title: Driven equilibrium magnetic resonance imaging of articular cartilage: initial clinical experience.
abstract: OBJECTIVE
  To evaluate three-dimensional driven equilibrium Fourier transform (3D-DEFT) for image quality and detection of articular cartilage lesions in the knee.
  
  
  METHODS
  We imaged 104 consecutive patients with knee pain with 3D-DEFT and proton density (PD-FSE) and T2-weighted (T2-FSE) fast spin echo. Twenty-four went on to arthroscopy. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) efficiency were measured. Subjective image quality, fat suppression, and cartilage thickness visibility were assessed. Cartilage lesions on 3D-DEFT and T2-FSE were compared with findings outlined in operative reports.
  
  
  RESULTS
  SNR efficiency was higher for 3D-DEFT and PD-FSE than for T2-FSE (P < 0.02). 3D-DEFT and PD-FSE showed superior cartilage thickness visibility compared with T2-FSE (P < 0.02). T2-FSE showed better fat suppression and fewer image artifacts than 3D-DEFT (P < 0.04). 3D-DEFT had similar sensitivity and similar specificity for cartilage lesions compared with PD-FSE and T2-FSE.
  
  
  CONCLUSIONS
  3D-DEFT provides excellent synovial fluid-to-cartilage contrast while preserving signal from cartilage, giving this method a high cartilage SNR. 3D-DEFT shows the full cartilage thickness better than T2-FSE. T2-FSE had superior fat saturation and fewer artifacts than 3D-DEFT. Overall, 3D-DEFT requires further technical development, but is a promising method for imaging articular cartilage.
authors.affiliation: Department of Radiology, Stanford University, Stanford, California 94305-5105, USA. gold@stanford.edu
authors.forename: Garry E
authors.initials: GE
authors.lastname: Gold
authors.forename: Samuel E
authors.initials: SE
authors.lastname: Fuller
authors.forename: Brian A
authors.initials: BA
authors.lastname: Hargreaves
authors.forename: Kathryn J
authors.initials: KJ
authors.lastname: Stevens
authors.forename: Christopher F
authors.initials: CF
authors.lastname: Beaulieu
mesh_terms: D001182:Arthroscopy; D002358:Cartilage, Articular / Q000473:pathology*; D005583:Fourier Analysis; D006801:Humans; D021621:Imaging, Three-Dimensional; D007719:Knee Joint; D008279:Magnetic Resonance Imaging / Q000379:methods*; D012680:Sensitivity and Specificity