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Microfracture in the Ankle: Clinical Results and MRI with T2-Mapping at 3.0 T after 1 to 8 Years.

Domayer SE, Welsch GH, Stelzeneder D, Hirschfeld C, Quirbach S, Nehrer S, Dorotka R, Mamisch TC, Trattnig S - Cartilage (2011)

Bottom Line: Both clinical scores demonstrated significant improvement at the time of the MR examination (P < 0.001).Relative T2 (rT2) was 1.00 ± 0.20 (range, 0.72-1.36).MFX in the ankle can provide RT with T2 properties similar to adjacent cartilage.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Medical University of Vienna, Vienna, Austria ; Department of Radiology, MR Center of Excellence, Medical University of Vienna, Vienna, Austria.

ABSTRACT

Background: Microfracture (MFX) is frequently used to treat deep cartilage defects in the ankle; however, the data on repair tissue (RT) quality after MFX are very limited at this time. T2-mapping at 3 T has been optimized for the ankle and can be used to noninvasively evaluate cartilage collagen and water content. The aim of this study was to determine if the RT after MFX in the ankle had T2 properties similar to the adjacent reference cartilage (RC).

Methods: Fourteen cases after MFX in the ankle were assessed with morphological MRI and T2-mapping at 3 T. The American Orthopaedic Foot and Ankle Society (AOFAS) score and a modified Cinicinnati Knee Rating System rating were used to evaluate the clinical outcome. The MRI protocol included a 3-dimensional sequence and a proton-density sequence for morphological evaluation and a multiecho spin echo sequence for T2-mapping. Region of interest analyses were carried out in accordance with the morphological images to ensure complete coverage of the defect site.

Results: Both clinical scores demonstrated significant improvement at the time of the MR examination (P < 0.001). RT T2 was 49.3 ± 10.1 (range, 35.7-69.3) milliseconds, and RC T2 was 49.9 ± 8.2 (range, 38.4-63.7) milliseconds (P = 0.838). Relative T2 (rT2) was 1.00 ± 0.20 (range, 0.72-1.36).

Conclusion: MFX in the ankle can provide RT with T2 properties similar to adjacent cartilage.

No MeSH data available.


Related in: MedlinePlus

Three-dimensional defect assessment and field-of-view (FOV) planning with the true FISP sequence in case 7: (A) sagittal, (B) coronal, and (C) axial plane. The sequence was used to ensure the morphological images, and the T2-maps were placed accurately over the defect. The sagittal plane (A) was used to center the FOV (Fig. 2). White arrows indicate the repair site that is accurately delineated. The defect is completely covered; however, there is synovial fluid between the tibial and talar cartilages (hyperintense band over the defect in A and B). The repair tissue is hypointense compared to the adjacent native cartilage. Further morphological analyses were based on the 2-dimensional high-resolution sequences.
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fig1-1947603510380901: Three-dimensional defect assessment and field-of-view (FOV) planning with the true FISP sequence in case 7: (A) sagittal, (B) coronal, and (C) axial plane. The sequence was used to ensure the morphological images, and the T2-maps were placed accurately over the defect. The sagittal plane (A) was used to center the FOV (Fig. 2). White arrows indicate the repair site that is accurately delineated. The defect is completely covered; however, there is synovial fluid between the tibial and talar cartilages (hyperintense band over the defect in A and B). The repair tissue is hypointense compared to the adjacent native cartilage. Further morphological analyses were based on the 2-dimensional high-resolution sequences.

Mentions: All examinations were performed on a 3-T MR unit (Magnetom TIM Trio, Siemens, Erlangen, Germany) with a maximum gradient strength of 40 mT/m using an 8-channel (phased array) flexible multipurpose coil (Noras, Würzburg, Germany). For volumetric defect site measurements and for the field-of-view (FOV) planning of the morphological and T2-mapping sequences, we used an isotropic 3-dimensional (3-D) gradient echo (true FISP) sequence (Fig. 1). A 160-mm FOV and 5122 matrix resulted in 0.4 × 0.4 × 0.4-mm isotropic resolution; TR and TE were 8.86 and 1.95 milliseconds, respectively; the flip angle was 28°. Two averages were measured, and the bandwidth was 200 Hz/pixel. With the use of generalized autocalibrating partially parallel acquisition (GRAPPA), the acceleration factor was 3, resulting in an acquisition time of 9 minutes 33 seconds.


Microfracture in the Ankle: Clinical Results and MRI with T2-Mapping at 3.0 T after 1 to 8 Years.

Domayer SE, Welsch GH, Stelzeneder D, Hirschfeld C, Quirbach S, Nehrer S, Dorotka R, Mamisch TC, Trattnig S - Cartilage (2011)

Three-dimensional defect assessment and field-of-view (FOV) planning with the true FISP sequence in case 7: (A) sagittal, (B) coronal, and (C) axial plane. The sequence was used to ensure the morphological images, and the T2-maps were placed accurately over the defect. The sagittal plane (A) was used to center the FOV (Fig. 2). White arrows indicate the repair site that is accurately delineated. The defect is completely covered; however, there is synovial fluid between the tibial and talar cartilages (hyperintense band over the defect in A and B). The repair tissue is hypointense compared to the adjacent native cartilage. Further morphological analyses were based on the 2-dimensional high-resolution sequences.
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4300787&req=5

fig1-1947603510380901: Three-dimensional defect assessment and field-of-view (FOV) planning with the true FISP sequence in case 7: (A) sagittal, (B) coronal, and (C) axial plane. The sequence was used to ensure the morphological images, and the T2-maps were placed accurately over the defect. The sagittal plane (A) was used to center the FOV (Fig. 2). White arrows indicate the repair site that is accurately delineated. The defect is completely covered; however, there is synovial fluid between the tibial and talar cartilages (hyperintense band over the defect in A and B). The repair tissue is hypointense compared to the adjacent native cartilage. Further morphological analyses were based on the 2-dimensional high-resolution sequences.
Mentions: All examinations were performed on a 3-T MR unit (Magnetom TIM Trio, Siemens, Erlangen, Germany) with a maximum gradient strength of 40 mT/m using an 8-channel (phased array) flexible multipurpose coil (Noras, Würzburg, Germany). For volumetric defect site measurements and for the field-of-view (FOV) planning of the morphological and T2-mapping sequences, we used an isotropic 3-dimensional (3-D) gradient echo (true FISP) sequence (Fig. 1). A 160-mm FOV and 5122 matrix resulted in 0.4 × 0.4 × 0.4-mm isotropic resolution; TR and TE were 8.86 and 1.95 milliseconds, respectively; the flip angle was 28°. Two averages were measured, and the bandwidth was 200 Hz/pixel. With the use of generalized autocalibrating partially parallel acquisition (GRAPPA), the acceleration factor was 3, resulting in an acquisition time of 9 minutes 33 seconds.

Bottom Line: Both clinical scores demonstrated significant improvement at the time of the MR examination (P < 0.001).Relative T2 (rT2) was 1.00 ± 0.20 (range, 0.72-1.36).MFX in the ankle can provide RT with T2 properties similar to adjacent cartilage.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Medical University of Vienna, Vienna, Austria ; Department of Radiology, MR Center of Excellence, Medical University of Vienna, Vienna, Austria.

ABSTRACT

Background: Microfracture (MFX) is frequently used to treat deep cartilage defects in the ankle; however, the data on repair tissue (RT) quality after MFX are very limited at this time. T2-mapping at 3 T has been optimized for the ankle and can be used to noninvasively evaluate cartilage collagen and water content. The aim of this study was to determine if the RT after MFX in the ankle had T2 properties similar to the adjacent reference cartilage (RC).

Methods: Fourteen cases after MFX in the ankle were assessed with morphological MRI and T2-mapping at 3 T. The American Orthopaedic Foot and Ankle Society (AOFAS) score and a modified Cinicinnati Knee Rating System rating were used to evaluate the clinical outcome. The MRI protocol included a 3-dimensional sequence and a proton-density sequence for morphological evaluation and a multiecho spin echo sequence for T2-mapping. Region of interest analyses were carried out in accordance with the morphological images to ensure complete coverage of the defect site.

Results: Both clinical scores demonstrated significant improvement at the time of the MR examination (P < 0.001). RT T2 was 49.3 ± 10.1 (range, 35.7-69.3) milliseconds, and RC T2 was 49.9 ± 8.2 (range, 38.4-63.7) milliseconds (P = 0.838). Relative T2 (rT2) was 1.00 ± 0.20 (range, 0.72-1.36).

Conclusion: MFX in the ankle can provide RT with T2 properties similar to adjacent cartilage.

No MeSH data available.


Related in: MedlinePlus