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European Radiology
Published in: European Radiology 12/2021

Open Access 01-12-2021 | Musculoskeletal

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

Authors: Christoph Germann, Julien Galley, Anna L. Falkowski, Sandro F. Fucentese, Christian W. A. Pfirrmann, Daniel Nanz, Reto Sutter

Published in: European Radiology | Issue 12/2021

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Abstract

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).
Appendix
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Metadata
Title
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
Authors
Christoph Germann
Julien Galley
Anna L. Falkowski
Sandro F. Fucentese
Christian W. A. Pfirrmann
Daniel Nanz
Reto Sutter
Publication date
01-12-2021
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 12/2021
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-021-08062-x

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