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Articular Cartilage of Knee: Normal Patterns at MR Imaging That Mimic Disease in Healthy Subjects and Patients with Osteoarthritis¹

¹ From the Dept of Radiology, Brigham and Women’s Hospital Harvard Medical School, 75 Francis St, ASB-1, L-1, Room 003E, Boston, MA 02115 (H.Y., P.L.); Depts of Radiology (K.S.) and Immunology and Rheumatology (M.G.), Stanford Univ School of Medicine, Stanford, Calif; and Sports Orthopedic and Rehabilitation Medicine Associates, Menlo Park, Calif (M.F.D.). Received Apr 22, 2002; revision requested Jun 21; final revision received Aug 13, 2003; accepted Oct 8. Supported in part by grants from the Chiron Corporation, the Whitaker Foundation, and the Japanese Overseas Research Fellowships from Monbusho (the Ministry of Education, Science, Sports, and Culture of Japan). Address correspondence to P.L. (e-mail: pklang@partners.org).

View larger version (65K): [in a new window]   Figure 1. Sagittal fat-suppressed MR images in 60-year-old man with osteoarthritis. A, Short-TE FSE (4,000/13) and, B, long-TE FSE (4,000/39) images show clearly defined cartilage contour (arrowheads) in the posterior region of the femoral condylar cartilage. C, Fat-suppressed 3D SPGR image (60/5, 40° flip angle) shows ambiguous surface contour (solid arrows) on the posterior region of the femoral condylar cartilage and a linear area of high signal intensity (open arrows) in the deep zone adjacent to subchondral bone.

View larger version (56K): [in a new window]   Figure 2. Sagittal fat-suppressed MR images in same patient as in Figure 1. A, Short-TE FSE (4,000/13) and, B, long-TE FSE (4,000/39) images show a large, and in some areas, full-thickness cartilage defect (arrows) in the central and posterior regions of the lateral femoral condyle. Although, C, a 3D SPGR image (60/5, 40° flip angle), shows the cartilage defect, the margins are not well defined, particularly posteriorly (arrows). The full-thickness cartilage defect was confirmed at arthroscopy.

View larger version (48K): [in a new window]   Figure 3. Sagittal fat-suppressed MR images in 41-year-old woman with osteoarthritis obtained with, A, a short-TE FSE sequence (4,000/13), B, a long-TE FSE sequence (4,000/39), and, C, a 3D SPGR sequence (60/5, 40° flip angle). C, A pseudolaminar appearance (arrows) caused by truncation artifact is seen in the posterior region of the femoral condylar cartilage.

View larger version (64K): [in a new window]   Figure 4. Sagittal fat-suppressed MR images in 44-year-old woman with osteoarthritis. A, Short-TE FSE image (4,000/13) shows high-signal-intensity truncation artifact (arrows) in the trochlear cartilage. B, Long-TE FSE image (4,000/39) also shows faint high signal intensity in the same region. C, 3D SPGR image (60/5, 40° flip angle) shows typical truncation artifact (arrows).

View larger version (63K): [in a new window]   Figure 5. Sagittal fat-suppressed MR images in 46-year-old man with a history of knee surgery. A, Short-TE FSE (4,000/13) and, B, long-TE FSE (4,000/39) images show only faint signal intensity inhomogeneity. C, On a 3D SPGR image (60/5, 40° flip angle), metallic artifact obscures the cartilage contour, giving the cartilage the appearance of having focally inhomogeneous signal intensity (arrows).

View larger version (85K): [in a new window]   Figure 6. Sagittal fat-suppressed MR images in 40-year-old woman with osteoarthritis. A, Short-TE FSE (4,000/13), B, long-TE FSE (4,000/39), and, C, 3D SPGR (60/5, 40° flip angle) images show decreased signal intensity (arrow) in the distal part of the trochlear cartilage. The area of decreased signal intensity is more prominent, larger, and better seen in B.

View larger version (69K): [in a new window]   Figure 7. Sagittal fat-suppressed MR images in 46-year-old man with osteoarthritis. A, Short-TE FSE (4,000/13), B, long-TE FSE (4,000/39), and, C, 3D SPGR (60/5, 40° flip angle) images show heterogeneous signal intensity (arrows) in the distal part of the trochlear cartilage; this finding suggests degenerative change of the cartilage, which was confirmed at arthroscopy.

View larger version (47K): [in a new window]   Figure 8. Sagittal fat-suppressed MR images in 63-year-old man with osteoarthritis. A, Short-TE FSE (4,000/13), B, long-TE FSE (4,000/39), and, C, 3D SPGR (60/5, 40° flip angle) images show decreasing cartilage thickness (arrow) above the anterior horn of the lateral meniscus. The cartilage thickness in this region changes smoothly from that of adjacent cartilage.

View larger version (62K): [in a new window]   Figure 9. Sagittal fat-suppressed MR images in 68-year-old man with osteoarthritis. A, Short-TE FSE (4,000/13), and, B, long-TE FSE (4,000/39) images show focal cartilage flattening (arrows) in the posterior region of the lateral femoral cartilage. C, A 3D SPGR image (60/5, 40° flip angle) shows this finding less clearly.

View larger version (17K): [in a new window]   Figure 10. Bar graph shows mean values for contrast between cartilage and adjacent structures for short-TE FSE MR images (black bars), long-TE FSE MR images (gray bars), and 3D SPGR MR images (white bars). All three kinds of images were obtained with fat suppression.