C Glaser1, A Heuck2, A Horng2. 1. Radiologisches Zentrum München (RZM), Pippingerstr. 25, 81245, München, Deutschland. glaser@rzm.de. 2. Radiologisches Zentrum München (RZM), Pippingerstr. 25, 81245, München, Deutschland.
Abstract
BACKGROUND: In order to answer clinical therapy-oriented questions, reliable and consistent depiction of articular cartilage across technical platforms is necessary. MATERIALS AND METHODS: Technical standards and developments in cartilage imaging are summarized based on current literature and experience from clinical daily routine. RESULTS: Clinical questions that need to be answered relate to cross-sectional extent, depth, differentiating cartilaginous from bony components of a lesion and to the lesion's location within the compartment. If present, displaced fragments, concomitant meniscal, ligamentous and/or degenerative lesions should be identified. To date, magnetic resonance imaging (MRI) is the workhorse of cartilage imaging and is largely based on moderately T2-weighted and also proton-density (PD)-weighted fat-suppressed turbo-spin-echo sequences. Direct MR- and CT-arthrography are the gold standard to evaluate thin cartilage layers. Recent advances in coil and MR sequence design, increased availability of 3T-MR scanners and more and more sophisticated acceleration techniques allow for better spatial resolution and more robust image contrast at acceptable scan times. DISCUSSION: As abundant as current developments in clinical routine cartilage imaging may be, the radiologist must carefully select the approach best suited to answering the clinical questions.
BACKGROUND: In order to answer clinical therapy-oriented questions, reliable and consistent depiction of articular cartilage across technical platforms is necessary. MATERIALS AND METHODS: Technical standards and developments in cartilage imaging are summarized based on current literature and experience from clinical daily routine. RESULTS: Clinical questions that need to be answered relate to cross-sectional extent, depth, differentiating cartilaginous from bony components of a lesion and to the lesion's location within the compartment. If present, displaced fragments, concomitant meniscal, ligamentous and/or degenerative lesions should be identified. To date, magnetic resonance imaging (MRI) is the workhorse of cartilage imaging and is largely based on moderately T2-weighted and also proton-density (PD)-weighted fat-suppressed turbo-spin-echo sequences. Direct MR- and CT-arthrography are the gold standard to evaluate thin cartilage layers. Recent advances in coil and MR sequence design, increased availability of 3T-MR scanners and more and more sophisticated acceleration techniques allow for better spatial resolution and more robust image contrast at acceptable scan times. DISCUSSION: As abundant as current developments in clinical routine cartilage imaging may be, the radiologist must carefully select the approach best suited to answering the clinical questions.
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