Demonstration of Knee Hyaline Cartilage with 3d_Watsc/T1a Ge Technique, Comparison with Standart MRI, Correlation with Arthroscopy

Objective: The primary aim of this prospective study was to compare fat-suppressed three-dimensional water selective cartilage scan (3D_ WATSc) magnetic resonance (MR) imaging with standard MR imaging for the detection of defects in the hyaline cartilage of the knee, using arthroscopy as the reference standard. Methods: Overall, 40 patients who were referred for knee MRI by orthopedic surgeons before arthroscopy were included in the study. Chondromalacia was diagnosed in 19 patients by arthroscopy and built the mainframe of the study. Hyaline cartilage damage was imaged using 3D_WATSc sequence with the appropriate parameters. Standard MRI imaging of the knee consisted of two-dimensional coronal T1-weighted spin-echo, coronal, and sagittal T2-weighted spin-echo, and sagittal and axial superior pericardial recess sequences. With arthroscopy as the gold standard, sensitivity, and specificity of 3D_WATSc and standard MR imaging for detecting cartilage damage were determined in six articular surfaces (patellar facets, trochlear facets, medial and lateral femoral condyles, and medial and lateral tibial plateaus). Results: In total, 240 cartilage surfaces in 40 patients were evaluated by arthroscopy, and 28 of them had shown to have chondromalacia. 3D_WATSc had higher sensitivity and specificity (92% and 96%, respectively) than standard MR images (60% and 95%, p<0.05) and was also more successful in the detection of early-stage (stage 1–2) cartilage defects than standard MR images and arthroscopy (p<0.05). Conclusion: 3D_WATSc MRI sequence is more sensitive than standard MR imaging for the detection of abnormalities of the hyaline cartilage in the knee. Routine use of this low-cost technique in addition to standard imaging strengthens the role of non-invasive MR imaging in the evaluation of cartilage damages