Session Type: Abstract Submissions (ACR)
Acute anterior cruciate ligament (ACL) injuries are high-risk factors for post-traumatic osteoarthritis. Cartilage changes in such cases have been widely studied; however, there are fewer reports on MR quantitative evaluation of meniscus after acute ACL injuries. The goal of this study was to evaluate changes in meniscal T1ρ and T2 quantification in patients with acute ACL injuries and correlate those changes to MR clinical grading and patient-reported outcomes.
18 control patients and 30 patients with acute ACL injuries (19 females; age = 29.9 ± 7.2 years) were studied using a 3T GE MR scanner. Injured patients were scanned post-injury and prior to ACL reconstruction (58 ± 48 days). Patients filled out the Knee Injury and Osteoarthritis Outcome Score (KOOS), a validated self-assessed questionnaire with five categories: pain, other symptoms, function in sport and recreation, function in daily living (ADL), and knee-related quality of life (QOL), on the same day of MR scan. Imaging protocol included sagittal T2-weighted 3D fast spin-echo images (CUBE) and sagittal 3D T1ρ and T2 quantification sequences. Modified whole-organ magnetic resonance imaging scores (WORMS) were determined using CUBE images. Menisci were segmented semi-automatically using CUBE images into four sub-compartments: anterior horn of the lateral/medial meniscus (AHLAT/AHMED) and the posterior horn of the lateral/medial meniscus (PHLAT/PHMED). These regions of interest (ROI) were overlaid onto T1ρ and T2 maps. Mean T1ρ and T2 values were calculated for each ROI. Paired T-tests were performed when comparing injured knees to contralateral (contra) knees; unpaired T-tests were performed when comparing injured knees to the control group; Spearman correlation coefficients were calculated between meniscal T1ρ/T2 and KOOS.
Mean T2 values were significantly higher in ACL-injured knees than control group knees in the AHLAT, PHLAT, and AHMED (P < 0.05), but were not significant (P = 0.06) in the PHMED. T2 values were significantly higher in the AHLAT of ACL-injured knees than the contra knees (P < 0.01) but did not reach statistical significance in the PHLAT, AHMED, or PHMED (P = 0.08, P = 0.11, P = 0.09). ACL-injured patients with meniscal tears in the PHLAT (meniscus WORMS > 1) had significantly elevated T1ρ and T2 values (P < 0.03) compared to those without meniscal tears in the PHLAT. There was a significant negative correlation between KOOS and T2 (P < 0.05) in the PHLAT for pain, symptoms, and ADL (ρ= -0.38, -0.48, -0.46).
Quantitative MR imaging can be used to detect damage and early degeneration in meniscal matrices. This study found that acute ACL injuries led to elevated T2 values in the meniscus. We observed a significant association of meniscal degeneration to elevated T1ρ and T2 measurements in patients with acute ACL injuries in the PHLAT. There were more significantly elevated T1ρ and T2 in comparing the injured knees to control group than to contra knees. We also observed that T1ρ and T2 increased with severity of meniscal tears in acute ACL injuries. The correlation between T2 (especially in PHLAT) and KOOS suggested a relationship between meniscal damage and patient outcomes after acute injuries.
T. M. Link,
C. B. Ma,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/mr-t1%cf%81-and-t2-of-meniscus-after-acute-anterior-cruciate-ligament-injuries/