POSTCONTRAST MR ARTHROGRAPHY IN ASSESSMENT OF CARTILAGE LESIONS

Objective: Although MR has been proven effective in evaluating many co mponents of the musculoskeletal system, including ligaments, fibrocart ilage, muscle, and bone marrow, its role in the evaluation of articula r cartilage remains controversial. Recent studies have demonstrated th at intraarticular injection of Gd-DTPA [MR arthrography (MRA)] improve s the detection of cartilage abnormalities in cadaveric specimens. The aim of this study was to determine the efficacy of MRA for the detect ion of naturally occurring cartilage lesions in a clinical population. Materials and Methods: Sixty knees of 58 patients were studied with a three-dimensional (3D) T2-weighted GE sequence (FISP) both before an d after and a T1-weighted (T1W) SE sequence after the intraarticular i njection of a 2 mmol/L Gd-DTPA solution. All knees subsequently underw ent arthroscopy or arthrotomy. Results: The MRA sequences performed si gnificantly better(K = 0.85) than the routine FISP sequences (K = 0.39 ) in both the detection and the staging of cartilage abnormalities. Th e MRA FISP sequence (K = 0.91) performed slightly better than the MRA T1W sequence (K = 0.85), but there was no statistically significant di fference between the two sequences. No complications from the intraart icular injection of contrast material occurred. Conclusion: Therefore, MRA appears to be an effective and safe method for the evaluation of articular cartilage abnormalities.