Detection of degenerative cartilage disease: comparison of high-resolution morphological MR and quantitative T2 mapping at 3.0 Tesla

Objective: The aim of the study was to investigate the association of T2 relaxation times of the knee with early degenerative cartilage changes. Furthermore the impact of unloading the knee on T2 values was evaluated. Methods: Forty-three patients with knee pain and an ICRS (International Cartilage Repair Society) cartilage defect grade <= 2 were examined with 3 T magnetic resonance imaging (MRI). Morphological cartilage grading was based on high-resolution proton-density (PD), turbo-spin-echo (TSE) and three-dimensional (3D) isotropic True fast imaging with steady-state precession (FISP) images of slices covering the cartilage layer above the posterior horn of the meniscus. T2 maps were calculated from a multi-echo, spin-echo (MESE) sequence, performed at the beginning and at the end of the scan (time interval 40 min). Influence of cartilage defect grading on deep, superficial, and global T2 values as well as on T2 values for zonal variation was assessed using analysis of variance (ANOVA) and Spearman rank correlation test. Differences among both T2 measurements were compared using paired t-test. Results: Global and superficial T2 values significantly increased with cartilage defect grade regardless of the time elapsed from unloading (global T2: ICRS grade 0, 38.9 and 40.1 ms; grade 1, 41.2 and 44.5 ms; grade 2, 47.7 and 53.4 ms; P=0.041 and 0.008) with stronger correlation for second T2 measurement. In contrast there were no significant differences among grades in the zonal variation at any time. Significant differences for T2 values between the two subsequent measurements were consistently found. Conclusion: T2 mapping might be a sensitive method for the detection of early cartilage degeneration. From our results we would recommend to measure T2 after unloading. (C) 2010 Published by Elsevier Ltd on behalf of Osteoarthritis Research Society International.