Abstract

Objective: Primary goal of this prospective study was to compare fat-suppressed three-dimensional water selective cartilage scan (3D_WATSc) MR imaging with standard MR imaging for detection of defects in the hyaline cartilage of the knee, using arthroscopy as the reference standard.

Methods: 40 patients who were referred for knee MRI by orthopedic surgeons before arthroscopy were included in the study. Chondomalacia was diagnosed in 19 of these patients by artroscopy and builded the mainframe of the study. Hyaline cartilage damage was imaged 3D_WATSc  sequence with the appropriate parameters. Standard MRI imaging of the knee consisted of two-dimensional coronal T1- weighted spin-echo, coronal, and sagittal T2- weighted spin-echo, sagittal and axial SPR sequences. With arthroscopy as the gold standard, sensitivity and specificity of 3D_WATSc and standard MR imaging for detecting cartilage damage were determined in six articular surfaces (patellar facets, trochlear facets, femoral condyles, and tibial plateos).

Results: 240 cartilage surface in 40 patients were evaluated by arthroscopy and 28 of them had shown to have chondromalacia. 3D_WATSc had higher sensitivity and specificity (92%, 96%) than standard MR images (%60, 95%, p<0,05) and also were more successful in detection of early stage (stage 1-2) cartilage defects than standart MR images and arthroscopy (p<0.05).

Conclusion: 3D_ WATSc MRI sequence is more sensitive than standard MR imaging for the detection of abnormalities of the hyaline cartilage in the knee. Routine use of this low-cost technique in addition to standart imaging strengthens the role of non-invasive MR imaging in evaluation of cartilage damages.