Comparison of multislice CT arthrography and MR arthrography for the detection of articular cartilage lesions of the elbow

The objective of this study was to compare the value of multislice CT arthrography and MR arthrography in the assessment of cartilage lesions of the elbow joint. Twenty-six cadaveric elbow specimens were examined with the use of CT arthrography and MR arthrography prior to joint exploration and macroscopic inspection of articular cartilage. Findings at CT and MR arthrography were compared with macroscopic assessments in 104 cartilage areas. At macroscopic inspection, 45 cartilage lesions (six grade 2 lesions, 25 grade 3 lesions, 14 grade 4 lesions) and 59 areas of normal articular cartilage were observed. With macroscopic assessment as the gold standard CT and MR arthrography showed an overall sensitivity/specificity of 80/93% and 78/95% for the detection of cartilage lesions, respectively. Only two of six grade 2 lesions were detected by CT and MR arthrography. For the diagnosis of grade 3 and 4 lesions, the sensitivity/specificity was 87/94% with CT arthrography, and 85/95% with MR arthrography. In an experimental setting multislice CT arthrography and MR arthrography showed a similar performance in the detection of cartilage lesions. Both methods indicated limited value in the diagnosis of grade 2 articular cartilage lesions.

[1]  S. Nehrer Treatment of Articular Cartilage Defects , 2000, Investigative radiology.

[2]  T Stammberger,et al.  Validation of high-resolution water-excitation magnetic resonance imaging for quantitative assessment of thin cartilage layers. , 2000, Osteoarthritis and cartilage.

[3]  A. Minami,et al.  Long term outcome of osteochondritis dissecans of the humeral capitellum. , 1999, Clinical orthopaedics and related research.

[4]  D G Disler,et al.  MR imaging of articular cartilage. , 1998, Skeletal radiology.

[5]  V. Chandnani,et al.  Detection and staging of chondromalacia patellae: relative efficacies of conventional MR imaging, MR arthrography, and CT arthrography. , 1994, AJR. American journal of roentgenology.

[6]  H K Genant,et al.  Emerging applications of magnetic resonance imaging in the evaluation of articular cartilage. , 1996, Radiologic clinics of North America.

[7]  D. W. Jackson,et al.  Cartilage Substitutes: Overview of Basic Science and Treatment Options , 2001, The Journal of the American Academy of Orthopaedic Surgeons.

[8]  Baudouin Maldague,et al.  Assessment of knee cartilage in cadavers with dual-detector spiral CT arthrography and MR imaging. , 2002, Radiology.

[9]  S. Erickson,et al.  In vitro and in vivo MR imaging of hyaline cartilage: zonal anatomy, imaging pitfalls, and pathologic conditions. , 1997, Radiographics : a review publication of the Radiological Society of North America, Inc.

[10]  D. Sartoris,et al.  Articular cartilage defects: detectability in cadaver knees with MR. , 1987, AJR. American journal of roentgenology.

[11]  R. Putz,et al.  Funktionelle Morphologie des Ellenbogengelenks , 2003, Der Orthopäde.

[12]  S. Santavirta,et al.  Periosteal and perichondral grafting in reconstructive surgery. , 1994, Clinical orthopaedics and related research.

[13]  H. Baba,et al.  Transplantation of tissue-engineered cartilage for excessive osteochondritis dissecans of the elbow. , 2004, Journal of shoulder and elbow surgery.

[14]  A. Imhoff,et al.  Osteochondrale autologe Transplantation an verschiedenen Gelenken , 1999 .

[16]  K A Athanasiou,et al.  A biomechanical analysis of articular cartilage of the human elbow and a potential relationship to osteochondritis dissecans. , 1994, Clinical orthopaedics and related research.

[17]  A. Burkart,et al.  [Autologous osteochondral transplantation on various joints]. , 1999, Der Orthopade.

[18]  M. Ochi,et al.  Allogeneic deep frozen meniscal graft for repair of osteochondral defects in the knee joint , 2004, Archives of Orthopaedic and Trauma Surgery.

[19]  J. Hodler,et al.  MR arthrography of the elbow: normal anatomy and diagnostic pitfalls. , 1997, Journal of computer assisted tomography.

[20]  H. Imhof,et al.  Magnetic Resonance Imaging of Articular Cartilage and Evaluation of Cartilage Disease , 2000, Investigative radiology.

[21]  T. McCauley MR imaging of chondral and osteochondral injuries of the knee. , 2002, Radiologic clinics of North America.

[22]  Takashi Nakamura,et al.  Osteochondral Grafting and Arthroplasty for End-Stage Osteochondritis Dissecans of the Capitellum , 2001, The American journal of sports medicine.

[23]  Herwig Imhof,et al.  Postcontrast MR Arthrography in Assessment of Cartilage Lesions , 1994, Journal of computer assisted tomography.

[24]  M. R. Schmid,et al.  Cartilage lesions in the ankle joint: comparison of MR arthrography and CT arthrography , 2003, Skeletal Radiology.

[25]  L. Hangody,et al.  Mosaicplasty for the treatment of articular cartilage defects: application in clinical practice. , 1998, Orthopedics.

[26]  J. Hodler,et al.  Current status of imaging of articular cartilage , 1996, Skeletal Radiology.

[27]  K. Jonsson,et al.  Osteochondritis dissecans of the elbow. A long-term follow-up study. , 1992, Clinical orthopaedics and related research.