Abstract
Objective
To compare MR arthrography and CT arthrography for the evaluation of cartilage lesions in the ankle joint.
Design and patients
Thirty-six consecutive patients with clinically suspected cartilage lesions were prospectively included in the study. A 1:1 mixture of diluted gadoteridol (4 mmol/l) and iopamidol (300 mg iodine/ml) was injected. The articular cartilages of the talus, tibia, and fibula were analyzed separately by two musculoskeletal radiologists. A review panel consisting of two musculoskeletal radiologists and an orthopedic surgeon represented the standard of reference.
Results
For reader 1 accuracy of MR arthrography in the talus/tibia/fibula (88%/88%/94%) was slightly inferior to CT arthrography (90%/94%/92%). For reader 2, the accuracy was 76%/78%/83% for MR arthrography, and 92%/93%/92% for CT arthrography, respectively. Interobserver agreement for MR arthrography was 79%/74%/89% (kappa 0.47/0.34/0.27), while interobserver agreement for CT arthrography was 89%/90%/89% (kappa 0.69/0.54/0.54).
Conclusion
CT arthrography appears to be more reliable than MR arthrography for the detection of cartilage lesions in the ankle joint.
Similar content being viewed by others
References
Lahm A, Erggelet C, Steinwachs M, Reichelt A. Arthroscopic management of osteochondral lesions of the talus: results of drilling and usefulness of magnetic resonance imaging before and after treatment. Arthroscopy 2000; 16:299–304.
Schneider T, Fink B, Jerosch J, Assheuer J, Ruther W. The value of magnetic resonance imaging as postoperative control after arthroscopic treatment of osteochondritis dissecans. Arch Orthop Trauma Surg 1998;117:235–239.
Hangody L, Kish G, Modis L, et al. Mosaicplasty for the treatment of osteochondritis dissecans of the talus: two to seven year results in 36 patients. Foot Ankle Int 2001; 22:552–558.
Gagliardi JA, Chung EM, Chandnani VP, et al. Detection and staging of chondromalacia patellae: relative efficacies of conventional MR imaging, MR arthrography, and CT arthrography. AJR Am J Roentgenol 1994; 163:629-636.
Rand T, Brossmann J, Pedowitz R, Ahn JM, Haghigi P, Resnick D. Analysis of patellar cartilage: comparison of conventional MR imaging and MR and CT arthrography in cadavers. Acta Radiol 2000; 41:492–497.
Kramer J, Recht MP, Imhof H, Stiglbauer R, Engel A. Postcontrast MR arthrography in assessment of cartilage lesions. J Comput Assist Tomogr 1994; 18:218–224.
Ro DW, Paletta GA, Schils JP, Belhobeck GH. Accuracy of fat-suppressed three-dimensional spoiled gradient-echo FLASH MR imaging in the detection of patellofemoral articular cartilage abnormalities. Radiology 1996; 198:209–212.
Disler DG, McCauley TR, Kelman CG, et al. Fat-suppressed three-dimensional spoiled gradient-echo MR imaging of hyaline cartilage defects in the knee: comparison with standard MR imaging and arthroscopy. AJR Am J Roentgenol 1996; 167:127–132.
Bredella MA, Tirman PFJ, Peterfy CG, et al. Accuracy of T2-weighted fast spin-echo MR imaging with fat saturation in detecting cartilage defects in the knee: comparison with arthroscopy in 130 patients. AJR Am J Roentgenol 1999; 172:1073–1080.
Murphy BJ. Evaluation of grades 3 and 4 chondromalacia of the knee using T2*-weighted 3D gradient-echo articular cartilage imaging. Skeletal Radiol 2001; 30:305–311.
Tan TCF, Wilcox DM, Frank L, Trudell DJ, Sartoris DJ, Resnick D. MR imaging of articular cartilage in the ankle: comparison of available imaging sequences and methods of measurements in cadavers. Skeletal Radiol 1996; 25:749–755.
Shepherd DET, Seedhom BB. Thickness of human cartilage in joints of the lower limb. Ann Rheum Dis 1999; 58:27–34.
Reiser M, Karpf PM, Bernett P. Diagnosis of chondromalacia patellae using CT arthrography. Eur J Radiol 1982; 2:181–186.
Vande Berg BC, Lecouvet FE, Poilvache P, et al. Assessment of knee cartilage in cadavers with dual-detector spiral CT arthrography and MR imaging. Radiology 2002; 222:430–436.
Vande Berg BC, Lecouvet FE, Poilvache P, Maldague B, Malghem J. Spiral CT arthrography of the postoperative knee. Semin Musculoskelet Radiol 2002; 6:47–56.
Binkert CA, Zanetti M, Gerber C, Hodler J. MR arthrography of the glenohumeral joint: two concentrations of gadoteridol versus Ringer solution as the intraarticular contrast material. Radiology 2001; 220:219-224.
Altman DG. Mathematics for kappa. In: Altman DG, ed. Practical statistics for medical research, 1st edn. London: Chapman & Hall, 1991:406–407.
Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33:159–174.
De Smet AA, Ilahi OA, Graf BK. Reassessment of the MR criteria for stability of osteochondritis dissecans in the knee and ankle. Skeletal Radiol 1996; 25:159–163.
Ruehm S, Zanetti M, Romero J, Hodler J. MRI of patellar articular cartilage: evaluation of an optimized gradient echo sequence (3D-DESS). J Magn Reson Imaging 1998; 8:1246–1251.
Daenen BR, Ferrara MA, Marcelis S, Dondelinger RF. Evaluation of patellar cartilage surface lesions: comparison of CT arthrography and fat-suppressed FLASH 3D MR imaging. Eur Radiol 1998; 8:981–985.
Shahriaree H. Chondromalacia. Contemp Orthop 1985; 11:27–39.
Feiwell LA, Frey C. Anatomic study of arthroscopic debridement of the ankle. Foot Ankle Int 1994; 15:614–621.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Schmid, M.R., Pfirrmann, C.W.A., Hodler, J. et al. Cartilage lesions in the ankle joint: comparison of MR arthrography and CT arthrography. Skeletal Radiol 32, 259–265 (2003). https://doi.org/10.1007/s00256-003-0628-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00256-003-0628-y