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Abstract
ObjectivesTo evaluate the clinical feasibility of ultrahigh field 7-T SWI to visualize vessels and assess their density in the immature epiphyseal cartilage of human knee joints.Methods7-T SWI of 12 knees (six healthy volunteers, six patients with osteochondral abnormalities; mean age 10.7 years; 3 female, 9 male) were analysed by two readers, classifying intracartilaginous vessel densities (IVD) in three grades (no vessels, low IVD and high IVD) in defined femoral, tibial and patellar zones. Differences between patients and volunteers, IVDs in different anatomic locations, differences between cartilage overlying osteochondral abnormalities and corresponding normal zones, and differences in age groups were analysed.ResultsInterrater reliability showed moderate agreement between the two readers (κ = 0.58, p < 0.001). The comparison of IVDs between patients and volunteers revealed no significant difference (p = 0.706). The difference between zones in the cartilage overlying osteochondral abnormalities to corresponding normal zones showed no significant difference (p = 0.564). IVDs were related to anatomic location, with decreased IVDs in loading areas (p = 0.003). IVD was age dependent, with more vessels present in the younger participants (p = 0.001).ConclusionsThe use of SWI in conjunction with ultrahigh field MRI makes the in vivo visualization of vessels in the growing cartilage of humans feasible, providing insights into the role of the vessel network in acquired disturbances.Key Points• SWI facilitates in vivo visualization of vessels in the growing human cartilage.• Interrater reliability of the intracartilaginous vessel grading was moderate.• Intracartilaginous vessel densities are dependent on anatomical location and age.
Highlights
The cartilaginous distal femoral epiphysis is penetrated by a complex canal network of blood vessels, showing successive stages in the development of the epiphysis [1,2,3,4]
Intracartilaginous vessel densities are dependent on anatomical location and age
The feasibility of susceptibility-weighted imaging (SWI) to image vessels and cartilage layers in juvenile human joints in vivo has recently been reported in a methodological study at 7 T [12]. We extend this prior work to assess the vascularity of juvenile epiphyseal cartilage in normal and diseased human knees using SWI in a human 7-T magnetic resonance imaging (MRI) scanner
Summary
The cartilaginous distal femoral epiphysis is penetrated by a complex canal network of blood vessels, showing successive stages in the development of the epiphysis [1,2,3,4]. As the ossification progresses the network of blood vessels within the cartilage diminishes, leaving the hyaline cartilage avascular at the end of growth [5, 6]. The relatively high incidence of OCD in the human knee (6–10 per 100,000 patients) and potential need for surgery in OCD patients suggest the clinical importance of these intracartilaginous vessels. The proposed use of susceptibility-weighted imaging (SWI) in conjunction with ultrahigh field MRI is a new approach to visualize vessels in vivo in the growing cartilage [12]. To the authors’ best knowledge, no previous studies have been conducted to quantify intracartilaginous vessels in immature patients and volunteers
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