MR Imaging of Cartilage Lesions of the Knee: What is the Clinical Indication? (Radiologist's View)

ABSTRACT

This commentary focuses on the clinical application of magnetic resonance (MR) imaging in the assessment of articular cartilage of the knee. MR imaging is superior to conventional imaging techniques for evaluation of the articular cartilage. Several pulse sequences are advocated for demonstration of the normal articular cartilage and cartilage lesions. However, a consensus has not yet been reached in regard to the most appropriate sequence for evaluation of the articular cartilage. Early morphological changes in the degenerative cartilage are not reliably diagnosed even with the use of tailored MR imaging techniques. The detection of the biochemical changes of cartilage will serve as an important tool for the early diagnosis of cartilage degeneration in the near future. Further prospective studies are needed to establish the role of MR imaging in clinical use.

KEYWORD

Cartilage lesions of the knee - magnetic resonance imaging - cartilage biochemical abnormalities

REFERENCES

• 1 Rubenstein J D, Li J G, Majumdar S. Image resolution and signal-to-noise ratio requirements for MR imaging of degenerative cartilage.  AJR . 1997;  169 1089-1096
• 2 Disler D G, McCauley T R, Kelman C G. Fat-suppressed three-dimensional spoiled gradient-echo MR imaging of hyaline cartilage defects in the knee: comparison with standard MR imaging and arthroscopy.  AJR . 1996;  167 127-132
• 3 Recht M P, Piraino D W, Paletta G A. Accuracy of fat-suppressed three-dimensional spoiled gradient-echo FLASH MR imaging in the detection of patellofemoral articular cartilage abnormalities.  Radiology . 1996;  198 209-212
• 4 Potter H G, Linklater J M, Allen A A. Magnetic resonance imaging of articular cartilage in the knee. An evaluation with use of fast-spin-echo imaging.  J Bone Joint Surg Am . 1998;  80 1276-1284
• 5 Bredella M A, Tirman P F, Peterfy C G. 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.  AJR . 1999;  172 1073-1080
• 6 Woertler K, Strothmann M, Tombach B. Detection of articular cartilage lesions: experimental evaluation of low- and high-field-strength MR imaging at 0.18 and 1.0 T.  J Magn Reson Imaging . 2000;  11 678-685
• 7 Kawahara Y, Uetani M, Nakahara N. Fast spin-echo MR of the articular cartilage in the osteoarthrotic knee. Correlation of MR and arthroscopic findings.  Acta Radiol . 1998;  39 120-125
• 8 Drape J L, Pessis E, Auleley G R. Quantitative MR imaging evaluation of chondropathy in osteoarthritic knees.  Radiology . 1998;  208 49-55
• 9 Dardzinski B J, Mosher T J, Li S. Spatial variation of T2 in human articular cartilage.  Radiology . 1997;  205 546-550
• 10 Mosher T J, Dardzinski B J, Smith M B. Human articular cartilage: influence of aging and early symptomatic degeneration on the spatial variation of T2-preliminary findings at 3 T.  Radiology . 2000;  214 259-266
• 11 Xia Y, Farquhar T, Burton-Wurster N. Diffusion and relaxation mapping of cartilage-bone plugs and excised disks using microscopic magnetic resonance imaging.  Magn Reson Med . 1994;  31 273-282
• 12 Frank L R, Wong E C, Luh W M. Articular cartilage in the knee: mapping of the physiologic parameters at MR imaging with a local gradient coil-preliminary results.  Radiology . 1999;  210 241-246
• 13 Burstein D, Bashir A, Gray M L. MRI techniques in early stages of cartilage disease.  Invest Radiol . 2000;  35 622-638
• 14 Bashir A, Gray M L, Hartke J. Nondestructive imaging of human cartilage glycosaminoglycan concentration by MRI.  Magn Reson Med . 1999;  41 857-865
• 15 Gold G E, Thedens D R, Pauly J M. MR imaging of articular cartilage of the knee: new methods using ultrashort TEs.  AJR . 1998;  170 1223-1226
• 16 Reddy R, Insko E K, Noyszewski E A. Sodium MRI of human articular cartilage in vivo.  Magn Reson Med . 1998;  39 697-701
• 17 Gelb H J, Glasgow S G, Sapega A A. Magnetic resonance imaging of knee disorders. Clinical value and cost-effectiveness in a sports medicine practice.  Am J Sports Med . 1996;  24 99-103
• 18 Munk B, Madsen F, Lundorf E. Clinical magnetic resonance imaging and arthroscopic findings in knees: a comparative prospective study of meniscus anterior cruciate ligament and cartilage lesions.  Arthroscopy . 1998;  14 171-175