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Postcontrast MR Arthrography in Assessment of Cartilage Lesions

Objective Although MR has been proven effective in evaluating many components of the musculoskeletal system, including ligaments, fibrocartilage, muscle, and bone marrow, its role in the evaluation of articular cartilage remains controversial. Recent studies have demonstrated that intraarticular injection of Gd-DTPA [MR arthrography (MRA)] improves the detection of cartilage abnormalities in cadaveric specimens. The aim of this study was to determine the efficacy of MRA for the detection of naturally occurring cartilage lesions in a clinical population. Materials and Methods Sixty knees of 58 patients were studied with a three-dimensional (3D) T2*-weighted GE sequence (FISP) both before and after and a Tl-weighted (TlW) SE sequence after the intraarticular injection of a 2 mmol/L Gd-DTPA solution. All knees subsequently underwent arthroscopy or arthrotomy. Results The MRA sequences performed significantly better (k = 0.85) than the routine FISP sequences (k = 0.39) in both the detection and the staging of cartilage abnormalities. The MRA FISP sequence (k = 0.91) performed slightly better than the MRA TlW sequence (k = 0.85), but there was no statistically significant difference between the two sequences. No complications from the intraarticular injection of contrast material occurred. Conclusion Therefore, MRA appears to be an effective and safe method for the evaluation of articular cartilage abnormalities.