Related Experiment Videos
Degenerative changes of the menisci of the knee. Value of different MR pulse sequences
J Hodler1, P Haghighi, D Trudell
1Department of Radiology, VA Medical Center, San Diego, CA.
Abstract:
Increased meniscal MR signal attributable to meniscal degeneration is a common finding. The role of different MR sequences in the analysis of the extent and distribution of meniscal degeneration in middle-aged and elderly patients has not been thoroughly evaluated. We retrospectively studied the role of different MR sequences in 175 anatomic meniscal sections originating from 20 freshly frozen knees from 10 cadavers using MR-anatomic correlation. T1-weighted and proton-density spin-echo images as well as postprocessed meniscal windows based on T1-weighted spin-echo images proved to be the most reliable in this diagnosis (53.7%, 54.9%, and 53.1% correctly diagnosed meniscal sections, respectively). T2-weighted spin-echo images and gradient-echo images proved to be less reliable (37.1% and 40.0% correctly diagnosed meniscal sections). While the T2-weighted spin-echo images commonly underestimated the extent of meniscal degeneration, gradient-echo images commonly overestimated the extent of such changes. These last two types of sequences should not be used alone in the description of meniscal degeneration.
Insights
T1-weighted and proton-density spin-echo MRI sequences, along with postprocessed meniscal windows, are most reliable for diagnosing meniscal degeneration. T2-weighted and gradient-echo images are less reliable and should not be used alone.
Area of Science:
- Orthopedics
- Radiology
- Medical Imaging
Background:
- Meniscal degeneration is frequently identified by increased meniscal MRI signal.
- The effectiveness of various MRI sequences for evaluating meniscal degeneration in older adults requires further investigation.
Purpose of the Study:
- To assess the diagnostic reliability of different MRI sequences for meniscal degeneration in middle-aged and elderly populations.
- To compare the accuracy of T1-weighted, proton-density, T2-weighted spin-echo, and gradient-echo sequences.
Main Methods:
- Retrospective analysis of 175 meniscal sections from 20 cadaveric knees.
- Utilized MR-anatomic correlation for evaluating meniscal degeneration.
- Compared diagnostic accuracy across multiple MRI sequences.
Main Results:
- T1-weighted spin-echo (53.7%), proton-density spin-echo (54.9%), and postprocessed meniscal windows (53.1%) showed the highest diagnostic accuracy.
- T2-weighted spin-echo (37.1%) and gradient-echo (40.0%) sequences were less reliable.
- T2-weighted sequences tended to underestimate, while gradient-echo sequences tended to overestimate, degeneration extent.
Conclusions:
- T1-weighted and proton-density spin-echo sequences, with or without postprocessed meniscal windows, are recommended for assessing meniscal degeneration.
- T2-weighted spin-echo and gradient-echo sequences alone are insufficient for accurate diagnosis and should be used cautiously or in conjunction with other sequences.