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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Musculoskeletal Disorders 1/2015

Diffusion tensor imaging can detect the early stages of cartilage damage: a comparison study

BMC Musculoskeletal Disorders > Ausgabe 1/2015
Taku Ukai, Masato Sato, Tomohiro Yamashita, Yutaka Imai, Genya Mitani, Tomonori Takagaki, Kenji Serigano, Joji Mochida
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

MS, YI, TY, and JM contributed to the conception and design of the study. TU, KS, and TT acquired and analyzed the data. GM, TT, and KS performed the arthroscopic surgery and graded the cartilage damage. TU, TT, KS, and TY measured the areas of cartilage damage on the MRI. TU, MS, KS, and TT contributed to the interpretation of the data. TU wrote the first version of the manuscript, and all other authors revised it critically for important intellectual content. All authors read and approved the final manuscript. All authors agree to be accountable for all aspects of the work.



In the present study, we measured damaged areas of cartilage with diffusion tensor (DT) imaging and T2 mapping, and investigated the extent to which cartilage damage could be determined using these techniques.


Forty-one patients underwent arthroscopic knee surgery for osteoarthritis of the knee, a meniscus injury, or an anterior cruciate ligament injury. Preoperative magnetic resonance imaging of the knee was performed, including T2 mapping and diffusion tensor imaging. The presence of cartilage injury involving the medial and lateral femoral condyles and tibia plateau was assessed during surgery using the Outerbridge scale. The ADC, T2 values and fractional anisotropy of areas of cartilage injury were then retrospectively analysed.


The ADC results identified significant differences between Outerbridge grades 0 and 2 (P = 0.041); 0 and 3 (P < 0.001); 1 and 2 (P = 0.045); 1 and 3 (P < 0.001); and 2 and 3 (P = 0.028). The FA results identified significant differences between grades 0 and 1 (P < 0.001); 0 and 2 (P < 0.001); and 0 and 3 (P < 0.001). T2 mapping identified significant differences between Outerbridge grades 0 and 2 (P = 0.032); 0 and 3 (P < 0.001); 1 and 3 (P < 0.001); and 2 and 3 (P < 0.001). Both the T2 mapping (R2 = 0.7883) and the ADC (R2 = 0.9184) correlated significantly with the Outerbridge grade. The FA (R2 = 0.6616) correlated slightly with the Outerbridge grade.


T2 mapping can be useful for detecting moderate or severe cartilage damage, and the ADC can be used to detect early stage cartilage damage. The FA can also distinguish normal from damaged cartilage.
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