Direct magnetic resonance arthrography

Magnetic resonance (MR) arthrography has gained increasing popularity as a diagnostic tool in the assessment of intra-articular derangements. Its role has been studied extensively in the shoulder, but it also has been explored in the hip, elbow, knee, wrist and ankle. This article reviews the current role of direct MR arthrography in several major joints, with consideration of pertinent anatomy, techniques and applications.     

Magnetic resonance imaging of articular cartilage: ex vivo study on normal cartilage correlated with magnetic resonance microscopy

The aims of this study were (a) to compare the MR appearance of normal articular cartilage in ex vivo MR imaging (MRI) and MR microscopy (MRM) images of disarticulated human femoral heads, (b) to evaluate by MRM the topographic variations in articular cartilage of disarticulated human femoral heads, and subsequently, (c) to compare MRM images with histology. Ten disarticulated femoral heads were examined. Magnetic resonance images were obtained using spin-echo (SE) and gradient-echo (GE) sequences. Microimages were acquired on cartilage–bone cylindrical plugs excised from four regions (superior, inferior, anterior, posterior) of one femoral head, using a modified SE sequence. Both MRI and MRM images were obtained before and after a 90 ° rotation of the specimen, around the axis perpendicular to the examined cartilage surface. Finally, MRM images were correlated with histology. A trilaminar appearance of articular cartilage was observed with MRI and with a greater detail with MRM. A good correlation between MRI and MRM features was demonstrated. Both MRI and MRM showed a loss of the trilaminar cartilage appearance after specimen rotation, with greater evidence on MRM images. Cartilage excised from the four regions of the femoral head showed a different thickness, being thickest in the samples excised from the superior site. The MRM technique confirms the trilaminar MRI appearance of human articular cartilage, showing good correlation with histology. The loss of the trilaminar appearance of articular cartilage induced by specimen rotation suggests that this feature is partially related to the collagen-fiber orientation within the different layers. The MRM technique also shows topographic variations in thickness of human articular cartilage. Received 28 July 1997; Revision received 31 December 1997; Accepted 6 January 1998     

Determination of knee joint cartilage thickness using three-dimensional magnetic resonance chondro-crassometry (3D MR-CCM)

The objective of this article was to analyze the accuracy and precision with which the quantitative distribution of articular cartilage can be determined in the knee joint using MRI. A three-dimensional (3D) technique that accounts for the out-of-plane deviation of the interface normal in strongly curved joint surfaces (3D MR-CCM) has been developed for cartilage thickness measurements. Eight cadaveric knee-joint specimens and six volunteers were imaged using a fat-suppressed gradient-echo sequence at a resolution of 2 × 0.31 × 0.31 mm³. Cartilage volumes and topographical thickness maps were obtained and compared with those derived from anatomical sections by image analysis. The deviation of the MR volumes from those of the sections was 1–12%, the coefficient of variation after repositioning ranged from 2.9% (patella) to 8.2% (lateral tibial plateau). Between 60% and 80% of all image points could be attributed to identical thickness intervals, less than 20% deviating by more than 0.5 mm. The intraobserver and interobserver reproducibilities were very high in both the specimens and the volunteers. In the knee joint, 3D reconstructions of the cartilages, and measurements that take into account the out-of-plane deviation of the interface normals (3D MR-CCM), are required.     

Indirect magnetic resonance arthrography

Indirect MR arthrography is useful for evaluation of joints such as the elbow, wrist, ankle and shoulder where there is a large synovial surface area relative to joint volume. It allows simultaneous assessment of both intra-articular and extra-articular soft tissues with the added advantage of minimal invasiveness. The established and potential uses of this imaging technique are reviewed below and the pathology that is demonstrated by this technique is discussed.     

Moving-table reduced-dose gadolinium-enhanced three-dimensional magnetic resonance angiography: velocity-dependent method with three-phase gadolinium infusion

The purpose of this study was to develop a method for reducing gadolinium dose and suppressing venous overlap in moving-table three-dimensional (3D) magnetic resonance (MR) angiography from the abdomen to the feet. Thirty-one patients underwent three-phase infusion of 16-18 mL of gadolinium: infusion rates and imaging times were determined after taking into account mean blood flow velocity, so that image acquisition was synchronized with peak arterial enhancement at both the first and third stations (velocity-dependent method). Twenty-three other patients underwent slow infusion of 38 mL of gadolinium with fixed acquisition time (high-dose method). The image quality for the two methods was compared. The velocity-dependent method produced good image quality with significantly less venous overlap than the high-dose method, especially in the below-the-knee region (P <.001). The velocity-dependent method provides satisfactory MR angiograms using 16-18 mL of gadolinium in patients having various blood flow velocities.     

Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC), after slipped capital femoral epiphysis

Objective

The aim of this study was to assess the glycosaminoglycan (GAG) content in hip joint cartilage in mature hips with a history of slipped capital femoral epiphysis (SCFE) using delayed gadolinium-enhanced MRI of cartilage (dGEMRIC).

Methods

28 young-adult subjects (32 hips) with a mean age of 23.8 ± 4.0 years (range: 18.1-30.5 years) who were treated for mild or moderate SCFE in adolescence were included into the study. Hip function and clinical symptoms were evaluated with the Harris hip score (HHS) system at the time of MRI. Plain radiographic evaluation included Tonnis grading, measurement of the minimal joint space width (JSW) and alpha-angle measurement. The alpha-angle values were used to classify three sub-groups: group 1 = subjects with normal femoral head-neck offset (alpha-angle <50°), group 2 = subjects with mild offset decrease (alpha-angle 50°-60°), and group 3 = subjects with severe offset decrease (alpha-angle >60°).

Results

There was statistically significant difference noted for the T1_Gd values, lateral and central, between group 1 and group 3 (p-values = 0.038 and 0.041). The T1_Gd values measured within the lateral portion were slightly lower compared with the T1_Gd values measured within the central portion that was at a statistically significance level (p-value <0.001). HHS, Tonnis grades and JSW revealed no statistically significant difference.

Conclusion

By using dGEMRIC in the mid-term follow-up of SCFE we were able to reveal degenerative changes even in the absence of joint space narrowing that seem to be related to the degree of offset pathology. The dGEMRIC technique may be a potential diagnostic modality in the follow-up evaluation of SCFE.     

Early-enhancing nonneoplastic lesions on gadolinium-enhanced magnetic resonance imaging of the liver following partial hepatectomy

PURPOSE: To assess the frequency, imaging findings, and significance of early-enhancing nonneoplastic (EN) lesions with gadolinium-enhanced magnetic resonance imaging (MRI) of the liver following partial hepatectomy. MATERIALS AND METHODS: We retrospectively reviewed MR images after partial hepatectomy in 30 patients. Postoperative MRI was performed in 1-12 months (mean, 3.7 months) after partial hepatectomy. We defined the EN lesion as a lesion that was ill defined; irregular, wedge shaped, or serpiginous; located along the liver edge; not visible on unenhanced MR images; did not appear hypointense on portal venous- or equilibrium-phase images; or a combination of those imaging findings. RESULTS: A total of 39 EN lesions (size range, 5-60 mm; mean, 25.2 mm) in 19 patients and 17 recurrent tumors (size range, 5-50 mm; mean, 16.8 mm) in 10 patients newly appeared after partial hepatectomy. The EN lesions were diagnosed as pseudolesions by the second postoperative follow-up MRI in 17 patients or contrast-enhanced computed tomography (CT) in two. A total of 13 EN lesions (33%) were located along the liver edge and 20 (51%) were adjacent to the resected area. The shape was circular in 11 (28%), oval in three (8%), irregular in 11 (28%), wedge shaped in five (13%), and serpiginous in nine (23%). No EN lesion showed hypointensity on gadolinium-enhanced portal venous-phase or equilibrium-phase images. A total of 14 EN lesions (36%) showed slight hyperintensity on T2-weighted images. The confidence levels for malignancy probability assigned by blinded radiologists were lower with EN lesions than with recurrent tumors (P < 0.001). CONCLUSION: EN lesions are frequently seen in MRI following partial hepatectomy, and occasionally are slightly hyperintense on T2-weighted images, mimicking malignant tumors. However, most EN lesions can be correctly diagnosed with MRI findings.     

Patient perception of magnetic resonance arthrography

Objective. Magnetic resonance (MR) arthrography has been demonstrated to be more accurate than MR imaging alone in the identification of a variety of musculoskeletal pathology. While the complication rate of intra-articular gadolinium: saline injection has been shown to be relatively low, MR arthrography is more invasive, painful, and costly, and less convenient, than MR imaging alone. The purpose of this study was to evaluate patients’ perception of the fear and discomfort, and to assess their overall acceptance of the intra-articular gadolinium injection. Design and patients. Between October 1997 and January 1998, 113 outpatients who were referred to Yale-New Haven Hospital for MR arthrography of the ankle, elbow, hip, knee, shoulder, or wrist were asked to complete a questionnaire rating their fear of factors most commonly associated with the procedure including ”pain”, ”needles”, ”complications”, and ”discovery of results that would lead to surgery”. In addition, after having undergone the intra-articular gadolinium:saline injection, patients were asked to rate their perception of pain. Results. While many patients expressed fear of ”pain” and ”needles”, after having undergone the injection their overall pain rating score was low. Only 6% actually found gadolinium arthrography more painful than expected. Conclusion. Despite the fact that patients expressed apprehension about certain aspects of MR arthrography, subjects who underwent the intra-articular gadolinium injection considered the discomfort less than expected. Clinicians should not hesitate to order MR arthrography because the accuracy of the procedure is high enough that patients accept the discomfort. Received: 15 November 1999 Revision requested: 30 December 1999 Revision received: 4 February 2000 Accepted: 8 February 2000     

髋关节MR造影在髋臼唇撕裂诊断中的应用

目的 探讨髋关节MR造影在髋臼唇撕裂诊断中的应用价值.方法 临床高度怀疑髋臼唇撕裂的15例20个髋关节在透视下行髋关节穿刺造影,采用SE T1WI加脂肪抑制技术,进行髋关节冠状面、矢状面、斜轴面及放射状位扫描.其中12例行关节镜检查.结果 在行髋关节镜检查的12例14个髋关节中,11例13个髋关节MR造影诊断为髋臼唇撕裂,与关节镜诊断相符;1例MR造影示正常,关节镜检查亦未发现髋臼唇撕裂.13个髋臼唇撕裂中位于前上象限12个髋关节,后上象限1个髋关节.在关节镜诊断髋臼唇撕裂的13个髋关节中,MR造影冠状面诊断髋臼唇撕裂3个髋关节,矢状面诊断10个髋关节,斜轴面及放射状位诊断髋臼唇撕裂均为13个髋关节.15例20个髋关节中有5例6个髋关节在后下象限有髋臼唇下沟表现.结论 MR髋关节造影是诊断髋臼唇撕裂的可靠方法,扫描方法应选择T1WI加脂肪抑制的矢状面及斜轴面或矢状面加放射状位.后下象限撕裂的诊断中应注意正常变异的存在.

Abstract：

Objective To investigate the application value of MR rthrography (MRA) in the diagnosis of acetabular labral tears. Methods Fifteen patients with a high degree of suspected acetabular labral tears received fluoroscope-guided injection of the contrast media into the hip joint ( hip arthrography) and fat-saturated spin-echo T1-weighted images were obtained in the coronal, sagittal, oblique-axial and radial planes. Hip arthroscopy was performed on 12 of them. Results Labral tears which were diagnosed in 11 patients by hip MRA were confirmed at hip arthroscopy. One patient showed no MRA indication of labral tear, also showed normal on arthroscopy. Tear in the anterior-superior quadrant 10 cases of 12 joints ( 12/13), posterior-superior quadrant 1 case of a joint (1/13). In 11 patients who underwent arthroscopy, hip MRA diagnosed 3 (3/13) joints labral tears in coronal planes, 10 (10/13) joints in sagittal planes and 13 (13/13) labral tears in axial-oblique and radial planes. In 15 patients with 20 hip joints, 5 cases 6 joints (6/20) with normal acetabular sublabral sulcus were performed. Conclusions MR arthrography of hip is a reliable method in the diagnosis of acetabular labral tears. Scanning method should be included fat-saturated spin-echo T1-weighted images in sagittal and oblique-axial planes or sagittal plus radial planes. The diagnosis of tor posterior-inferior quadrant should pay attention to the existence of a normal variation.     

Conventional magnetic resonance imaging versus MR arthrography (MRA) of the wrist in the evaluation of triangular fibrocartilage lesions

Objective

The aim of this study is to assess the diagnostic value of direct MR arthrography compared to conventional MR imaging in the diagnosis of different pathologic entities affecting the triangular fibrocartilage.

Subjects and methods

This study included 51 patients complaining of chronic wrist pain. Conventional MRI and MR arthrography (MRA) was done for all cases.

Results

A comparison of the sensitivity of conventional MRI versus MRA was done by correlating the final diagnosis of each modality with the results of arthroscopy. MRI revealed a sensitivity (SEN) of 88.5%, specificity (SPE) of 100%, positive predictive value (PPV) of 100%, and a negative predictive value (NPV) of 69.2%, with an overall accuracy (ACC) of 90.9%, while MRA revealed a SEN of 94.2%, SPE of 100%, PPV of 100%, NPV of 81.8%, and ACC of 95.5%.

Conclusion

MR arthrography is a potent additional tool facilitating the diagnosis of different pathologic entities affecting the triangular fibrocartilage requiring surgical intervention and help to reduce arthroscopic interventions.     

Wash-in kinetics for gadolinium-enhanced magnetic resonance imaging of carotid atheroma

PURPOSE: To determine the wash-in kinetics of intravenous gadolinium into the fibrous cap and lipid core of carotid atheroma, and identify the time following gadolinium administration that maximizes contrast between the cap and core. MATERIALS AND METHODS: Seven subjects with carotid artery stenosis were studied. Magnetic resonance (MR) images of the atheroma were acquired using a single-inversion-recovery fast-spin-echo (IR FSE) sequence, which was serially repeated during the first 30 minutes following intravenous gadolinium administration. Postcontrast time was divided into three intervals: <10, 11-20, and >21 minutes. Adjusted signal intensity (SI), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) values for postcontrast images were compared to adjusted precontrast values. RESULTS: The mean SNRs of the cap and core were significantly elevated in each postcontrast interval compared with mean precontrast values. The CNRs of the cap vs. the core increased by 19.8% (3.03 to 4.14, P = 0.03) in the first 10 minutes following gadolinium administration, and remained elevated over the next two intervals with a slight decrease in the final interval. CONCLUSION: Increased signal and contrast between the cap and core can be achieved by imaging up to 30 minutes following gadolinium administration, with peak enhancement occurring in the first 10 minutes.     

The diagnostic performance of non-contrast 3-Tesla magnetic resonance imaging (3-T MRI) versus 1.5-Tesla magnetic resonance arthrography (1.5-T MRA) in femoro-acetabular impingement

ObjectiveThe aim of this study was to evaluate the diagnostic accuracy of 3-T non-contrast MRI versus 1.5-T MRA for assessing labrum and articular cartilage lesions in patients with clinical suspicion of femoro-acetabular impingement (FAI).Subjects and methodsFifty patients (thirty men and twenty women, mean age 42.5 years) underwent 1.5-T MRA, 3-T MRI and arthroscopy on the same hip. An optimized high-resolution proton density spin echo pulse sequence was included in the 3-T non-contrast MRI protocol.ResultsThe 3-T non-contrast MRI identified forty-two of the forty-three arthroscopically proven tears at the labral-chondral transitional zone (sensitivity, 97.7%; specificity, 100%; positive predictive value (PPV), 100%; negative predictive value (NPV), 87.5%; accuracy 98%). With 1.5-T MRA, forty-four tears were diagnosed. However, there was one false positive (sensitivity, 100%; specificity, 85.7%; PPV, 97.7%; NPV, 100%; accuracy 98%).Agreement between arthroscopy and MRI, whether 3-T non-contrast MRI or 1.5-T MRA, as to the degree of chondral lesion in the acetabulum was reached in half of the patients and in the femur in 76% of patients.ConclusionNon-invasive assessment of the hip is possible with 3-T MR magnet. 3-T non-contrast MRI could replace MRA as the workhorse technique for assessing hip internal damage. MRA would then be reserved for young adults with a strong clinical suspicion of FAI but normal findings on 3-T non-contrast MRI.When compared with 1.5-T MRA, optimized sequences with 3-T non-contrast MRI help in detecting normal variants and in diagnosing articular cartilage lesions.     

Magnetic resonance imaging of cartilage and cartilage repair

Magnetic resonance (MR) imaging of articular cartilage has assumed increased importance because of the prevalence of cartilage injury and degeneration, as well as the development of new surgical and pharmacological techniques to treat damaged cartilage. This article will review relevant aspects of the structure and biochemistry of cartilage that are important for understanding MR imaging of cartilage, describe optimal MR pulse sequences for its evaluation, and review the role of experimental quantitative MR techniques. These MR aspects are applied to clinical scenarios, including traumatic chondral injury, osteoarthritis, inflammatory arthritis, and cartilage repair procedures.     

Comparison of aerosolized gadoteridol and gadopentetate dimeglumine for magnetic resonance ventilation imaging of the lung.

The purpose of this study was to compare aerosolized gadoteridol and gadopentetate dimeglumine in regard to homogeneity of aerosol distribution and relative pulmonary signal intensity (SI) changes after a 10-min mechanical ventilation period. Twenty experimental procedures were performed in 10 intubated domestic pigs that were mechanically aerosolized with the nebulized contrast medium. Images were obtained by using a respiratory-gated T(1)-weighted TSE sequence. Pulmonary SI increase for the right and left lung was 26% +/- 25% and 25% +/- 12%, respectively, for gadopentetate dimeglumine, and 45% +/- 12% and 43% +/- 10%, respectively, for gadoteridol. Aerosol distribution was rated homogeneous in all cases by two readers. It is concluded that both contrast agents in aerosolized form are capable of depicting pulmonary ventilation in healthy animals with lung capacities comparable to those of humans. SI differences between gadoteridol and gadopentetate dimeglumine are explained by their considerable difference in viscosity.     

Proteoglycan depletion-induced changes in transverse relaxation maps of cartilage: comparison of T2 and T1rho

RATIONALE AND OBJECTIVES: The authors performed this study to (a) measure changes in T2 relaxation rates, signal-to-noise ratio (SNR), and contrast with sequential depletion of proteoglycan in cartilage; (b) determine whether there is a relationship between the T2 relaxation rate and proteoglycan in cartilage; and (c) compare the T2 mapping method with the spin-lattice relaxation time in the rotating frame (T1rho) mapping method in the quantification of proteoglycan-induced changes. MATERIALS AND METHODS: T2- and T1rho-weighted magnetic resonance (MR) images were obtained in five bovine patellae. All images were obtained with a 4-T whole-body MR unit and a 10-cm-diameter transmit-receive quadrature birdcage coil tuned to 170 MHz. T2 and T1rho maps were computed. RESULTS: The SNR and contrast on the T2-weighted images were, on average, about 43% lower than those on the corresponding T1rho-weighted images. The T2 relaxation rates varied randomly without any particular trend, which yielded a poor correlation with sequential depletion of proteoglycan (R2 = 0.008, P < .70). There was excellent linear correlation between the percentage of proteoglycan in the tissue and the T1rho relaxation rate (R2 = 0.85, P < .0001). CONCLUSION: T2-weighted imaging neither yields quantitative information about the changes in proteoglycan distribution in cartilage nor can be used for longitudinal studies to quantify proteoglycan-induced changes. T1rho-weighted imaging, however, is sensitive to sequential depletion of proteoglycan in bovine cartilage and can be used to quantify proteoglycan-induced changes.     

Evaluation of lesions of the internal ligaments of the wrist; conventional magnetic resonance imaging versus MR arthrography (MRA)

Objective

The aim of this study is to assess the diagnostic value of direct MR arthrography compared to conventional MR imaging in the diagnosis of different pathologic entities affecting the internal ligaments of the wrist mainly the scapholunate and lunotriquetral ligaments.

Subjects and methods

This study included 51 patients complaining of chronic wrist pain. Conventional MRI and MR arthrography (MRA) were done in all cases.

Results

A comparison of the sensitivity of conventional MRI versus MRA was done by correlating the final diagnosis of each modality with the results of arthroscopy. Regarding complete SLL tears, MRI revealed a SEN, SPE and ACC of 61.54%, 96.77%, and 86.36%, while MRA showed a SEN, SPE and ACC of 92.31%, 100%, and 97.73% respectively, partial SLL tears, un-enhanced MRI revealed SEN, SPE and ACC of 10%, 94.12%, and 75%, while MRA showed 66.67%, 85.71%, and 81.82% respectively, complete LTL tears un-enhanced MRI revealed a SEN, SPE, and ACC of 25%, 100%, and 79.5% respectively, while MRA showed 91.67%, 100%, and 97.73% respectively.

Conclusion

MR arthrography is a potent additional tool facilitating the diagnosis of different pathologic entities affecting the major internal ligaments of the wrist joint and helps to reduce arthroscopic interventions.     

Direct magnetic resonance arthrography of the knee: utility of axial traction

The purpose of this study was to determine the impact of axial traction during acquisition of direct magnetic resonance (MR) arthrography examination of the knee in terms of joint space width and amount of contrast material between the cartilage surfaces. Direct knee MR arthrography was performed in 11 patients on a 3-T MR imaging unit using a T1-weighted isotropic gradient echo sequence in a coronal plane with and without axial traction of 15 kg. Joint space widths were measured at the level of the medial and the lateral femorotibial joint with and without traction. The amount of contrast material in the medial and lateral femorotibial joint was assessed independently by two musculoskeletal radiologists in a semiquantitative manner using three grades (‘absence of surface visualization, ‘partial surface visualization or ‘complete surface visualization’). With traction, joint space width increased significantly at the lateral femorotibial compartment (mean = 0.55 mm, p = 0.0105) and at the medial femorotibial compartment (mean = 0.4 mm, p = 0.0124). There was a trend towards an increased amount of contrast material in the femorotibial compartment with axial traction. Direct MR arthrography of the knee with axial traction showed a slight and significant increase of the width of the femorotibial compartment with a trend towards more contrast material between the articular cartilage surfaces.     

三维FLASH序列关节软骨MR成像的实验研究

目的:比较3D-FLASH(三维快速小角度激发成像)序列不同参数成像对关节软骨病变模型的评价。方法:羊膝关节10只,分别制作关节积液模型、软骨缺损模型和缺损并积液模型。扫描序列采用伴脂肪抑制(FS)和水激发(WE)的3D-FLASH,采用不同的脉冲重复时间(TR)、回波时间(TE)和反转角(FA),序列分为四组,包括一组WE3D-FLASH和三组FS3D-FLASH序列。测量和比较不同参数成像关节软骨的信噪比(SNR)、软骨与周围组织的对比噪声比(CNR)以及最小缺损模型的显示能力。结果:①关节软骨SNR各组间没有显著性差异(P>0.05);②软骨与骨皮质的CNR各组间有显著差异,WE3D-FLASH(TR19ms、TE8.39msF、A15°)组显著高于其他三组,其它三组间比较未见显著差异;软骨与骨髓的CNR各组间有显著性差异,WE3D-FLASH(TR19ms、TE8.39ms、FA15°)组显著高于其它三组(P<0.001),其它三组间比较未见显著差异。软骨与积液的CNR各组间有显著性差异,FS3D-FLASH(TR33ms、TE6.06ms、FA15°)组显著低于其它三组(P<0.001),其它三组间比较未见显著差异;③3D-FLASH序列合用水激发技术代替脂肪抑制可显著缩短扫描时间;④四组不同参数3D-FLASH序列均显示了0.5mm的最小缺损模型。结论:3D-FLASH序列合用水激发技术代替脂肪抑制可显著缩短扫描时间,而不降低图像质量。     

Fat suppression gradient-echo magnetic resonance imaging of experimental articular cartilage lesions: comparison between phase-contrast method at 0.23T and chemical shift selective method at 1.5T

PURPOSE: To evaluate the diagnostic performance of a newly developed single-scan phase-contrast water-fat imaging technique for fat suppression at 0.23T open magnet, compared to the conventional chemical shift selective fat suppression method at 1.5T, in the detection of experimental articular cartilage lesions. MATERIALS AND METHODS: Sixty regions of 20 knee joint specimens of pigs with artificially created articular cartilage lesions were examined with 0.23T and 1.5T MR scanners. Sagittal fat-suppressed three-dimensional gradient-echo (3D GRE) images, obtained with the phase-contrast method at 0.23T, and fat-suppressed three-dimensional spoiled gradient recalled echo (3D SPGR) images, obtained with a chemical shift selective method at 1.5T, were evaluated. Diagnostic performance was analyzed. The conspicuity of the lesions, the amount of artifacts, and the uniformity of fat suppression were evaluated. The contrast-to-noise (CNR) values of cartilage-to-bone marrow, and cartilage-to-infrapatellar fat were calculated. RESULTS: At 0.23T, sensitivity and specificity were 80% and 95% for partial cartilage lesions (grade 2), and 91% and 100% for full-thickness lesions (grade 3). At 1.5T, sensitivity and specificity were 85% and 95% for grade 2 lesions, and 96% and 97% for grade 3 lesions. No significant difference was detected in the conspicuity of lesions. The uniformity of fat suppression was more constant with 3D SPGR images compared to 3D GRE images. More susceptibility artifacts, derived from the procedure of creating lesions, were detected at 1.5T. The cartilage-to-fat CNRs were significantly higher with high-field images. CONCLUSION: Phase-contrast method for fat suppression at 0.23T is a useful technique in detecting articular cartilage lesions.