title: Chondral lesions in the patellofemoral joint in MRI: Intra-individual comparison of short-tau inversion recovery sequence (STIR) with 2D multiple-echo data image combination sequence (MEDIC).
abstract: OBJECTIVE
  To determine the value of the 2D multiple-echo data image combination (MEDIC) sequence relative to the short-tau inversion recovery (STIR) sequence regarding the depiction of chondral lesions in the patellofemoral joint.
  
  
  METHODS
  During a period of 6 month patients with acute pain at the anterior aspect of the knee, joint effusion and suspected chondral lesion defect in the patellofemoral joint underwent MRI including axial MEDIC and STIR imaging. Patients with chondral lesions in the patellofemoral joint on at least one sequence were included. The MEDIC and STIR sequence were quantitatively compared regarding the patella cartilage-to-effusion contrast-to-noise ratio (CNR) and qualitatively regarding the depiction of chondral lesions independently scored by two radiologists on a 3-point scale (1 = not depicted; 2 = blurred depicted; 3 = clearly depicted) using the Wilcoxon-Mann-Whitney-Test. For the analysis of inter-observer agreement the Cohen's Weighted Kappa test was used.
  
  
  RESULTS
  30 of 58 patients (male: female, 21:9; age: 44 ± 12 yrs) revealed cartilage lesions (fissures, n = 5 including fibrillation; gaps, n = 15; delamination, n = 7; osteoarthritis, n = 3) and were included in this study. The STIR-sequence was significantly (p < 0.001) superior to the MEDIC-sequence regarding both, the patella cartilage-to-effusion CNR (mean CNR: 232 ± 61 vs. 40 ± 16) as well as the depiction of chondral lesion (mean score: 2.83 ± 0.4 vs. 1.75 ± 0.7) with substantial inter-observer agreement in the rating of both sequences (κ = 0.76-0.89).
  
  
  CONCLUSIONS
  For the depiction of chondral lesions in the patellofemoral joint, the axial STIR-sequence should be chosen in preference to the axial MEDIC-sequence.
authors.affiliation: Goethe University of Frankfurt, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
authors.forename: Boris
authors.initials: B
authors.lastname: Bodelle
authors.affiliation: Goethe University of Frankfurt, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Luboldt
authors.affiliation: Goethe University of Frankfurt, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
authors.forename: Julian L
authors.initials: JL
authors.lastname: Wichmann
authors.affiliation: Goethe University of Frankfurt, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Fischer
authors.affiliation: Goethe University of Frankfurt, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Vogl
authors.affiliation: Goethe University of Frankfurt, Department of Diagnostic and Interventional Radiology, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Beeres
keywords: Chondral Lesion; MEDIC; MEDIC, 2D multiple-echo data image combination sequence; MRI; Patellofemoral Joint; STIR; STIR, short-tau inversion recovery sequence