MR imaging of the arthritic knee: improved discrimination of cartilage, synovium, and effusion with pulsed saturation transfer and fat-suppressed T1-weighted sequences

Radiology. 1994 May;191(2):413-9. doi: 10.1148/radiology.191.2.8153315.


Purpose: To assess the applicability of three-dimensional (3D) magnetic resonance (MR) imaging with pulsed saturation transfer (ST) or fat saturation in depicting articular structures in arthritic knees.

Materials and methods: Eleven patients underwent MR imaging with T1-weighted spin-echo (SE); unenhanced and contrast material-enhanced T2*-weighted 3D gradient-echo with and without on-resonance pulsed ST; and T1-weighted, fat-presaturated 3D gradient-echo techniques. Images with ST were subtracted from those without ST.

Results: Both fat-suppressed imaging and ST-subtraction (STS) techniques generated a high contrast-to-noise ratio among cartilage, synovium, effusion, bone, and adipose tissue. Both techniques depicted hypertrophic synovial tissue on unenhanced images; contrast material was necessary to differentiate between synovium and cartilage on STS images.

Conclusion: 3D MR imaging with fat-suppressed or STS techniques provides good discrimination among articular structures in arthritic knees. Fat-suppressed imaging is faster than STS imaging and offers better contrast between cartilage and synovium. These techniques may improve monitoring of arthritic disease progression and therapeutic response.

MeSH terms

  • Arthritis, Rheumatoid / pathology*
  • Cartilage, Articular / pathology
  • Female
  • Humans
  • Image Enhancement / methods
  • Image Processing, Computer-Assisted*
  • Knee Joint / pathology*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Osteoarthritis / pathology*
  • Synovial Membrane / pathology
  • Synovitis / pathology