• AJR Am J Roentgenol · Dec 2004

    Comparative Study

    MR arthrography of the hip: diagnostic performance of a dedicated water-excitation 3D double-echo steady-state sequence to detect cartilage lesions.

    • Patrick R Knuesel, Christian W A Pfirrmann, Hubert P Noetzli, Claudio Dora, Marco Zanetti, Juerg Hodler, Bernd Kuehn, and Marius R Schmid.
    • Department of Radiology, University Hospital Balgrist, Forchstrasse 340, Zurich CH-8008, Switzerland.
    • AJR Am J Roentgenol. 2004 Dec 1; 183 (6): 1729-35.

    ObjectiveThe objective of our study was to compare the diagnostic performance of a dedicated cartilage MR sequence (water-excitation 3D double-echo steady-state) with a standard MR sequence (T1-weighted spin-echo) in detecting articular cartilage lesions of the hip after intraarticular injection of gadopentetate dimeglumine.Materials And MethodsIn 50 MR arthrograms of the hip joint obtained in 47 consecutive patients, a sagittal 3D double-echo steady-state sequence (TR/TE, 24/6.5; flip angle, 25 degrees ) was compared with a sagittal T1-weighted spin-echo sequence (350/14). Two musculoskeletal radiologists independently evaluated articular cartilage. Sensitivity and specificity for detecting cartilage defects were calculated for those hips that underwent open surgery (n = 21). Lesion conspicuity was retrospectively reviewed and graded between 1 (not visible) and 5 (well defined).ResultsAt surgery, a total of 26 lesions of the acetabular (n = 20) and femoral (n = 6) cartilage were found. For the 3D double-echo steady-state and T1-weighted spin-echo sequences, sensitivities and specificities for cartilage lesion detection were 58% and 88% and 81% and 81% for reviewer 1 and 62% and 94% and 62% and 100% for reviewer 2, respectively. Lesion conspicuity was significantly superior (p = 0.036) for the 3D double-echo steady-state sequence (mean grade, 3.4) compared with the T1-weighted spin-echo sequence (mean grade, 3.0). The kappa value was fair for the 3D double-echo steady-state sequence (kappa = 0.40) and moderate for the T1-weighted spin-echo sequence (kappa = 0.55).ConclusionThe 3D double-echo steady-state sequence optimized for cartilage imaging improves lesion conspicuity but does not improve diagnostic performance.

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