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Characterization of the "Red Zone" of Knee Meniscus: MR Imaging and Histologic Correlation¹

¹ From the Departments of Radiology (O.H., L.R.F., R.D.B., N.L., C.B.C., D.R.) and Pathology (P.H.), University of California, San Diego, Veterans Affairs Medical Center, 3350 La Jolla Village Dr, San Diego, CA 92161. Received August 10, 1999; revision requested September 20; revision received December 13; accepted January 11, 2000. Supported by Veterans Administration grant SA-360. Address correspondence to D.R. (e-mail: dresnick@ucsd.edu).

PURPOSE: To determine the extent and vascularity of knee menisci with conventional and gadolinium-enhanced magnetic resonance (MR) imaging in cadaveric specimens, with histologic findings as the reference standard, and to investigate signal intensity changes in menisci and perimeniscal soft tissues in symptomatic patients.

MATERIALS AND METHODS: Radial dimensions and enhancement patterns of menisci were recorded and compared in (a) 12 cadaveric menisci examined with conventional and gadolinium-enhanced intermediate-weighted and fat-suppressed T1-weighted spin-echo MR imaging, high-spatial-resolution T1-weighted and fast low-angle shot MR imaging, and gross anatomic and histologic specimens and (b) 18 patients examined with conventional and gadolinium-enhanced fat-suppressed T1-weighted spin-echo MR imaging.

RESULTS: No differences in radial measurements of the meniscus were found for different MR techniques (P = .551). Despite the presence of vessels in the peripheral 10%–15% of the menisci, no enhancement of menisci was detected in specimens or patients. Perimeniscal soft-tissue enhancement adjacent to the posterior horn was greater than that adjacent to the anterior horn (P < .05), and enhancement of the lateral meniscal body was greater than that of the medial meniscal body (P < .05).

CONCLUSION: The wedge-shaped low-signal-intensity structure seen on MR images represents the entire meniscus. Intravenous injection of contrast material does not appear to be useful for differentiation of the vascularized from the nonvascularized zone of the meniscus.

Index terms: Gadolinium • Knee, injuries, 452.4852 • Knee, ligaments, menisci, and cartilage • Knee, MR, 452.121411, 452.121415, 452.12143 • Specimens, MR, 452.121411, 452.121412, 452.121415, 452.12143

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