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T2 mapping in patellar chondromalacia.

Fernando Ruiz Santiago1, Rocío Pozuelo Calvo2, Julio Almansa López3

  • 1Department of Radiology, Traumatology Hospital, University Hospital Virgen de las Nieves, Granada, SPAIN.

European Journal of Radiology
|April 10, 2014
PubMed
Summary

T2 relaxation times in patellar cartilage increase with mild chondromalacia but decrease in severe stages, indicating early degeneration. This MRI finding helps assess cartilage health.

Keywords:
CartilageChondromalacia patellaeMagnetic resonance imagingT2 mappingT2 relaxation time

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Area of Science:

  • Orthopedics and Sports Medicine
  • Radiology and Medical Imaging
  • Biomedical Engineering

Background:

  • Chondromalacia, a common cause of anterior knee pain, involves the degeneration of patellar cartilage.
  • Magnetic Resonance Imaging (MRI) is crucial for evaluating cartilage morphology and integrity.
  • T2 relaxation time mapping is a quantitative MRI technique sensitive to changes in cartilage matrix composition.

Purpose of the Study:

  • To investigate the correlation between T2 relaxation times of the patellar cartilage and the severity of chondromalacia as assessed by morphological MRI findings.
  • To determine if T2 mapping can differentiate between normal cartilage and various stages of chondromalacia.

Main Methods:

  • A prospective study involving 50 patients (27 men, 23 women) with anterior knee pain.
  • 97 knee MRIs were acquired at 1.5T, including T2 mapping sequences.
  • Patellar cartilage was segmented into 12 regions, and T2 relaxation times were measured for each area.
  • Chondromalacia severity was graded using a modified Noyes classification.

Main Results:

  • T2 values significantly increased in mild chondromalacia compared to normal cartilage in most patellar cartilage areas (p<0.05).
  • Severe chondromalacia showed a decrease in T2 relaxation times, approaching normal values, except in the external middle central (EMC) and internal middle central (IMC) areas.
  • Exceptions to the T2 increase in mild chondromalacia included specific distal and proximal regions (IDC, IDM, EPC, EDL, IMM).

Conclusions:

  • An increase in patellar cartilage T2 values is indicative of early-stage chondromalacia.
  • As chondromalacia progresses to severe stages, T2 relaxation times tend to decrease, nearing baseline values in most areas.
  • The central area of the middle patellar cartilage section (EMC and IMC) may retain elevated T2 values even in severe chondromalacia, suggesting persistent matrix changes.