MR arthrography of the hip: diagnostic performance of a dedicated water-excitation 3D double-echo steady-state sequence to detect cartilage lesions

AJR Am J Roentgenol. 2004 Dec;183(6):1729-35. doi: 10.2214/ajr.183.6.01831729.


Objective: The objective of our study was to compare the diagnostic performance of a dedicated cartilage MR sequence (water-excitation 3D double-echo steady-state) with a standard MR sequence (T1-weighted spin-echo) in detecting articular cartilage lesions of the hip after intraarticular injection of gadopentetate dimeglumine.

Materials and methods: In 50 MR arthrograms of the hip joint obtained in 47 consecutive patients, a sagittal 3D double-echo steady-state sequence (TR/TE, 24/6.5; flip angle, 25 degrees ) was compared with a sagittal T1-weighted spin-echo sequence (350/14). Two musculoskeletal radiologists independently evaluated articular cartilage. Sensitivity and specificity for detecting cartilage defects were calculated for those hips that underwent open surgery (n = 21). Lesion conspicuity was retrospectively reviewed and graded between 1 (not visible) and 5 (well defined).

Results: At surgery, a total of 26 lesions of the acetabular (n = 20) and femoral (n = 6) cartilage were found. For the 3D double-echo steady-state and T1-weighted spin-echo sequences, sensitivities and specificities for cartilage lesion detection were 58% and 88% and 81% and 81% for reviewer 1 and 62% and 94% and 62% and 100% for reviewer 2, respectively. Lesion conspicuity was significantly superior (p = 0.036) for the 3D double-echo steady-state sequence (mean grade, 3.4) compared with the T1-weighted spin-echo sequence (mean grade, 3.0). The kappa value was fair for the 3D double-echo steady-state sequence (kappa = 0.40) and moderate for the T1-weighted spin-echo sequence (kappa = 0.55).

Conclusion: The 3D double-echo steady-state sequence optimized for cartilage imaging improves lesion conspicuity but does not improve diagnostic performance.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Cartilage Diseases / diagnosis*
  • Cartilage, Articular / pathology*
  • Contrast Media
  • Female
  • Gadolinium DTPA
  • Hip Joint / pathology*
  • Humans
  • Image Processing, Computer-Assisted
  • Imaging, Three-Dimensional
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Retrospective Studies
  • Sensitivity and Specificity
  • Statistics, Nonparametric


  • Contrast Media
  • Gadolinium DTPA