OBJECTIVE: We sought to evaluate the diagnostic value of a 2D multiple-echo data image combination (MEDIC) MRI sequence in the detection of patellar cartilage defects. MATERIALS AND METHODS: Our study included 52 consecutive patients who had knee surgery within 4 months of undergoing an MRI examination including an axial 2D MEDIC (TR/TE, 884/26; flip angle, 30 degrees ) sequence. Cartilage was surgically graded on a 5-point scale: 0, normal; 1, softening or swelling; 2, partial thickness defect; 3, fissuring to the level of the subchondral bone; or 4, exposed subchondral bone. Cartilage was graded on MRI according to a scale that was almost identical to the surgical scale except that grade 1 lesions were defined as signal alteration or swelling of cartilage. Two blinded reviewers independently analyzed patellar cartilage. Sensitivity, specificity, accuracy, and weighted kappa values for interobserver variability were calculated. RESULTS: Low-grade cartilage lesions predominated in our study group. When grade 2 or higher was considered the threshold for relevance, the sensitivity, specificity, and accuracy for the MEDIC sequence was as high as 79%, 82%, and 81%, respectively. Increasing the threshold of relevance to grade 3 increased the sensitivity, specificity, and accuracy to as high as 83%, 91%, and 90%, respectively. Interobserver agreement for the MEDIC sequence was good (weighted kappa = 0.68). CONCLUSION: The 2D MEDIC sequence performs comparably to previously described sequences optimized for cartilage imaging such as the 3D double-echo steady-state or 3D spoiled gradient-recalled sequences with good interobserver agreement, high sensitivity, and excellent specificity for revealing low- to intermediate-degree cartilage defects.
OBJECTIVE: We sought to evaluate the diagnostic value of a 2D multiple-echo data image combination (MEDIC) MRI sequence in the detection of patellar cartilage defects. MATERIALS AND METHODS: Our study included 52 consecutive patients who had knee surgery within 4 months of undergoing an MRI examination including an axial 2D MEDIC (TR/TE, 884/26; flip angle, 30 degrees ) sequence. Cartilage was surgically graded on a 5-point scale: 0, normal; 1, softening or swelling; 2, partial thickness defect; 3, fissuring to the level of the subchondral bone; or 4, exposed subchondral bone. Cartilage was graded on MRI according to a scale that was almost identical to the surgical scale except that grade 1 lesions were defined as signal alteration or swelling of cartilage. Two blinded reviewers independently analyzed patellar cartilage. Sensitivity, specificity, accuracy, and weighted kappa values for interobserver variability were calculated. RESULTS: Low-grade cartilage lesions predominated in our study group. When grade 2 or higher was considered the threshold for relevance, the sensitivity, specificity, and accuracy for the MEDIC sequence was as high as 79%, 82%, and 81%, respectively. Increasing the threshold of relevance to grade 3 increased the sensitivity, specificity, and accuracy to as high as 83%, 91%, and 90%, respectively. Interobserver agreement for the MEDIC sequence was good (weighted kappa = 0.68). CONCLUSION: The 2D MEDIC sequence performs comparably to previously described sequences optimized for cartilage imaging such as the 3D double-echo steady-state or 3D spoiled gradient-recalled sequences with good interobserver agreement, high sensitivity, and excellent specificity for revealing low- to intermediate-degree cartilage defects.
Authors: Xiaoxuan He; M Arcan Ertürk; Andrea Grant; Xiaoping Wu; Russell L Lagore; Lance DelaBarre; Yiğitcan Eryaman; Gregor Adriany; Eddie J Auerbach; Pierre-François Van de Moortele; Kâmil Uğurbil; Gregory J Metzger Journal: Magn Reson Med Date: 2019-12-17 Impact factor: 4.668
Authors: J M Theysohn; O Kraff; S Maderwald; P C Kokulinsky; M E Ladd; J Barkhausen; S C Ladd Journal: Skeletal Radiol Date: 2012-06-13 Impact factor: 2.199
Authors: Alex D Leow; Andrea D Klunder; Clifford R Jack; Arthur W Toga; Anders M Dale; Matt A Bernstein; Paula J Britson; Jeffrey L Gunter; Chadwick P Ward; Jennifer L Whitwell; Bret J Borowski; Adam S Fleisher; Nick C Fox; Danielle Harvey; John Kornak; Norbert Schuff; Colin Studholme; Gene E Alexander; Michael W Weiner; Paul M Thompson Journal: Neuroimage Date: 2006-02-15 Impact factor: 6.556