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Patellar Articular Cartilage Lesions: In Vitro MR Imaging Evaluation after Placement in Gadopentetate Dimeglumine Solution¹

¹ From the Department of Radiology, Technische Universitaet Muenchen, Ismaninger Str 22, D-81675 Munich, Germany (K.W., J.M., E.J.R.); and the Gerhard Domagk Institute of Pathology, Westfaelische Wilhelms Universitaet Muenster, Germany (H.B.). Received October 24, 2002; revision requested January 7, 2003; final revision received June 3; accepted June 24. Address correspondence to K.W. (e-mail: woertler@roe.med.tu-muenchen.de).

View larger version (111K): [in a new window]   Figure 1.  A, Transverse T1-weighted SE (630/15) MR images (top) and B, transverse inversion-recovery turbo SE (7,900/90/300 [inversion time]) MR images (top) and corresponding subtraction (SUBTR) images of human patella specimens obtained immediately (t0) and 4 hours after (t4) placement in gadopentetate dimeglumine solution (2.5 mmol/L). Delayed MR and subtraction images demonstrate homogeneously increased signal intensity (arrows) of articular cartilage after gadopentetate dimeglumine diffusion. C, Corresponding macroscopic section with subdivision of patellar cartilage into three regions for pathologic correlation shows intact surface and normal height of articular cartilage. D, Photomicrographs from region 2 demonstrate normal histologic appearance of articular cartilage. (Hematoxylin-eosin stain; original magnification, x40 [left] and x100 [right].)

View larger version (106K): [in a new window]   Figure 2.  A, Delayed transverse T1-weighted SE (630/15) MR image and B, corresponding subtraction image of human patella specimen in gadopentetate dimeglumine solution show a cartilage area of decreased signal intensity (arrows) at the lateral facet. C, Corresponding macroscopic section demonstrates intact surface and normal appearance of articular cartilage. D, Histologic sections from the lateral facet show cartilage degradation (arrows) and clusters of proliferating chondrocytes (arrowheads) consistent with a grade 1 cartilage lesion. (Hematoxylin-eosin stain; original magnification, x100.)

View larger version (145K): [in a new window]   Figure 3.  A, Transverse inversion-recovery turbo SE (7,900/90/300) and B, transverse T1-weighted SE (630/15) MR images of human patella specimens obtained immediately after placement into gadopentetate dimeglumine solution. C, Subtraction image from SE MR images obtained immediately and after a delay (not shown). Images demonstrate grade 3 articular cartilage lesion (arrows) at the lateral patellar facet. A small area of increased signal intensity (arrowheads) lateral to the surface lesion is visible. D, Corresponding macroscopic section of patella specimen shows surface lesion (arrow). E, Histologic sections obtained from the lateral patellar facet demonstrate surface lesion (*) and grade 2 articular cartilage lesion with fissuring (arrows) and proliferative changes (arrowheads), which correspond to signal intensity alteration on MR images. (Hematoxylin-eosin stain; original magnification, x20 [top], x40 [bottom left], x100 [bottom right].)

View larger version (109K): [in a new window]   Figure 4.  A, Transverse T1-weighted SE (630/15) delayed MR image and B, corresponding SE subtraction image of a human patella specimen in gadopentetate dimeglumine solution show diffuse thinning of articular cartilage and a deep surface defect with exposure of subchondral bone and intraosseous herniation (arrows) of cartilage. Note inhomogeneous articular cartilage enhancement. C, Corresponding macroscopic section demonstrates diffuse thinning of articular cartilage and a grade 4 defect (arrow) close to the apex of the patella. D, Histologic section obtained from the central portion of the patella shows diffuse cartilage degeneration, a focal defect (arrow), and herniation of articular cartilage (arrowheads) caused by collapse of subchondral bone. (Hematoxylin-eosin stain; original magnification, x40.)