Li Susan, Roemer Frank W, Guermazi Ali, Nevitt Michael C, Lynch John A, Segal Neil A
Department of Physical Medicine and Rehabilitation, University of Kansas Medical Center, Kansas City, KS, USA.
Department of Radiology, Boston University, Boston, MA, USA.
Skeletal Radiol. 2025 Jul 5. doi: 10.1007/s00256-025-04956-9.
Using WBCT arthrography (WBCTa) as the referent standard, this study evaluated the diagnostic performance of MRI for visualizing cartilage lesions and determined the rates at which WBCTa detects cartilage lesions that were missed or scored as more severe compared to MRI.
This cross-sectional, level II evidence, prospective observational study included 65 participants undergoing MRI for evaluation of suspected cartilage damage. WBCTa images were acquired following MRI. Knee cartilage morphology was semi-quantitatively assessed using the MRI Osteoarthritis Knee Score (MOAKS) on both imaging modalities. Sensitivity, specificity, accuracy, PPV, and NPV were calculated. The frequencies for cartilage severity detected on WBCT versus MRI in patellar, femoral, and tibial subregions were summarized.
MRI visualization of cartilage lesions had a sensitivity ranging from 0-79% for lesions detected on WBCT, specificity of 84-100%, and accuracy of 71-92%. Excluding the posterolateral tibia, cartilage lesion severity was greater on WBCTa than on MRI in all other subregions (3.1-33.8% of knees) where lesions were detected by both modalities.
MRI did not visualize a significant proportion of cartilage lesions that were visualized with WBCTa. In all subregions, excluding the posterolateral tibia, cartilage lesion severity was found to be greater on WBCTa than on MRI. Reasons for lower performance of MRI compared to WBCTa are likely multifactorial, potentially relating to scanning configurations, inferior conspicuity of the articular surfaces due to a lack of intraarticular contrast or fluid, and technical reasons such as inferior resolution and type of MRI sequence used.
本研究以重量负荷计算机断层扫描关节造影（WBCTa）作为参考标准，评估磁共振成像（MRI）对软骨损伤的诊断性能，并确定与MRI相比，WBCTa检测到的漏诊或评分更高的软骨损伤的发生率。
本横断面、II级证据、前瞻性观察性研究纳入了65名接受MRI检查以评估疑似软骨损伤的参与者。在MRI检查后获取WBCTa图像。使用MRI膝关节骨关节炎评分（MOAKS）对两种成像方式下的膝关节软骨形态进行半定量评估。计算敏感性、特异性、准确性、阳性预测值和阴性预测值。总结了在髌、股和胫亚区域中，WBCT与MRI检测到的软骨严重程度的频率。
对于WBCT检测到的病变，MRI对软骨损伤的可视化敏感性范围为0-79%，特异性为84-100%，准确性为71-92%。除胫骨后外侧外，在所有其他亚区域（通过两种方式均检测到病变的膝关节的3.1-33.8%），WBCTa上的软骨损伤严重程度高于MRI。
MRI未能显示出很大一部分在WBCTa上可见的软骨损伤。在所有亚区域中，除胫骨后外侧外，WBCTa上的软骨损伤严重程度高于MRI。与WBCTa相比，MRI性能较低的原因可能是多因素的，可能与扫描配置、由于缺乏关节内造影剂或液体导致关节表面的辨识度较差以及诸如分辨率较低和所用MRI序列类型等技术原因有关。
