MRI Of Knee Joint Research Articles

Visualisation of meniscus from knee joint MRI and assessment of its size differences due to age, gender and BMI

Menisci play a major role in cushioning and distributing the stress due to body weight over the cartilage surface of femur and tibia. They also contribute in joint lubrication and provide stability...

Clinical study on reconstruction of posterior cruciate ligament with platelet rich plasma combined with 3-strand peroneus longus tendons

To investigate the effectiveness of the reconstruction of posterior cruciate ligament (PCL) with platelet rich plasma (PRP) and 3-strand peroneal longus tendons under arthroscope. Between June 2014 and December 2017, 58 patients with PCL rupture were randomly divided into two groups: the trial group (PRP assisted reconstruction of 3-strand peroneal longus tendons) and the control group (4-strand hamstring tendon reconstruction alone), 29 cases in each group. There was no significant difference in gender, age, injury side, Kellgren-Lawrence grade, time from injury to operation, and preoperative American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, International Knee Documentation Committee (IKDC) score, Lysholm score between the two groups ( P>0.05). Before operation, at 3 months and 12 months after operation, the IKDC score and Lysholm score of the two groups were recorded to evaluate the knee joint function, AOFAS ankle-hindfoot score was used to evaluate ankle function; KT-2000 examination (knee flexion of 90°, 30 lbs) was used to evaluate the difference of bilateral knee joint posterior relaxation at 12 months after operation, and MRI was used to evaluate ligament reconstruction; CT was used to evaluate the bone tunnel expansion of femur and tibia at 3 months and 12 months after operation. The operation was completed successfully in both groups, there was no complication in the donor tendon area. All the incisions healed by first intention. All the patients were followed up for more than 1 year. The follow-up time of the trial group was 13-17 months, with an average of 15.0 months; that of the control group was 15-20 months, with an average of 15.4 months. At 3 and 12 months after operation, there was no significant difference in AOFAS ankle-hindfoot score when compared with preoperative score and between the two groups ( P>0.05). At 3 and 12 months after operation, the IKDC score and Lysholm score of the two groups were significantly improved, and further improvement was found at 12 months when compared with at 3 months ( P<0.05); the scores in the trial group were significantly better than those of the control group ( P<0.05). At 12 months after operation, the difference of the posterior relaxation of the bilateral knees in the trial group was less than 5 mm in 27 cases, 6-10 mm in 2 cases; in the control group was less than 5 mm in 20 cases, 6-10 mm in 6 cases, and >10 mm in 3 cases; the difference between the two groups was not significant ( Z=0.606, P=0.544). At 12 months after operation, MRI of knee joint showed that all patients had good PCL graft. The MRI score of the trial group was better than that of the control group ( t=2.425, P=0.019). CT examination at 3 and 12 months after operation showed that the bone tunnel expansion of femur and tibia in the trial group were significantly better than those in the control group ( P<0.05). PRP combined with 3-stand peroneal longus tendons can significantly improve the function and stability of knee joint, effectively promote graft remodeling, and promote tendon bone healing, reduce the expansion of bone tunnel. The effectiveness is satisfactory.

Dervan rim sign new, simple radiological sign for unique Indian medial femoral condylar osteoarthritis

Introduction: OA knee is most common form of arthritis in Asian population. The medial compartment of knee is most commonly involved. Most X-ray studies have been from the Western Caucasian patients with different genetic pool, habitus and lifestyle. The accepted norm for surgical intervention like unicondylar knee replacement or High Tibial Osteotomy is bone on bone Arthritis which has simultaneous affection of both medial Tibial & Femoral compartments. We however noted a different radiological pattern also causing severe pain on medial side of knee, without bone on bone arthritis. This was labeled DERVAN RIM SIGN.Materials and Method: This pilot Study describes a new radiological sign based on standard Anteroposterior Xray of knee joint, taken in standing weight bearing position with toes and patella pointing forwards in 15 degrees of flexion.The findings of this sign and correlation to selective medial condylar femoral cartilage loss in 25 patients are confirmed with1 MRI of knee joint 17 patients2 Arthroscopy of knee joint 3 patients3 Open Arthrotomy during Unicondylar knee Arthroplasty 5 patientsResults: 100 percent correlation is seen in all 25 cases between the Dervan RIM sign & Eburnation and loss of Medial femoral cartilage in the three modalities of visual confirmation viz MRI, Arthroscopy or Visual examination in open surgery. Mild involvement of the Tibial condyle was noted in all cases and this was the cause of absence of bone on bone Arthritis.

Discoid lateral meniscus of the knee-joint (questions of classification and diagnostics)

In this article is analysed MRI of knee-joints of 409 patients and results of 15 knee joint arthroscopic revisions of patients with a discoid lateral meniscus. Considered a few classifications of discoid lateral meniscus types. Based on the possibilities of MRI and arthroscopy in detecting of discoid lateral meniscus abnormalities, taking into account the correlation these researches’ results there was highlighted Watanabe classification as the main for discoid lateral meniscus description as at MRI so at during arthroscopy. The third type of discoid lateral meniscus in Watanabe classification is selected as most clinically significant, while it is most hardness differentiated on MRI, that requires further scientific research.

Analisis Informasi Anatomi antara Sekuens T2WI FSE dan Proton Density Fat Saturation pada Pemeriksaan MRI Knee Joint Potongan Sagital (Studi pada Anterior Cruciate Ligament (ACL) dan Posterior Cruciate Ligament (PCL))

Background: There are clinical situations that radiology physicians need to assess Anterior Cruciate Ligament (ACL) and Posterior Cruciate Ligament (PCL) clearly with the two typical sequences (T2WI FSE sequence and Proton Density Fat Saturation). However, a slight difference in using the applied sequences will result different levels of image quality information. The aim of this study is to compare clinical manifest in anatomical information on the resulted images between T2WI FSE sequence and Proton Density Fat Saturation and to define the best sequence that fit to reveal ACL and PCL of the knee joint..Methods: The research was an experimental quasy. 20 sagital slices of the knee jointMRI were acquired from 10 volunteers who underwent MRI examinations with the two methods (T2WI FSE and Proton Density Fat Saturation). 3 experienced radiology physicians blended in the image scoring when review ACL and PCL appearances on knee MRI images. Inter-observer suitability was checked with Kappa test. A non-parametric Wilcoxon analyses was the statistical tool to test the null hypothesis.Results: The result showed a significant difference in anatomical information of ACL and PCL when T2WI FSE and Proton Density Fat Saturation sequences applied on the MRI of the knee jointsagital slices (p-value 0,05). The mean rank of T2WI FSE was better than Proton Density Fat Saturation which contributed to the value at 4,50. There was an increase in signals that lead to ACL and PCL appear to be more hyper-intens compared to sorrounding organs in general, except the border line of PCL. By this means, it was useful for evaluating the patient whose particularly with ACL post-grafting.Conclusion: There was the difference in anatomical information between T2WI FSE sequence and Proton Density Fat Saturation on MRI knee jointwith sagital slices for ACL and PCL studies. T2WI FSE sequence was the best method for showing anatomical information of ACL and PCL, although a relative low signal still occured from border line of PCL.

Correlation of clinical, MRI and arthroscopic findings in diagnosing meniscus and ligament injuries at knee joint: A prospective study

Objective: The purpose of this study was to correlate clinical, MRI, and arthroscopic findings in diagnosing ligament and meniscus tears in knee joint injuries. Materials and Methods: Our study included 20 patients in the age range of 11-60 years who were referred to radiology department for MRI of knee joint following injury to the knee. Prior to MRI, a detailed history, clinical, and local examination was done in all the subjects. MRI was carried out on 1.5 Tesla MR Machine and the standard protocol consisted of fat-suppressed PD (TE 45, TR 2800) in axial, sagittal, and coronal planes, T2W (TE 80, TR 4000) in sagittal plane and T1W (TE 11, TR 495) in sagittal plane. All the patients underwent arthroscopy by an orthopedic surgeon. Results: MR had 100% sensitivity and NPV of diagnosing ACL tears in this study. Clinical examination had sensitivity of 88% and NPV 75% in diagnosing ACL injuries. There was high NPV of MR examination (96%) in diagnosing meniscus tear while the PPV of MR examination was low (71%). These values were low in case of clinical examination. Conclusions: MRI is a useful non-invasive modality having high diagnostic accuracy, sensitivity, and negative predictive value making it a very reliable screening test for diagnosing internal derangements.

Clinico-radiological correlation in the diagnosis of ligament and meniscus injuries at knee joint: A prospective study

Purpose: The purpose of this study was to determine the MRI appearances and various patterns of ligament and meniscus tears in knee joint injuries and to correlate the clinical findings with MRI findings. Materials and Methods: Our study included 50 patients, who were referred to radiology department for MRI of knee joint following injury. Prior to MRI, a detailed clinical and local examination was done in all the subjects. MRI was carried out on MAGNETOM Avanto 18 Channel 1.5 Tesla Machine by Siemens India Ltd and the standard protocol consisted of PD(TE 45 TR 2800), T2W(TE 73 TR 5090), fat suppressed T2W(TE 26 TR 5000) spin echo sequences in axial, sagittal and coronal planes. The MRI findings were compared with arthroscopic findings in 30 subjects and in rest of the subjects characteristic MRI features were considered diagnostic. Results: Diagnostic accuracy of clinical examination (83%) was relatively low as compared to MR examination (88%) in our study. The percentage correlation between clinical and MRI findings regarding presence or absence of ligament/meniscus tear was highest in case of PCL tears (94%). Amongst ligament injuries, complete tear of ACL alone was the most common injury (53%) and ACL injury was most commonly associated with MM injury (16%), intrasubstance tears were more common than attachment site tears. Conclusions: MR is unique in its ability to evaluate the architecture as well as the surface of ligaments and menisci. MRI is more sensitive than clinical examination in diagnosing ligament and meniscus injuries.

The MRI study of correlation between patella location and chondromalacia

Objective To discuss the relationship between patella location and chondromalacia patella,explore its mechanism and clinical significance.Methods Knee joint MRI was performed in 1052 patients (506 men and 546 female).Among them,there were 299 patients( 100 men and 199 female)with chondromalacia patella.They were divide into the group of 1-19,the group of 20-39,the group of 40-59 years old and the group of older than 60 years to compute the positive rate respectively.Insall-Salvati method was used to measure the length of chondromalacia ligaments(L) and the length of chondromalacia path(P).The relationship between patella location and chondromalacia was tested by using t test and x2 test.Results The total positive rate of chondromalacia patella was 28.4％ (299/1052).In female it was 36.4％ (199/546) and in men was 19.8％ (100/506).The group of 1-19 years old had 16 patients ( 16.8％,16/95).The group of 20-39 years old had 71 patients( 17.9％,71/396).The group of 40-59 years old had 116 patients ( 33.2％,116/349 ).The group of older than 60 years had 96 patients (45.3％,96/212).The positive rate of chondromalacia patella increased with age.The L/P value of normal group and chondromalacia patella group were 1.15 ±0.15 and 1.24 ±0.17 respectively.The L/P value of normal group of men and women were 1.13 ± 0.15 and 1.17 ± 0.14 respectively.The L/P value of chondromalacia patella group of men and women were 1.20 ±0.17 and 1.26 ±0.16 respectively.The InsallSalvati index of age groups showed significant differences.The L/P value of pathological changes group and normal group of 1-19 years old were 1.38 ± 0.25 and 1.24 ± 0.16 respectively.The L/P value of pathological changes group and normal group of 20-39 years old were 1.24 ± 0.17 and 1.15 ± 0.16 respectively.The L/P value of pathological changes group and normal group of 40-59 years old were 1.24 ±0.16 and 1.12 ±0.12 respectively.The L/p value of pathological changes group and normal group of older than 60 years were 1.21 ±0.16 and 1.12 ±0.12 respectively.All of them had significant differences (P ＜ 0.01 ).Conclusions The positive rate of chondromalacia patella for female is higher than that for men,which also increases with age.High patella location is relevant to chondromalacia patella. Key words: Chondromalacia patella; Magnetic resonance imaging

Relevant traumatic injury of the knee joint—MRI follow-up after 7–10 years

Objective To evaluate prospectively the history of relevant traumatic knee injuries at least 7 years after trauma by MRI focusing on the development of degenerative changes. Materials and methods Seventeen patients without baseline degenerative changes had a follow-up knee MRI several years after relevant knee injury (interval baseline—follow-up was 9.1 years, S.D. ±1.3 years). Relevant knee injury was defined as complete cruciate or collateral ligament rupture, traumatic meniscal tear or osteochondral injury. Baseline MRI examinations were evaluated for traumatic ligamentous, chondral, meniscal and osseous lesions. Follow-up MRIs were evaluated for ligamentous and meniscal status, articular surface and incidence of degenerative changes such as cartilage loss, osteophytes and bone marrow lesions. Results Among the 11 patients who had a complete rupture of the ACL at baseline, 3 (27.3%) presented with cartilage loss. Among the eight patients who had suffered a post-traumatic meniscal tear at baseline, four (50%) presented with cartilage loss at follow-up. Among the five patients who had an osteochondral fracture at baseline, two (40%) presented with cartilage loss at follow-up imaging. Cartilage loss in all cases was observed adjacent to the subregions where meniscal damage and/or osteochondral incongruence was/were present at follow-up imaging. Conclusion We hypothesize that the post-traumatic or postsurgical meniscal damage and the persistence of an irregular articular surface may have played a role in the subsequent loss of cartilage in our patient population.

Ultra–High-Field MRI of Knee Joint at 7.0T: Preliminary Experience

To measure signal-to-noise ratio (SNR), contrast, and relaxation times (T1 and T2) in human knee joint at 7.0T whole-body scanner. MRI experiments were performed on a 7.0T Siemens whole-body scanner using an 18-cm diameter transmit/receive knee coil. Normalized SNR and relaxation times (T1 and T2) were computed on all volunteers (healthy, n=5) for femoral, tibial, and patellar cartilage. Average T1 values of femoral, tibial, and patellar cartilages were found as 1.55, 1.76, and 1.62 seconds, respectively. Average T2 values of femoral, tibial, and patellar cartilages were found as 51.3, 43.9, and 39.7 milliseconds, respectively. No statistically significant differences were observed between T1 and T2 values of different cartilage tissues (P>.08 for all comparisons). Compared with previously reported relaxation times of cartilage tissue at 3.0T, an approximately 35% increase was observed in T1 values, whereas no significant change was observed in T2. Regional analysis was also performed to investigate the change in relaxation parameters for weight-bearing vs. non-weight-bearing areas. A statistically significant difference was observed in T2 of tibial cartilage (P=.009). The rest of the comparisons yielded insignificant differences (P>.32). Our preliminary results demonstrate the feasibility of acquiring high resolution three-dimensional images of knee joint (with and without fat suppression) at 7.0T whole-body scanner.

Bone Signal Abnormality, as seen on Knee Joint MRI: Relationship between Its Location and Associated Injury

Bone Signal Abnormality, as seen on Knee Joint MRI: Relationship between Its Location and Associated Injury

422. 膝関節 MRI における 3DFT-SPGR 法の有用性(MR MRI-関節)

422. 膝関節 MRI における 3DFT-SPGR 法の有用性(MR MRI-関節)