Value of Adding a T2 Mapping Sequence to a Routine MR Imaging Protocol in Evaluation of Articular Cartilage of the Knee Joint

Abstract

Osteoarthritis (OA), whether 1ry or 2ry to trauma or other cause is considered as one of the most disabling arthritic conditions, affecting the synovial joint. With articular cartilage progressive metabolic and structural modifications. Evaluation and treatment of patients with early stages of osteoarthritis (OA) is dependent upon an accurate assessment of the cartilage lesions. However, standard cartilage dedicated magnetic resonance (MR) techniques are inconclusive in quantifying early degenerative changes. The objective of this study was to determine the ability of MR T2 mapping to detect cartilage matrix degeneration between normal and early OA patients. This study was held in the period between September 2019 and December 2020.Using MR T2 mapping imaging in addition to routine MRI knee protocol to visualize the articular cartilage of the knee on 1.5 T MR Scanner using special software to evaluate the efficiency of T2 mapping to detect cartilage lesions in patients representing with knee pain and not diagnosed clinically to have osteoarthritis. The material of this study included twenty (20) patients presented by knee pain. 20 knee MRI examinations and 20 corresponding T2 maps were analyzed. In this study, the addition of a T2 mapping of the knee cartilage sequence to a routine MR knee protocol improved sensitivity and accuracy in the detection of cartilage lesions within the knee joint. The improvement in sensitivity with use of the T2 maps was in the identification of early cartilage degeneration. So, MR has proved to be the best non-invasive method in imaging assessment of articular cartilage. T2 mapping is able to perform a quantitative analysis of the collagen matrix and detect its damage in early stages; these alterations can be overlooked in purely morphologic MR studies, carrying a delay in diagnosis and treatment. In conclusion; this study confirmed that addition of T2 maps to standard views of the MR knee protocol improved accuracy in diagnosing early cartilage degeneration in knee pain and it provides a useful addition to standard MR imaging when cartilage degeneration is suspected especially among the young population. Helping the target of the future to early diagnose the cartilage degeneration and hopefully to prevent the disease progress as well.