Assessment of Articular Cartilage of Knee Joint by Magnetic Resonance Imaging in Comparison with Arthroscopy of the Knee
Iraqi Postgraduate Medical Journal,
2020, Volume 19, Issue 2, Pages 86-96
The use of new and faster MRI techniques with higher resolution, contrast and greater diagnostic
accuracy, make the MRI as an excellent method for evaluating articular cartilage disorders.
To evaluate the sensitivity and specificity of different sequences of MRI in diagnosing and grading
damage of articular cartilage of the knee joint.
PATIENTS AND METHODS:
From March 2017 to Feb. 2018 ,40 Patients (50 knees) with age ranging from (34-67 years) MRI
evaluation of the knee articular cartilage was performed using a 1.5T MRI scanner . Arthroscopic
surgery was done for them after a maximum delay of 2 months from the MRI study, Employing
the outer bridge grading system, the MRI grade 0, I, II, III and IV lesions were compared to
the arthroscopic results. The sensitivity, specificity and accuracy were evaluated for each sequence.
Of the 40 patients, 22 (55%) were females and 18 (45%) were males. Of 300 joint surfaces
135(45%) grade 0 ,16(5.3%) grade I , 36(12%) grade II , 85(28%) grade III and 28(9.3%) grade IV
by arthroscopy, when comparing to MRI findings, there was good and very good Kappa values
(0.759-0.818). Chondral lesions were undergraded by MRI in (13%) and overgraded in (6.6%),
the sensitivity of MRI was ranging between (60-92%), the specificity ranging (68.7-88.8%) and
the accuracy (70-86%) .Results demonstrated poor sensitivity of MRI in detecting grade I(33.3%) &
grade II(35.8%) and better sensitivity in detecting grade III(85.5%) & grade IV(76.4%). IW-FS-FSE
sequence showed the highest sensitivity (88%) & accuracy (97%), followed by FS-PD with
a sensitivity of (85%) and accuracy (95%).
MRI is an adequately sensitive and specific diagnostic tool for identifying the presence of articular
damage, but still not reliably described as Arthroscopy. Among the 2D and 3D GRE images the best
diagnostic evaluation of cartilage disorders was obtained by the IW-FS-FSE sequence . The PD
sequence can be used to evaluate knee cartilage, the dynamic range and the findings of subchondral
bone disorders are increased by fat suppression during imaging techniques so that it is important in
cartilage disorders interpretation.
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