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Ultra-high resolution 3D MRI for chondrocalcinosis detection in the knee—a prospective diagnostic accuracy study comparing 7-tesla and 3-tesla MRI with CT
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Ultra-high resolution 3D MRI for chondrocalcinosis detection in the knee—a prospective diagnostic accuracy study comparing 7-tesla and 3-tesla MRI with CT
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Journal Article
Ultra-high resolution 3D MRI for chondrocalcinosis detection in the knee—a prospective diagnostic accuracy study comparing 7-tesla and 3-tesla MRI with CT
2021
Overview
Objectives
To test the diagnostic accuracy of a 3D dual-echo steady-state (DESS) sequence at 7-T MRI regarding the detection of chondral calcific deposits of the knee in comparison to 3-T MRI, using CT as cross-sectional imaging reference standard.
Methods
CT and 7-T MRI (DESS) of knee joints in 42 patients with radiographically known chondrocalcinosis (13 of 42 bilateral) were prospectively acquired for all included patients (n = 55 knee joints). Additionally, 3-T MRI (DESS) was performed for 20 of these 55 knee joints. Two fellowship-trained musculoskeletal radiologists scored eight cartilage regions of each knee joint separately regarding presence of cartilage calcification, diagnostic confidence level, and sharpness of calcific deposits. In an explorative subanalysis, micro-CT of the menisci was evaluated after knee arthroplasty in one patient. Diagnostic performance metrics and nonparametric tests were used to compare between modalities.
p
values < 0.05 were considered to represent statistical significance.
Results
Sensitivity for chondrocalcinosis detection was significantly higher for 7-T MRI (100%) compared to 3-T MRI (reader 1: 95.9%,
p
= 0.03; reader 2: 93.2%,
p
= 0.002). The diagnostic confidence was significantly higher for both readers at 7 T compared to both 3-T MRI (
p
< 0.001) and to CT (
p
= 0.03). The delineation of chondral calcifications was significantly sharper for 7-T compared to both 3-T MRI and CT (
p
< 0.001, both readers). Micro-CT in one patient suggested that 7-T MRI may potentially outperform standard CT in diagnosing chondral calcifications.
Conclusion
3D-DESS imaging at 7-T MRI offers a significantly higher sensitivity in detection of chondral calcific deposits compared to 3-T MRI.
Key Points
• 3D dual-echo steady-state (DESS) MRI at 7 T has a higher sensitivity in detection of chondral calcific deposits compared to 3-T MRI (p ≤ 0.03).
• 3D DESS MRI at 7 T yields no false-negative cases regarding presence of chondral calcific deposits.
• 3D DESS MRI at 7 T offers better delineation and higher diagnostic confidence in detection of chondral calcific deposits compared to 3-T MRI (p < 0.001).
Publisher
Springer Berlin Heidelberg,Springer Nature B.V
