Victor Casula1,2, Jukka Hirvasniemi3,4, Petri Lehenkari3,5,6, Risto Ojala7, Marianne Haapea8, Simo Saarakkala3,4,8, Eveliina Lammentausta3,8, Miika T Nieminen7,3,8. 1. Department of Radiology, University of Oulu, POB 50, 90029, Oulu, Finland. victor.casula@oulu.fi. 2. Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland. victor.casula@oulu.fi. 3. Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland. 4. Department of Medical Technology, University of Oulu, Oulu, Finland. 5. Department of Anatomy, University of Oulu, Oulu, Finland. 6. Department of Surgery, Oulu University Hospital, Oulu, Finland. 7. Department of Radiology, University of Oulu, POB 50, 90029, Oulu, Finland. 8. Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.
Abstract
PURPOSE: To investigate the association of quantitative magnetic resonance imaging (qMRI) parameters with arthroscopic grading of cartilage degeneration. Arthroscopy of the knee is considered to be the gold standard of osteoarthritis diagnostics; however, it is operator-dependent and limited to the evaluation of the articular surface. qMRI provides information on the quality of articular cartilage and its changes even at early stages of a disease. METHODS: qMRI techniques included T 1 relaxation time, T 2 relaxation time, and delayed gadolinium-enhanced MRI of cartilage mapping at 3 T in ten patients. Due to a lack of generally accepted semiquantitative scoring systems for evaluating severity of cartilage degeneration during arthroscopy, the International Cartilage Repair Society (ICRS) classification system was used to grade the severity of cartilage lesions. qMRI parameters were statistically compared to arthroscopic grading conducted with the ICRS classification system. RESULTS: qMRI parameters were not linearly related to arthroscopic grading. Spearman's correlation coefficients between qMRI and arthroscopic grading were not significant. The relative differences in qMRI parameters of superficial and deep cartilage varied with degeneration, suggesting different macromolecular alterations in different cartilage zones. CONCLUSIONS: Results suggest that loss of cartilage and the quality of remaining tissue in the lesion site may not be directly associated with each other. The severity of cartilage degeneration may not be revealed solely by diagnostic arthroscopy, and thus, qMRI can have a role in the investigation of cartilage degeneration.
PURPOSE: To investigate the association of quantitative magnetic resonance imaging (qMRI) parameters with arthroscopic grading of cartilage degeneration. Arthroscopy of the knee is considered to be the gold standard of osteoarthritis diagnostics; however, it is operator-dependent and limited to the evaluation of the articular surface. qMRI provides information on the quality of articular cartilage and its changes even at early stages of a disease. METHODS: qMRI techniques included T 1 relaxation time, T 2 relaxation time, and delayed gadolinium-enhanced MRI of cartilage mapping at 3 T in ten patients. Due to a lack of generally accepted semiquantitative scoring systems for evaluating severity of cartilage degeneration during arthroscopy, the International Cartilage Repair Society (ICRS) classification system was used to grade the severity of cartilage lesions. qMRI parameters were statistically compared to arthroscopic grading conducted with the ICRS classification system. RESULTS: qMRI parameters were not linearly related to arthroscopic grading. Spearman's correlation coefficients between qMRI and arthroscopic grading were not significant. The relative differences in qMRI parameters of superficial and deep cartilage varied with degeneration, suggesting different macromolecular alterations in different cartilage zones. CONCLUSIONS: Results suggest that loss of cartilage and the quality of remaining tissue in the lesion site may not be directly associated with each other. The severity of cartilage degeneration may not be revealed solely by diagnostic arthroscopy, and thus, qMRI can have a role in the investigation of cartilage degeneration.
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