-signal-intensity deep layer (white
arrow).
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Fig. 3B. —78-year-old man with lateral tibial plateau removed at
arthroplasty. B0 = main magnetic field. T2 map has orientation and
location identical to that of A. Transitional layer T2 (black
arrow) is longer than deep layer T2 (white arrow).
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Fig. 3C. —78-year-old man with lateral tibial plateau removed at
arthroplasty. B0 = main magnetic field. Spin-echo MRI shows sample
oriented at 55° to B0 with slice location and imaging
parameters identical to those in A. Deep layer (white arrow)
signal intensity is increased, and orientation effect is also present in
transitional layer (black arrow), in which striations of lower signal
intensity are present on sample scanned at 55°.
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Fig. 3D. —78-year-old man with lateral tibial plateau removed at
arthroplasty. B0 = main magnetic field. T2 map shows orientation
and location identical to that of C. Deep layer T2 (white
arrow) is longer, and transitional layer T2 (black arrow) is
shorter than that in map acquired with surface perpendicular to B0
(B).
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Fig. 3E. —78-year-old man with lateral tibial plateau removed at
arthroplasty. B0 = main magnetic field. Low-power scanning electron
micrograph shows same sample (A–D) acquired after tissue was
first cut into 2-mm-thick slab in plane of imaging and then fractured
perpendicular to that plane. Cut surface (CS) faces viewer and subchondral
bone (B) is at bottom of image. Plane of fracture extends perpendicularly from
subchondral bone in deep region (small arrows) of tissue and then
curves into plane of joint surface (large arrow). Level of curve
matches location of transitional layer on spin-echo image (A) and T2
map (B) obtained with surface perpendicular to B0.
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Fig. 4A. —Medial tibial plateau of 55-year-old woman. sm = submeniscal
region. Spin-echo image (TR/TE, 1,000/20; field of view, 50 mm; slice
thickness, 1 mm; matrix size, 512 x 512) was obtained in midcoronal
plane. Single arrow = thin and superficial transitional layer, double arrows =
deep layer.
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Fig. 4B. —Medial tibial plateau of 55-year-old woman. sm = submeniscal
region. Spin-echo MRI was obtained in midsagittal plane with imaging
parameters identical to those in A. Single arrow = thin and superficial
transitional layer, double arrows = deep layer.
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Fig. 4C. —Medial tibial plateau of 55-year-old woman. sm = submeniscal
region. Photograph shows that specimen corresponding to A and B
was fractured in midcoronal plane. Superficial level of tissue curvature in
central region of plateau (single arrow) correlates with thin and
superficial transitional layer on MRI (single arrow, A and
B). In submeniscal region of joint, more oblique curvature of cartilage
is present at same location where increases in relative thickness of surface
and transitional layers are apparent on MRI. Vertical striations in deep layer
(double arrows, A and B) on MRIs correspond to location
of columnlike arrangement of tissue (double arrows) in deepest region
of cartilage, as displayed on this fractured specimen.
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Fig. 5A. —Lateral tibial plateau of 58-year-old man. Coronal image
(TR/TE, 1,000/20; field of view, 50 mm; matrix size, 512 x 256) was
obtained as multislice acquisition (slice thickness, 1 mm; interslice gap, 4
mm). Prominent high-signal-intensity transitional layer (black arrow)
on this coronal plane image of posterior aspect of tibial plateau reflects
large amount of submeniscal cartilage included in plane of imaging. No
lower-signal-intensity deep layer is evident at margin of joint (white
arrow). B0 = main magnetic field.
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Fig. 5B. —Lateral tibial plateau of 58-year-old man. Sagittal spin-echo
MRI was obtained with same parameters as A. Only thin deep layer
(single arrow) is apparent on this far lateral sagittal plane image
in submeniscal region. Double arrows indicate higher signal intensity at
posterior margin of joint. B0 = main magnetic field.
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Fig. 5C. —Lateral tibial plateau of 58-year-old man. Photograph shows
specimen fractured in same plane of imaging as in B. Regional changes
in shape of matrix correlate with regional variations in layering of signal
intensity displayed on spin-echo image (B). Location where matrix
curves out of plane of fracture (arrows), resulting in large
overhanging edge, corresponds to higher signal intensity at posterior margin
of joint (double arrows, B).
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Fig. 6. —Drawing shows architecture of extracellular matrix of tibial
plateau. Viewed from above (a), split lines in peripheral region of plateau
are arranged in wheel-spoke pattern. After fracture sectioning in coronal
plane, surface of anterior half is viewed en face (b) and then viewed
at oblique orientation (c). In central portion of tibial plateau (1),
cartilage has columnlike structure that is perpendicular to underlying
subchondral bone and curves at superficial level (2). At tibial eminence (3),
cartilage maintains columnlike structure, but instead of perpendicular
alignment relative to subchondral bone, its alignment approaches
weight-bearing axis of joint. At submeniscal region of joint (4), tissue
curves both away from center of joint and in annular direction perpendicular
to orientation of split lines in articular surface (5).
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Copyright © 2004 by the American Roentgen Ray Society.
