Accuracy of magnetic resonance imaging to detect cartilage loss in severe osteoarthritis of the first carpometacarpal joint: comparison with histological evaluationReportar como inadecuado




Accuracy of magnetic resonance imaging to detect cartilage loss in severe osteoarthritis of the first carpometacarpal joint: comparison with histological evaluation - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Arthritis Research and Therapy

, 19:55

First Online: 14 March 2017Received: 13 December 2016Accepted: 14 February 2017

Abstract

BackgroundMagnetic resonance imaging MRI is increasingly used for research in hand osteoarthritis, but imaging the thin cartilage layers in the hand joints remains challenging. We therefore assessed the accuracy of MRI in detecting cartilage loss in patients with symptomatic osteoarthritis of the first carpometacarpal CMC1 joint.

MethodsTwelve patients scheduled for trapeziectomy to treat severe symptomatic osteoarthritis of the CMC1 joint underwent a preoperative high resolution 3D spoiled gradient SPGR MRI scan. Subsequently, the resected trapezium was evaluated histologically. The sections were scored for cartilage damage severity Osteoarthritis Research Society International OARSI score, and extent of damage percentage surface area. Each MRI scan was scored for the area of normal cartilage, partial cartilage loss and full cartilage loss. The percentages of the total surface area with any cartilage loss and full-thickness cartilage loss were calculated using MRI and histological evaluation.

ResultsMRI and histological evaluation both identified large areas of overall cartilage loss. The median IQR surface area of any cartilage loss on MRI was 98% 82–100%, and on histological assessment 96% 87–98%. However, MRI underestimated the extent of full-thickness cartilage loss. The median IQR surface area of full-thickness cartilage loss on MRI was 43% 22–70%, and on histological evaluation 79% 67–85%. The difference was caused by a thin layer of high signal on the articulating surface, which was interpreted as damaged cartilage on MRI but which was not identified on histological evaluation.

ConclusionsThree-dimensional SPGR MRI of the CMC1 joint demonstrates overall cartilage damage, but underestimates full-thickness cartilage loss in patients with advanced osteoarthritis.

KeywordsMagnetic resonance imaging First carpometacarpal joint Cartilage Histology Osteoarthritis AbbreviationsBMLBone marrow lesions

CMC1First carpometacarpal joint

CRConventional radiology

ETLEcho train length

FOVField of view

FRFSEFast recovery fast spin echo

FSFat suppression

ICCIntraclass correlation coefficient

MOAKSMagnetic resonance imaging osteoarthritis knee score

MRIMagnetic resonance imaging

OAOsteoarthritis

OARSIOsteoarthritis Research Society International

PDProton density

SPGRSpoiled gradient

TEEcho time

TRRepetition time

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Autor: Michael S. Saltzherr - J. Henk Coert - Ruud W. Selles - Johan W. van Neck - Jean-Bart Jaquet - Gerjo J. V. M. van Osc

Fuente: https://link.springer.com/







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