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Rofo 2001; 173(4): 279-288
DOI: 10.1055/s-2001-12456
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© Georg Thieme Verlag Stuttgart · New York

Gelenkknorpel in der MR-Tomographie

MR imaging of articular cartilageF. K. W. Schäfer, C. Muhle, M.  Heller, J. Brossmann
  • Klinik für Diagnostische Radiologie der Christian-Albrechts-Universität zu Kiel
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Publication History

Publication Date:
31 December 2001 (online)

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Zusammenfassung.

Die MR-Tomographie hat sich zur besten nichtinvasiven bildgebenden Methode für die Untersuchung von Gelenkknorpel entwickelt. Die MR-Tomographie liefert einen Beitrag zum Verständnis der Knorpelstruktur und der Physiologie sowie zur Diagnostik von Knorpelschäden. Zahlreiche MR-Studien konnten eine hohe Genauigkeit und Zuverlässigkeit bei der Detektion chondraler Läsionen sowie früher Veränderungen struktureller und biochemischer Natur zeigen. Neben einem hohen Kontrast/Rausch-Verhältnis ist für die Gelenkknorpelanalyse eine hohe räumliche Auflösung erforderlich. Im klinischen Routinebetrieb empfehlen sich für die Erkennung von Knorpelläsionen besonders fettunterdrückte 3D-T1-gewichtete Gradientenecho- und T2-gewichtete Fastspinecho-Sequenzen mit oder ohne Fettunterdrückung. Die vorliegende Arbeit geht auf die Anatomie und Pathologie des hyalinen Gelenkknorpels ein und diskutiert das komplexe MR-Signalverhalten.

MR imaging of articular cartilage.

MR imaging has evolved to the best non-invasive method for the evaluation of articular cartilage. MR imaging helps to understand the structure and physiology of cartilage, and to diagnose cartilage lesions. Numerous studies have shown high accuracy and reliability concerning detection of cartilage lesions and early changes in both structure and biochemistry. High contrast-to-noise ratio and high spatial resolution are essential for analysis of articular cartilage. Fat-suppressed 3D-T1 weighted gradient echo and T2-weighted fast spin echo sequences with or without fat suppression are recommended for clinical routine. In this article the anatomy and pathology of hyaline articular cartilage and the complex imaging characteristics of hyaline cartilage will be discussed.

Schlüsselwörter:

Magnetresonanztomographie - Knorpel - Physiologie - Pathologie - MR-Arthrographie

Key words:

Magnetic resonance imaging - Cartilage - Physiology - Pathology - MR-arthrography

Literatur

  • 1 Balkissoon A. MR imaging of cartilage: Evaluation and comparison of MR imaging techniques.  Top Magn Reson lmaging. 1996;  8 ((1)) 57-67
    PubMedGoogle Scholar
  • 2 Erickson S J. High-resolution imaging of the musculosceletal system.  Radiology. 1997;  205 ((39)) 593-618
    PubMedGoogle Scholar
  • 3 Recht M P, Resnick D. MR imaging of articular cartilage: current status and future directions.  AJR Am J Roentgenol. 1994;  163 ((2)) 283-290
    CrossrefPubMedGoogle Scholar
  • 4 Hunziger E B. Articular cartilage structure in humans and experimental animals. In: Kuettner KE, Schleyerbach R, Peyron JG, Hascall VC (eds). Articular cartilage and osteocarthritis.  New York; Raven Press 1992: 183-199
    Google Scholar
  • 5 Akeson W H, Amiel D A, Gershuni D H. Articular cartilage physiology and metabolism. In: Resnick D (ed) Diagnosis of bone and joint disorders, 3rd ed.  Philadelphia; WB Saunders 1995: 769-790
    Google Scholar
  • 6 Buckwalter J A, Hunziker E B, Rosenberg L C, Coutts R D, Adams M E, Eyre D R. Articular cartilage: Composition and structure. In: Woo SL-Y, Buckwalter JA (eds) Injury and repair of the musculosceletal soft tissues.  Park Ridge, IL; The American Academy of Orthopedic Surgeons 1988: 405-425
    Google Scholar
  • 7 Buckwalter J A, Mankin H J. Articular cartilage. Part 1: Tissue design and chondrocyte-matrix interactions.  J Bone Joint Surg. 1997;  79A 600-611
    PubMedGoogle Scholar
  • 8 Loeuille D, Olivier P, Mainard D, Gillet P, Netter P, Blum A. Review: Magnetic resonance imaging of normal and osteocarthritic cartilage.  Arthritis Rheum. 1998;  41 ((6)) 963-975
    CrossrefPubMedGoogle Scholar
  • 9 Modl J M, Sether L A, Haughton V M, Kneeland J B. Articular cartilage: correlation of histologic zones with signal intensity at MR imaging.  Radiology. 1991;  181 ((3)) 853-855
    PubMedGoogle Scholar
  • 10 Waldschmidt J G, Rilling R J, Kajdascy-Balla A A, Boynton M D, Erickson S J. In vitro and in vivo MR imaging of hyaline cartilage: zonal anatomy, imaging pitfalls, and pathologic conditions.  Radiographics. 1997;  17 ((6)) 1387-1402
    CrossrefPubMedGoogle Scholar
  • 11 Erickson S J, Prost R W, Timins M E. The “magic angle” effect: background, physics and clinical relevance.  Radiology. 1993;  188 ((1)) 23-25
    CrossrefPubMedGoogle Scholar
  • 12 Gray M L, Burstein D, Lesperance L M, Gehrke L. Magnetization transfer in cartilage and its constituent macromolecules.  Magn Reson Med. 1995;  34 ((3)) 319-325
    PubMedGoogle Scholar
  • 13 Young I R, Cox I J, Bryant D J, Bydder G M. The benefits of increasing spatial resolution as a means of reducing artifacts due to field inhomogeneities.  Magn Reson Imaging. 1988;  6 585-590
    CrossrefPubMedGoogle Scholar
  • 14 Erickson S J, Waldschmidt J G, Czervionke L F, Prost R W. Hyaline cartilage: truncation artifact as a cause of trilaminar appearance with fat-suppressed three-dimensional spoiled gradient-recalled sequences.  Radiology. 1996;  201 ((1)) 260-264
    PubMedGoogle Scholar
  • 15 Frank L R, Brossmann J, Buxton R B, Resnick D. MR imaging truncation artifacts can create a false laminar appearance in cartilage.  AJR Am J Roentgenol. 1997;  168 ((2)) 547-554
    CrossrefPubMedGoogle Scholar
  • 16 Hayes C, Sawyer R, Conway W. Patellar cartilage lesions: In vitro detection and staging with MR imaging and pathologic correlation.  Radiology. 1990;  176 ((2)) 479-483
    PubMedGoogle Scholar
  • 17 Lehner K B, Rechl H P, Gmeinwieser J K, Heuck A F, Lukas H P, Kohn H P. Structure, function, and degeneration of bovine hyaline cartilage: assessment with MR in vitro.  Radiology. 1989;  170 ((2)) 495-499
    PubMedGoogle Scholar
  • 18 Cova M, Toffanin R, Frezza F, Pozzi-Mucelli M, Mlynarik V, Pozzi-Mucelli R S, Vittur F, Dalla-Palma L. Magnetic resonance imaging of articular cartilage: ex vivo study on normal cartilage correlated with magnetic resonance microscopy.  Eur Radiol. 1998;  8 ((7)) 1130-1136
    CrossrefPubMedGoogle Scholar
  • 19 Rubenstein J D, Kim J K, Morava-Protzner I, Stanchev P L, Henkelman R M. Effects of collagen orientation on MR imaging characteristics of bovine articular cartilage.  Radiology. 1993;  188 ((1)) 219-226
    PubMedGoogle Scholar
  • 20 Recht M P, Kramer J, Marcelis S, Pathria M N, Trudell D, Haghighi P, Sartoris D J, Resnick D. Abnormalities of articular cartilage in the knee : analysis of available MR techniques.  Radiology. 1993;  187 ((2)) 473-478
    PubMedGoogle Scholar
  • 21 Rubenstein J D, Kim J K, Henkelman R M. Effects of compression and recovery on bovine articular cartilage: Appearance on MR images.  Radiology. 1996;  201 ((3)) 843-850
    PubMedGoogle Scholar
  • 22 Foster J E, Maciewicz R A, Taberner J, Dieppe P A, Freemont A J, Keen M C, Watt I, Waterton J C. Structural periodicity in human articular cartilage: comparison between magnetic resonance imaging and histological findings.  Osteoarthritis Cartilage. 1999;  7 ((5)) 480-485
    PubMedGoogle Scholar
  • 23 Minns R J, Steven F S, Hardinge K. Osteoarthritic articular cartilage lesions of the femoral head observed with scanning electron microscopy.  J Pathol. 1977;  122 63-70
    PubMedGoogle Scholar
  • 24 Noyes F R, Stabler C L. A system for grading articular cartilage lesions at arthroscopy.  Am J Sports Med. 1989;  17 505-513
    CrossrefPubMedGoogle Scholar
  • 25 Disler D G, McCauley T R, Kelman C G, Fuchs M D, Ratner L M, Wirth C R, Hospodar P P. 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. 1996;  167 ((1)) 127-132
    CrossrefPubMedGoogle Scholar
  • 26 Disler D G, Mc Cauley T R, Wirth C R, Fuchs M D. 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. 1995;  165 ((2)) 377-382
    CrossrefPubMedGoogle Scholar
  • 27 Disler D G, Peters T L, Muscoreil S J, Ratner L M, Wagle W A, Cousins J P, Rifkin M D. Fat-suppressed spoiled GRASS imaging of knee hyaline cartilage: technique optimization and comparison with conventional MR imaging.  AJR Am J Roentgenol. 1994;  163 ((4)) 887-892
    CrossrefPubMedGoogle Scholar
  • 28 Rand T, Brossmann J, Pedowitz R, Ahn J M, Haghigi P, Resnick D. Analysis of patellar cartilage - Comparison of conventional MR imaging and MR and CT arthrography in cadavers.  Acta Radiol. 2000;  41 492-497
    CrossrefPubMedGoogle Scholar
  • 29 Recht M, Piraino D, Paletta G, Schils J, Belhobek G. Accuracy of fat-suppressed three-dimensional spoiled gradient-echo FLASH MR imaging in the detection of patellofemoral articular cartilage abnormalities.  Radiology. 1996;  198 ((1)) 209-212
    PubMedGoogle Scholar
  • 30 Hasegawa Y, Fukatsu H, Matsuda T, lwase T, lwata H. Magnetic resonance imaging in osteoarthrosis of the dysplastic hip.  Arch Orthop Trauma Surg. 1996;  115 243-248
    PubMedGoogle Scholar
  • 31 Hodler J, Trudell D, Pathria M N, Resnick D. Width of the articular cartilage of the hip: quantification by using fat-suppression spin-echo MR imaging in cadavers.  Am J Roentgenol. 1992;  159 351-355
    PubMedGoogle Scholar
  • 32 Hodler J, Loredo R A, Longo C, Trudell D, Yu J S, Resnick D. Assessment of articular cartilage thickness of the humeral head: MR-anatomic correlation in cadavers.  Am J Roentgenol. 1995;  165 615-620
    PubMedGoogle Scholar
  • 33 Tan T C, Wilcox D M, Frank L, Shih C, Trudell D J, Sartoris D J, Resnick D. MR imaging of articular cartilage in the ankle: comparison of available imaging sequences and methods of measurement in cadavers.  Skeletal Radiol. 1996;  25 749-755
    CrossrefPubMedGoogle Scholar
  • 34 Trattnig S, Breitenseher M J, Huber M, Zetti R, Rottmann B, Hailer J, Imhof H. Bestimmung der Knorpeldicke am oberen Sprunggelenk. Eine MRT (1,5T)-anatomische Vergleichsstudie.  RöFo. 1997;  166 303-306
    PubMedGoogle Scholar
  • 35 Hodler J, Berthiaume M J, Schweitzer M E, Resnick D. Knee joint hyaline cartilage defects: a comparative study of MR and anatomic sections.  J Comput Assist Tomogr. 1992;  16 ((4)) 597-603
    PubMedGoogle Scholar
  • 36 Gagliardi J A, Chung E M, Chandnani V P, Kesling K L, Christensen K P, Null R N, Radvany M G, Hansen M F. Detection and staging of chondromalacia patellae: relative efficacies of conventional MR imaging, MR arthrography, and CT arthrography.  AJR Am J Roentgenol. 1994;  163 ((3)) 629-636
    PubMedGoogle Scholar
  • 37 Mc Cauley M R, Kier R, Lynch K J, Jokl P. Chondromalacia patellae: Diagnosis with MR imaging.  AJR Am J Roentgenol. 1992;  158 ((9)) 101-105
    PubMedGoogle Scholar
  • 38 Broderick L S, Turner D A, Renfrew D L, Schnitzer T J, Huff J P, Harris C. Severity of articular cartilage abnormality in patients with osteoarthritis: evaluation with fast spin-echo MR vs arthroscopy.  AJR Am J Roentgenol. 1994;  162 ((1)) 99-103
    PubMedGoogle Scholar
  • 39 Rose P M, Demlow T A, Szumowski J, Quinn S F. Chondromalacia patellae: fat-suppressed MR imaging.  Radiology. 1994;  193 ((2)) 437-440
    PubMedGoogle Scholar
  • 40 Potter H G, Linklater J M, Allen A A, Hannafin J A, Haas S B. Magnetic resonance imaging of articular cartilage in the knee: An evaluation with use of fast-spin-echo imaging.  J Bone Joint Surg Am. 1998;  80 ((9)) 1276-1284
    CrossrefPubMedGoogle Scholar
  • 41 Yao L, Gentili A, Thomas A. Incidental magnetization transfer contrast in fast spin-echo imaging of cartilage.  J Magn Reson Imaging. 1996;  6 180-184
    PubMedGoogle Scholar
  • 42 Mosher T J, Pruett S W. Magnetic resonance imaging of superficial cartilage lesions: role of contrast in lesion detection.  J Magn Reson Imaging. 1999;  10 178-182
    CrossrefPubMedGoogle Scholar
  • 43 Peterfy C G, Majumdar S, Lang P, van Dijke C F, Sack K, Genant H K. MR imaging of the arthritic knee : improved discrimination of cartilage, synovium and effusion with pulsed saturation transfer and fat-suppressed T1-weighted sequences.  Radiology. 1994;  191 ((2)) 413-419
    PubMedGoogle Scholar
  • 44 Bachmann G, Heinrichs C, Jurgensen I, Rominger M, Scheiter A, Rau W S. Vergleich von verschiedenen MRT-Techniken in der Diagnose von degenerativen Knorpelerkrankungen - In-vitro-Studie an 50 Gelenkpräparaten des Knies bei 1,5 T.  Fortschr Röntgenstr. 1997;  166 ((5)) 429-436
    PubMedGoogle Scholar
  • 45 Vahlensieck M, Dombrowski F, Leutner C, Wagner U, Reiser M. Magnetization transfer contrast (MTC) and MTC-subtraction: enhancement of cartilage lesions and intracartilaginous degeneration in vitro.  Skeletal Radiol. 1994;  23 535-539
    PubMedGoogle Scholar
  • 46 Brossmann J, Frank L R, Pauly J M, Boutin R D, Pedowitz R A, Haghighi P, Resnick D. Short echo time projection reconstruction MR imaging of cartilage: comparison with fat-suppressed spoiled GRASS and magnetization transfer contrast MR imaging.  Radiology. 1997;  203 ((2)) 501-507
    PubMedGoogle Scholar
  • 47 Cova M, Toffanin R, Szornolanyi P, Vittur F, Pozzi-Mucelli R S, Jellus V, Silvestri F, Dalla-Palma L. Short-TE projection reconstruction MR microscopy in the evaluation of articular cartilage thickness.  Eur Radiol. 2000;  10 1222-1226
    CrossrefPubMedGoogle Scholar
  • 48 Xia Y, Farquhar T, Burton-Wurster N, Ray E, Jelinski L. Diffusion and relaxation mapping of cartilage-bone plugs and excised disks using microscopic magnetic resonance imaging.  Magn Reson Med. 1994;  31 (3) 273-282
    PubMedGoogle Scholar
  • 49 Freeman D, Bergman G, Glover G. Short TE MR microscopy: accurate measurement and zonal differentiation of normal hyaline cartilage.  Magn Reson Med. 1997;  38 ((1)) 72-81
    PubMedGoogle Scholar
  • 50 Fischer A E, Carpenter T A, Tyler J A, Hall L D. Visualisation of mass transport of small organic molecules and metal ions through articular cartilage by magnetic resonance imaging.  Magn Reson Imaging. 1995;  13 ((6)) 819-826
    PubMedGoogle Scholar
  • 51 Frank L R, Wong E C, Luh W M, Ahn J M, Resnick D. Articular cartilage in the knee: mapping of the physiological parameters at MR imaging with a local gradient coil-preliminary results.  Radiology. 1999;  210 ((1)) 241-246
    PubMedGoogle Scholar
  • 52 Burstein D, Gray M L, Hartman A L, Gipe R, Foy B D. Diffusion of small solutes in cartilage as measured by nuclear magnetic resonance (NMR) spectroscopy and imaging.  J Orthop Res. 1993;  11 ((4)) 465-478
    CrossrefPubMedGoogle Scholar
  • 53 Frank L R, Wong E C, Buxton R B, Resnick D. Mapping the physiological parameters of articular cartilage with magnetic resonance imaging.  Top Magn Reson Imaging. 1999;  10 ((3)) 153-179
    PubMedGoogle Scholar
  • 54 Kramer J, Recht M P, Imhof H, Stiglbauer R, Engel A. Postcontrast MR arthrography in assessment of cartilage lesions.  J Comput Assist Tomogr. 1994;  18 ((2)) 218-224
    CrossrefPubMedGoogle Scholar
  • 55 Winalski C S, Aliabadi P, Wright R J, Shortkroff S, Sledge C B, Weissman B N. Enhancement of joint fluid with intravenously administered gadopentetate dimeglumine: technique, rationale and implications.  Radiology. 1993;  187 ((1)) 179-185
    PubMedGoogle Scholar
  • 56 Bashir A, Gray M L, Boutin R D, Burstein D. Glycosaminoglycan in articular cartilage: in vivo assessment with delayed Gd(DTPA)2- enhanced MR imaging.  Radiology. 1997;  205 ((2)) 551-558
    CrossrefPubMedGoogle Scholar
  • 57 Allen R G, Burstein D, Gray M L. Monitoring glycosaminoglycan replenishment in cartilage explants with gadolinium-enhanced magnetic resonance imaging.  J Orthop Res. 1999;  17 ((3)) 430-436
    CrossrefPubMedGoogle Scholar
  • 58 Andresen R, Radmer S, König H, Banzer D, Wolf K J. MR diagnosis of retropatellar chondral lesions under compression. A comparison with histological findings.  Acta Radiol. 1996;  37 91-97
    PubMedGoogle Scholar
  • 59 Andresen R, Radmer S, König H, Wolf K J. MRT-spezifische Einteilung der Chondromalacia patellae unter Zuhilfenahme eines speziellen Kniekompressors: Gegenüberstellung mit dem arthroskopischen Befund.  RöFo. 1993;  159 541-547
    PubMedGoogle Scholar

PD Dr. med. Joachim Brossmann

Klinik für Diagnostische Radiologie
der Christian Albrechts Universität Kiel

Arnold-Heller-Straße 9

24105 Kiel

Phone: 0431-597-3153

Fax: 0431-597-3151

Email: jbrossma@rad.uni-kiel.de

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