Abstract
A blind and prospective study was conducted to assess the accuracy of magnetic resonance imaging (MRI) for diagnosing patellar cartilage lesions. Thirty-three consecutive patients undergoing knee arthroscopy were examined by MRI prior to surgery. Imaging was performed in the axial plane on a 1.5-Tesla unit with spinecho and gradient-echo T1 and T2 sequences. The MRI and arthroscopic data were compared using a four-grade classification and a patellar map which divided the patellar surface into four quadrants. The overall sensitivity of MRI was 84.7% and the specificity 97.2%. The same pit-fall led to two MRI false positives. A perfect correlation of grading was obtained in 76.5%. When discordance was found, the tendency with MRI was commonly to underestimate the grade of the lesions. The MRI accuracy was high in this study in spite of a high rate of low-grade lesions which are difficult to assess. Related criteria for cartilage assessment with MRI and arthroscopy are suggested for further studies.
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References
Ficat RP, Hungerford DS (1977) Chondrosis and arthrosis, a hypothesis. In: Disorders of the patellofemoral joint. Williams & Wilkins, Baltimore, pp 194–243
Gylis-Morin VM, Hajek PC, Sartoris DJ, Resnick D (1987) Articular cartilage defects: detectability in cadaver knees with MR. AJR 148:1153–1157
Hajek PC, Baker LL, Sartoris DJ et al (1987) MR arthrography: anatomic-pathologic investigation. Radiology 163:141–147
Handelberg F, Shahabpour M, Casteleyn PP (1990) Chondral lesions of the patella evaluated with computed tomography, magnetic resonance imaging and arthroscopy. Arthroscopy 6: 24–29
Hayes CW, Sawyer RW, Conway WF (1990) Patellar cartilage lesions: in vitro detection and staging with MR imaging and pathologic correlation. Radiology 176:479–483
Heron CW, Calvert PT (1992) Three-dimensional gradientecho images MR imaging of the knee: comparison with arthroscopy in 100 patients. Radiology 183:839–844
Insall JN (1984) Disorders of the patella. In: Surgery of the knee, 1st edn. Churchill Livingstone, New York, pp 191–260
Konig H, Dinkelaker F, Wolf KJ (1991) The optimisation of chondromalacia patellae diagnosis by NMR tomography. The use of an apparatus for cartilage compression. ROFO 155: 142–148
McCauley R, Kier R, Lynch KJ, Jokl P (1992) Chondromalacia patellae: diagnosis with MR imaging. AJR 158:101–105
Mink JM, Levy T, Crues JV (1988) Tears of the anterior cruciate ligament and menisci of the knee: MR imaging evaluation. Radiology 167:769–775
Nakanishi K, Inoue M, Harada K et al (1992) Subluxation of the patella: evaluation of patellar articular cartilage with MR imaging. Br J Radiol 65:662–667
Noyes FR, Graig LS (1989) A system for grading articular cartilage lesions at arthroscopy. Am J Sports Med 17:505–513
Ochi PD, Yoshio S, Tsukasa K et al (1994) The diagnostic value and limitation of magnetic resonance imaging on chondral lesions in the knee joint. Arthroscopy 10:176–183
Outerbridge RE, Dunlop J (1975) The problem of chondromalacia of the patellae. Clin Orthop 110:177–196
Peterfy SG, Majumdar S, Lang P et al (1994) MR imaging of the arthritic knee: improved discrimination of cartilage, synovium, and effusion with pulsed aturation transfer and fat suppressed T1-weighted sequences. Radiology 191:413–419
Recht MP, Kramer J, Marcelis S et al (1993) Abnormalities of cartilage in the knee: analysis of available MR techniques. Radiology 187:473–478
Shahriaree H (1985) Chondromalacia. Contemp Orthop 11: 27–39
Speer KP, Spizer CE, Goldner JL, Garett WE (1991) Magnetic resonance imaging of traumatic knee articular injuries. Am J Sports Med 19:396–402
Terry GC, Flandry F, Van Manen JW et al (1988) Isolated chondral fractures of the knee. Clin Orthop 234:170–177
Wojtys E, Wilson M, Buckwalter K et al (1987) Magnetic resonance imaging of knee hyaline cartilage and intraarticular pathology. Am J Sports Med 15:455–463
Yulish BS, Montanez J, Goodfellow DB et al (1987) Chondromalacia patellae: assessment with MR imaging. Radiology 164:763–766
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Vallotton, J.A., Meuli, R.A., Leyvraz, P.F. et al. Comparison between magnetic resonance imaging and arthroscopy in the diagnosis of patellar cartilage lesions. Knee Surg, Sports traumatol, Arthroscopy 3, 157–162 (1995). https://doi.org/10.1007/BF01565475
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DOI: https://doi.org/10.1007/BF01565475