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The morphology of articular cartilage assessed by magnetic resonance imaging (MRI)

Appréciation de la morphologie du cartilage articulaire par la résonance magnétique nucléaire (IRM)

Reproducibility and anatomical correlation

  • Radiological Anatomy
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Summary

Quantitative assessment of cartilage volume and thickness in a formalin-alcohol fixed specimen of a human patella was conducted with magnetic resonance imaging (MRI), as it is still unclear whether the morphology of normal and damaged cartilage can be accurately demonstrated with this technique. MR imaging was carried out at 1.0 T (section thickness 2 mm, in-plane-resolution 0.39 – 0.58 mm) with the following pulse sequences: 1) T1-weighted spin-echo, 2) 3D-MPRA-GE, 3) 3D-FISP, 4) 3D-MTC-FISP, 5) 3D-DESS, 6) 3D-FLASH. Following imaging, the patella was sectioned perpendicular to the articular surface at intervals of 2 mm with a diamond band-saw. The volume of its cartilage was determined from the anatomical sections and the MR images, using a Vidas IPS 10 image analysing system (Kontron). Measurements were carried out with and without the low-signal layer in the transitional zone between the articular cartilage and the subchondral bone. If the low-signal layer was included, the volume was overestimated with MRI by 16 to 19 %. Without the low-signal layer the volumes were less than those determined from the anatomical sections: T1-SE −18,2 %, MPRAGE −22.6 %, FISP −17.1 %, MTC-FISP −9.5 %, DESS −9,3% and FLASH −6.1 %. The coefficient of variation for a 6-fold determination of the volume amounted to between 6.2 % (T1-SE) and 2.6 % (FLASH). The FLASH sequence allowed the most valid and reproducible assessment of the cartilage morphology. The remaining difference from the real volume of the cartilage may be due to the fact that the calcified zone of the cartilage is not delineated by MRI.

Résumé

L'évaluation quantitative de l'épaisseur et du volume du cartilage de patellas humaines, fixées dans un mélange d'alcool et de formol, a été réalisée en imagerie par résonance magnétique (IRM) car on ne sait encore avec exactitude si l'aspect morphologique du cartilage normal ou lésé peut être parfaitement démontré par cette technique. L'IRM a été réalisée sur un appareil 1.0 T (épaisseur de coupe : 2 mm, résolution : 0,39–0,58 mm) avec les séquences suivantes : 1) séquence en spin écho pondéré T1, 2) 3D-MRAGE, 3) 3D-FISP, 4) 3D-MTC-FISP, 5) 3D-DESS, 6) 3D-FLASH. Après la réalisation de l'IRM, la patella était sectionnée tous les 2 mm, perpendiculairement à sa surface articulaire, à l'aide d'une scie à ruban. Le volume de son cartilage était déterminé sur les coupes anatomiques et les images IRM grâce à un système d'analyse d'images Vidas IPS 10 (Kontron). Les mesures étaient réalisées avec et sans la couche en hyposignal correspondant à la zone transitionnelle située entre le cartilage articulaire et l'os sous-chondral. Lorsque cette couche en hyposignal était prise en compte, le volume était surestimé par l'IRM de 16 à 19%. Lorsque cette couche en hyposignal n'était pas prise en compte, les volumes étaient inférieurs à ceux déterminés par les coupes anatomiques :

T1-SE : −18,2%, MPRAGE : −22,6%, FISP : − 17,1%, MTC-FISP : − 9,5%, DESS : − 9,3% et FLASH : −6,1%. La séquence FLASH permettait l'appréciation la plus correcte et la plus reproductible de la morphologie du cartilage. La différence persistante par rapport au volume réel du cartilage peut être due au fait que la zone calcifiée du cartilage n'est pas délimitée par l'IRM.

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Authors and Affiliations

  1. Klinikum Großhadern, Institut für Radiologische Diagnostik, Marchioninistr. 15, D-81377, München, Germany

    F Eckstein, H Sittek & M Reiser

  2. Anatomische Anstalt, Ludwig-Maximilians Universität, Pettenkoferstr. 11, D-80336, München, Germany

    F Eckstein, S Milz & R Putz

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Eckstein, F., Sittek, H., Milz, S. et al. The morphology of articular cartilage assessed by magnetic resonance imaging (MRI). Surg Radiol Anat 16, 429–438 (1994). https://doi.org/10.1007/BF01627667

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