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Value of CT Arthrography in the Assessment of Cartilage Pathology

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Cartilage Imaging

Abstract

Intraarticular contrast material has long been used to delineate cartilage lesions with X-rays. The first reports of arthrography date back to 1905 [1]. Attempts were made to overcome the inherent limitations of arthrography (due to the projection of three-dimensional structures on a plane), using tomographic techniques [2] and various projections [3]. The advent of computed tomography (CT) enabled arthrography to develop further. First reported in 1979 for the study of cruciate ligaments [4], computed tomographic arthrography (CT arthrography) was very early proved to be useful for the study of cartilage [5–7]. Although magnetic resonance imaging (MRI) is now considered to be the technique of choice for the assessment of the structure of cartilage (including biochemical analysis) and intrachondral lesions [8, 9], CT arthrography gained new interest with the advent of multidetector computer tomography (MDCT). This technique provides true isotropic imaging, with the possibility of high-resolution multiplanar reformatting [10]. It thus allows the evaluation of the entire joint cartilage and not only of cartilage areas perpendicular to the acquisition plane as with conventional CT arthrography [11]. In comparison to magnetic resonance imaging arthrography (MR arthrography), studies have shown that CT arthrography is at least as accurate, sensitive, and specific for the evaluation of cartilage thickness [12, 13], surface cartilage lesions, and cartilage loss [14, 15]. CT arthrography is indicated for the study of joint surfaces whenever MR arthrography cannot be ­performed, either because it is less available as in some countries, or contraindicated, or technically impossible (e.g., with obese or claustrophobic patients; presence of metallic hardware) [16]. Its main drawbacks remain, however, the exposition to ionizing radiation and the need for a joint puncture.

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  1. Department of Radiology and Medical Imaging, Cliniques Universitaires Saint-Luc – UCLouvain, Avenue Hippocrate 10/2942, B-1200, Brussels, Belgium

    Frédéric E. Lecouvet

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  1. Patrick Omoumi
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Correspondence to Frédéric E. Lecouvet .

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  1. Dept. Radiology, University of California, San Francisco, 400 Parnassus Ave., A-367, San Francisco, 94143-0628, California, USA

    Thomas M. Link

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Omoumi, P., Berg, B.C.V., Lecouvet, F.E. (2011). Value of CT Arthrography in the Assessment of Cartilage Pathology. In: Link, T. (eds) Cartilage Imaging. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-8438-8_5

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