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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

Morphological T1-weighted spin echo image (A) and corresponding T2-map (B) of case 7. Subchondral alterations are visible in the area of the repair site. Synovial fluid is seen between talar and tibial cartilage in the T2-map (red area, corresponding to Fig. 1); however, the repair site shows a complete covering of the defect and a homogeneous distribution of T2 values throughout the cartilage layers. The white boxes indicate how the regions of interest (1, repair tissue; 2, reference cartilage) were placed for T2 assessment.
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fig2-1947603510380901: Morphological T1-weighted spin echo image (A) and corresponding T2-map (B) of case 7. Subchondral alterations are visible in the area of the repair site. Synovial fluid is seen between talar and tibial cartilage in the T2-map (red area, corresponding to Fig. 1); however, the repair site shows a complete covering of the defect and a homogeneous distribution of T2 values throughout the cartilage layers. The white boxes indicate how the regions of interest (1, repair tissue; 2, reference cartilage) were placed for T2 assessment.

Mentions: 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.


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)

Morphological T1-weighted spin echo image (A) and corresponding T2-map (B) of case 7. Subchondral alterations are visible in the area of the repair site. Synovial fluid is seen between talar and tibial cartilage in the T2-map (red area, corresponding to Fig. 1); however, the repair site shows a complete covering of the defect and a homogeneous distribution of T2 values throughout the cartilage layers. The white boxes indicate how the regions of interest (1, repair tissue; 2, reference cartilage) were placed for T2 assessment.
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4300787&req=5

fig2-1947603510380901: Morphological T1-weighted spin echo image (A) and corresponding T2-map (B) of case 7. Subchondral alterations are visible in the area of the repair site. Synovial fluid is seen between talar and tibial cartilage in the T2-map (red area, corresponding to Fig. 1); however, the repair site shows a complete covering of the defect and a homogeneous distribution of T2 values throughout the cartilage layers. The white boxes indicate how the regions of interest (1, repair tissue; 2, reference cartilage) were placed for T2 assessment.
Mentions: 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.

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