nach oben

Knee Surgery, Sports Traumatology, Arthroscopy

Erschienen in:

01.12.2012 | Knee

Accuracy of magnetic resonance imaging, magnetic resonance arthrography and computed tomography for the detection of chondral lesions of the knee

verfasst von: Toby O. Smith, Benjamin T. Drew, Andoni P. Toms, Simon T. Donell, Caroline B. Hing

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 12/2012

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To assess the diagnostic test accuracy of magnetic resonance imaging (MRI), magnetic resonance arthrography (MRA) and computed tomography arthrography (CTA) for the detection of chondral lesions of the patellofemoral and tibiofemoral joints.

Methods

A review of published and unpublished literature sources was conducted on 22nd September 2011. All studies assessing the diagnostic test accuracy (sensitivity/specificity) of MRI or MRA or CTA for the assessment of adults with chondral (cartilage) lesions of the knee (tibiofemoral/patellofemoral joints) with surgical comparison (arthroscopic or open) as the reference test were included. Data were analysed through meta-analysis.

Results

Twenty-seven studies assessing 2,592 knees from 2,509 patients were included. The findings indicated that whilst presenting a high specificity (0.95–0.99), the sensitivity of MRA, MRI and CTA ranged from 0.70 to 0.80. MRA was superior to MRI and CTA for the detection of patellofemoral joint chondral lesions and that higher field-strength MRI scanner and grade four lesions were more accurately detected compared with lower field-strength and grade one lesions. There appeared no substantial difference in diagnostic accuracy between the interpretation from musculoskeletal and general radiologists when undertaking an MRI review of tibiofemoral and patellofemoral chondral lesions.

Conclusions

Specialist radiological imaging is specific for cartilage disease in the knee but has poorer sensitivity to determine the therapeutic options in this population. Due to this limitation, there remains little indication to replace the ‘gold-standard’ arthroscopic investigation with MRI, MRA or CTA for the assessment of adults with chondral lesions of the knee.

Level of evidence

II.

Adams ME, Li DK, McConkey JP, Davidson RG, Day B, Duncan CP et al (1991) Evaluation of cartilage lesions by magnetic resonance imaging at 0.15 T: comparison with anatomy and concordance with arthroscopy. J Rheumatol 18:1573–1580PubMed

Bland M (2000) Introduction to medical statistics, 3rd edn. Oxford University Press, Oxford

Bredella MA, Tirman PF, Peterfy CG, Zarlingo M, Feller JF, Bost FW et al (1999) Accuracy of T2-weighted fast spin-echo MR imaging with fat saturation in detecting cartilage defects in the knee: comparison with arthroscopy in 130 patients. AJR Am J Roentgenol 172:1073–1080PubMed

Broderick LS, Turner DA, Renfrew DL, Schnitzer TJ, Huff JP, Harris C (1994) Severity of articular cartilage abnormality in patients with osteoarthritis: evaluation with fast spin-echo MR vs arthroscopy. AJR Am J Roentgenol 162:99–103PubMed

Burstein D, Gray M (2003) New MRI techniques for imaging cartilage. J Bone Joint Surg 85-A(Suppl 2):70–77PubMed

Cardello P, Gigli C, Ricci A, Chiatti L, Voglino N, Pofi E (2009) Retears of postoperative knee meniscus: findings on magnetic resonance imaging (MRI) and magnetic resonance arthrography (MRA) by using low and high field magnets. Skeletal Radiol 38:149–156PubMedCrossRef

Crawford R, Walley G, Bridgman S, Maffulli N (2007) Magnetic resonance imaging versus arthroscopy in the diagnosis of knee pathology, concentrating on meniscal lesions and ACL tears: a systematic review. Br Med Bull 84:5–23PubMedCrossRef

Crema MD, Roemer FW, Marra MD, Burstein D, Gold GE, Eckstein F et al (2011) Articular cartilage in the knee: current MR imaging techniques and applications in clinical practice and research. Radiographics 31:37–61PubMedCrossRef

Disler DG, McCauley TR, Kelman CG, Fuchs MD, Ratner LM, Wirth CR et al (1996) Fat-suppressed three-dimensional spoiled gradient-echo MR imaging of hyaline cartilage defects in the knee: comparison with standard MR imaging and arthroscopy. AJR Am J Roentgenol 167:127–132PubMed

10.

Disler DG, McCauley TR, Wirth CR, Fuchs MD (1995) Detection of knee hyaline cartilage defects using fat-suppressed three-dimensional spoiled gradient-echo MR imaging: comparison with standard MR imaging and correlation with arthroscopy. AJR Am J Roentgenol 165:377–382PubMed

11.

Eckstein F, Charles HC, Buck RJ, Kraus VB, Remmers AE, Hudelmaier M et al (2005) Accuracy and precision of quantitative assessment of cartilage morphology by magnetic resonance imaging at 3.0 T. Arthritis Rheum 52:3132–3136PubMedCrossRef

12.

Figueroa D, Calvo R, Vaisman A, Carrasco MA, Moraga C, Delgado I (2007) Knee chondral lesions: incidence and correlation between arthroscopic and magnetic resonance findings. Arthroscopy 23:312–315PubMedCrossRef

13.

Flanigan DC, Harris JD, Trinh TQ, Siston RA, Brophy RH (2010) Prevalence of chondral defects in athletes’ knees: a systematic review. Med Sci Sports Exerc 42:1795–1801PubMedCrossRef

14.

Friemert B, Oberländer Y, Schwarz W, Häberle HJ, Bähren W, Gerngross H et al (2004) Diagnosis of chondral lesions of the knee joint: can MRI replace arthroscopy? A prospective study. Knee Surg Sports Traumatol Arthrosc 12:58–64PubMedCrossRef

15.

Gagliardi JA, Chung EM, Chandnani VP, Kesling KL, Christensen KP, Null RN et al (1994) Detection and staging of chondromalacia patellae: relative efficacies of conventional MR imaging, MR arthrography, and CT arthrography. AJR Am J Roentgenol 163:629–636PubMed

16.

Ghanem I, Abou Jaoude S, Kharrat K, Dagher F (2002) Is MRI effective in detecting intraarticular abnormalities of the injured knee? J Med Liban 50:168–174PubMed

17.

Giovagnoni A, Valeri G, Ercolani P, Paci E, Carloni S, Soccetti A (1995) Magnetic resonance arthrography in chondral disease of the knee. Radiol Med 90:219–225PubMed

18.

Gold GE, Bergman AC, Pauly JM, Lang P, Butts RK, Beaulieu CF et al (1998) Magnetic resonance imaging of knee cartilage repair. Top Magn Imaging 9:377–392

19.

Gückel C, Jundt G, Schnabel K, Gächter A (1995) Spin-echo and 3D gradient-echo imaging of the knee joint: a clinical and histopathological comparison. Eur J Radiol 21:25–33PubMedCrossRef

20.

Gylys-Morin VM, Hajek PC, Sartoris DJ, Resnick D (1987) Articular cartilage defects: detectability in cadaver knees with MR. AJR Am J Roentgenol 45:1153–1157

21.

Harman M, Ipeksoy U, Dogan A, Arslan H, Etlik O (2003) MR arthrography in chondromalacia patellae diagnosis on a low-field open magnet system. Clin Imaging 27:194–199PubMedCrossRef

22.

Heron CW, Calvert PT (1992) Three-dimensional gradient-echo MR imaging of the knee: comparison with arthroscopy in 100 patients. Radiology 183:839–844PubMed

23.

Hodler J, Resnick D (1992) Chondromalacia patellae. AJR Am J Roentgenol 158:106–107PubMed

24.

Hughes RJ, Houlihan-Burne DG (2011) Clinical and MRI considerations in sports-related knee joint cartilage injury and cartilage repair. Semin Musculoskelet Radiol 15:69–88PubMedCrossRef

25.

Kawahara Y, Uetani M, Nakahara N, Doiguchi Y, Nishiguchi M, Futagawa S, Kinoshita Y et al (1998) Fast spin-echo MR of the articular cartilage in the osteoarthritic knee. Correlation of MR and arthroscopic findings. Acta Radiol 39:120–125PubMed

26.

Kettunen JA, Visuri T, Harilainen A, Sandelin J, Kujala UM (2005) Primary cartilage lesions and outcome among subjects with patellofemoral pain syndrome. Knee Surg Sports Traumatol Arthrosc 13:131–134PubMedCrossRef

27.

Lee SH, Suh JS, Cho J, Kim SJ (2001) Evaluation of chondromalacia of the patella with axial inversion recovery-fast spin-echo imaging. J Magn Reson Imaging 13:412–416PubMedCrossRef

28.

Macarini L, Perrone A, Murrone M, Marini S, Stefanelli M (2004) Evaluation of patellar chondromalacia with MR: comparison between T2-weighted FSE SPIR and GE MTC. Radiol Med 108:159–171PubMed

29.

Magee T, Shapiro M, Williams D (2004) Usefulness of simultaneous acquisition of spatial harmonics technique for MRI of the knee. AJR Am J Roentgenol 182:1411–1415PubMed

30.

Murphy BJ (2001) Evaluation of grades 3 and 4 chondromalacia of the knee using T2* weighted 3D gradient echo articular cartilage images. Skeletal Radiol 30:305–311PubMedCrossRef

31.

Noyes FR, Stabler CL (1989) A system for grading articular cartilage lesions at arthroscopy. Am J Sports Med 17:505–513PubMedCrossRef

32.

Oei EH, Nikken JJ, Verstijnen AC, Ginai AZ, Hunink MGM (2003) MR imaging of the menisci and cruciate ligaments: a systematic review. Radiology 226:837–848PubMedCrossRef

33.

Outerbridge RE (1961) The etiology of chondromalacia patellae. J Bone Joint Surg 43-B:752–757

34.

Perdikakis E, Karachalios T, Katonis P, Karantanas A (2011) Comparison of MR-arthrography and MDCT-arthrography for detection of labral and articular cartilage hip pathology. Skeletal Radiol 40:1441–1447PubMedCrossRef

35.

Pihlajamäki HK, Kuikka PI, Leppänen VV, Kiuru MJ, Mattila VM (2010) Reliability of clinical findings and magnetic resonance imaging for the diagnosis of chondromalacia patellae. J Bone Joint Surg 92-A:927–934CrossRef

36.

Rand T, Brossmann J, Pedowitz R, Ahn JM, Haghigi P, Resnick D (2000) Analysis of patellar cartilage. Comparison of conventional MR imaging and MR and CT arthrography in cadavers. Acta Radiol 41:492–497PubMed

37.

Recht MP, Piraino DW, Paletta GA, Schils JP, Belhobek GH (1996) Accuracy of fat-suppressed three-dimensional spoiled gradient-echo FLASH MR imaging in the detection of patellofemoral articular cartilage abnormalities. Radiology 198:209–212PubMed

38.

Recht M, Bobic V, Burstein D, Disler D, Gold G, Gray M (2001) Magnetic resonance imaging of articular cartilage. Clin Orthop Relat Res 391:S379–S396PubMedCrossRef

39.

Reiser M, Karpf PM, Bernett P (1982) Diagnosis of chondromalacia patellae using CT arthrography. Eur J Radiol 2:181–186PubMed

40.

Riel KA, Reinisch M, Kersting-Sommerhoff B, Hof N, Merl T (1999) 0.2-Tesla magnetic resonance imaging of internal lesions of the knee joint: a prospective arthroscopically controlled clinical study. Knee Surg Sports Traumatol Arthrosc 7:37–41PubMedCrossRef

41.

Rosas HG, De Smet AA (2009) Magnetic resonance imaging of the meniscus. Top Magn Reson Imaging 20:151–173PubMedCrossRef

42.

Russell GGQ, Johnson M, Johnston DWC, Arnett G, Swersky J (1994) Imaging studies in surgically proven chondromalacia patellae. Clin J Sport Med 4:11–13CrossRef

43.

Shahriaree H (1985) Chondromalacia. Contemp Orthop 11:27–39

44.

Spahn G, Wittig R, Kahl E, Klinger HM, Mückley T, Hofmann GO (2007) Evaluation of cartilage defects in the knee: validity of clinical, magnetic-resonance-imaging and radiological findings compared with arthroscopy. Unfallchirurg 110:414–424PubMedCrossRef

45.

Tyrrell RL, Gluckert K, Pathria M, Modic MT (1988) Fast three-dimensional MR imaging of the knee: comparison with arthroscopy. Radiology 166:865–872PubMed

46.

Vallotton JA, Meuli RA, Leyvraz PF, Landry M (1995) Comparison between magnetic resonance imaging and arthroscopy in the diagnosis of patellar cartilage lesions: a prospective study. Knee Surg Sports Traumatol Arthrosc 3:157–162PubMedCrossRef

47.

Vande Berg BC, Lecouvet FE, Poilvache P, Maldague B, Malghem J (2002) Spiral CT arthrography of the knee: technique and value in the assessment of internal derangement of the knee. Eur Radiol 12:1800–1810PubMedCrossRef

48.

von Engelhardt LV, Lahner M, Klussmann A, Bouillon B, Dàvid A, Haage P et al (2010) Arthroscopy vs. MRI for a detailed assessment of cartilage disease in osteoarthritis: diagnostic value of MRI in clinical practice. BMC Musculoskelet Disord 20:75CrossRef

49.

von Engelhardt LV, Schmitz A, Burian B, Pennekamp PH, Schild HH, Kraft CN (2008) 3-Tesla MRI vs. arthroscopy for diagnostics of degenerative knee cartilage diseases: preliminary clinical results. Orthopade 37:914–922CrossRef

50.

Whiting P, Rutjes AW, Dinnes J, Reitsma J, Bossuyt PM, Kleijnen J (2004) Development and validation of methods for assessing the quality of diagnostic accuracy studies. Health Technol Assess 8:1–234

51.

Whiting PF, Weswood ME, Rutjes AW, Reitsma JB, Bossuyt PN, Kleijnen J (2006) Evaluation of QUADAS, a tool for the quality assessment of diagnostic accuracy studies. BMC Med Res Methodol 6:9PubMedCrossRef

52.

Yoshioka H, Stevens K, Hargreaves BA, Steines D, Genovese M, Dillingham MF et al (2004) Magnetic resonance imaging of articular cartilage of the knee: comparison between fat-suppressed three-dimensional SPGR imaging, fat-suppressed FSE imaging, and fat-suppressed three-dimensional DEFT imaging, and correlation with arthroscopy. J Magn Reson Imaging 20:857–864PubMedCrossRef

53.

Zaragoza E, Lattanzio PJ, Beaule PE (2009) Magnetic resonance imaging with gadolinium arthrography to assess acetabular cartilage delamination. Hip Int 19:18–23PubMed

Titel: Accuracy of magnetic resonance imaging, magnetic resonance arthrography and computed tomography for the detection of chondral lesions of the knee
verfasst von: Toby O. Smith
Benjamin T. Drew
Andoni P. Toms
Simon T. Donell
Caroline B. Hing
Publikationsdatum: 01.12.2012
Verlag: Springer-Verlag
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 12/2012
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-012-1905-x

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

23.04.2024 | Leitsymptom Rückenschmerzen | Nachrichten

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Accuracy of magnetic resonance imaging, magnetic resonance arthrography and computed tomography for the detection of chondral lesions of the knee

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

Arthropedia

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Ärztliche Empathie hilft gegen Rückenschmerzen

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Vorsicht mit hohen NSAR-Dosen bei ankylosierender Spondylitis!

Brustkrebs in der Vorgeschichte macht Gelenkersatz komplikationsträchtiger

Update Orthopädie und Unfallchirurgie

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 12/2012

Evaluation of echogenic emboli during total knee arthroplasty using transthoracic echocardiography

An arthroscopic pleated capsular shift for recurrent anterior dislocation of the shoulder

Microfracture for knee chondral defects: a survey of surgical practice among Canadian orthopedic surgeons

Fixed versus mobile weight-bearing prosthesis in total knee arthroplasty

A new procedure for tibial spine avulsion fracture fixation

CT measurements prior to computer-assisted total knee arthroplasty do not improve rotational placement of the femoral component

Arthropedia

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Ärztliche Empathie hilft gegen Rückenschmerzen

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Vorsicht mit hohen NSAR-Dosen bei ankylosierender Spondylitis!

Brustkrebs in der Vorgeschichte macht Gelenkersatz komplikationsträchtiger

Update Orthopädie und Unfallchirurgie