DOI QR코드

DOI QR Code

Correlation of Histological Examination of Meniscus with MR Images: Focused on High Signal Intensity of the Meniscus Not Caused by Definite Meniscal Tear and Impact on MR Diagnosis of Tears

  • Li, Chun Ai (Department of Radiology, Chonbuk National University Hospital, Chonbuk National University College of Medicine) ;
  • Kim, Min Ki (Cham Orthopedic Clinic) ;
  • Kim, In Hwan (Department of Radiology, Chonbuk National University Hospital, Chonbuk National University College of Medicine) ;
  • Lee, Ju Hong (Department of Orthopedics, Chonbuk National University Hospital, Chonbuk National University College of Medicine) ;
  • Jang, Kyu Yun (Department of Pathology, Chonbuk National University Hospital, Chonbuk National University College of Medicine) ;
  • Lee, Sang Yong (Department of Radiology, Chonbuk National University Hospital, Chonbuk National University College of Medicine)
  • 투고 : 2012.05.02
  • 심사 : 2013.08.30
  • 발행 : 2013.11.01

초록

Objective: To document the causes of high signal intensity of the meniscus which is not caused by definite meniscal tears on MR imaging, through correlation with histological examination. Materials and Methods: For the correlation between the MR image and histology, we obtained prospectively 31 meniscal specimens from 21 patients. Proton density-weighted turbo spin-echo MR images were used. Minimal tear, thinning of the lamellar layer, degeneration of the central layer, and radial tie fibers were detected upon histological examination, and were correlated with the corresponding MR images. Results: Minimal tear of the lamellar layer was seen in 60 zones out of 100 slides. On MR images, 29 (48.3%) of these 60 zones had high signal intensity. Thinning of the lamellar layer was seen in 24 zones, with 7 (29.2%) having high signal intensity. 57 central zones showed degenerative change in the central layer and high signal intensity on all corresponding MR images. Radial tie fibers in the central layer appeared as high signal intensity areas. Conclusion: Minimal tear and thinning of the lamellar layer, degeneration and radial tie fibers of the central layer of the meniscus cause high signal intensity on MR images.

키워드

참고문헌

  1. Grossman JW, De Smet AA, Shinki K. Comparison of the accuracy rates of 3-T and 1.5-T MRI of the knee in the diagnosis of meniscal tear. AJR Am J Roentgenol 2009;193:509-514 https://doi.org/10.2214/AJR.08.2101
  2. Quinn SF, Brown TF. Meniscal tears diagnosed with MR imaging versus arthroscopy: how reliable a standard is arthroscopy? Radiology 1991;181:843-847 https://doi.org/10.1148/radiology.181.3.1947108
  3. De Smet AA, Tuite MJ, Norris MA, Swan JS. MR diagnosis of meniscal tears: analysis of causes of errors. AJR Am J Roentgenol 1994;163:1419-1423 https://doi.org/10.2214/ajr.163.6.7992739
  4. Justice WW, Quinn SF. Error patterns in the MR imaging evaluation of menisci of the knee. Radiology 1995;196:617-621 https://doi.org/10.1148/radiology.196.3.7644620
  5. Lotysch M, Mink J, Crues JV, Schwartz SA. Magnetic resonance imaging in the detection of meniscal injuries (abstract). Magn Reson Imaging 1986;4:185
  6. Negendank WG, Fernandez-Madrid FR, Heilbrun LK, Teitge RA. Magnetic resonance imaging of meniscal degeneration in asymptomatic knees. J Orthop Res 1990;8:311-320 https://doi.org/10.1002/jor.1100080302
  7. Dillon EH, Pope CF, Jokl P, Lynch K. The clinical significance of stage 2 meniscal abnormalities on magnetic resonance knee images. Magn Reson Imaging 1990;8:411-415 https://doi.org/10.1016/0730-725X(90)90049-8
  8. McCauley TR, Jee WH, Galloway MT, Lynch K, Jokl P. Grade 2C signal in the meniscus [correction of mensicus] on MR imaging of the knee. AJR Am J Roentgenol 2002;179:645-648 https://doi.org/10.2214/ajr.179.3.1790645
  9. De Smet AA, Tuite MJ. Use of the "two-slice-touch" rule for the MRI diagnosis of meniscal tears. AJR Am J Roentgenol 2006;187:911-914 https://doi.org/10.2214/AJR.05.1354
  10. Escobedo EM, Hunter JC, Zink-Brody GC, Wilson AJ, Harrison SD, Fisher DJ. Usefulness of turbo spin-echo MR imaging in the evaluation of meniscal tears: comparison with a conventional spin-echo sequence. AJR Am J Roentgenol 1996;167:1223-1227 https://doi.org/10.2214/ajr.167.5.8911185
  11. Petersen W, Tillmann B. Collagenous fibril texture of the human knee joint menisci. Anat Embryol (Berl) 1998;197:317-324 https://doi.org/10.1007/s004290050141
  12. Stoller DW, Martin C, Crues JV 3rd, Kaplan L, Mink JH. Meniscal tears: pathologic correlation with MR imaging. Radiology 1987;163:731-735 https://doi.org/10.1148/radiology.163.3.3575724
  13. Araki Y, Ootani F, Tsukaguchi I, Ootani M, Furukawa T, Yamamoto T, et al. MR diagnosis of meniscal tears of the knee: value of axial three-dimensional Fourier transformation GRASS images. AJR Am J Roentgenol 1992;158:587-590 https://doi.org/10.2214/ajr.158.3.1739000
  14. Disler DG, Kattapuram SV, Chew FS, Rosenthal DI, Patel D. Meniscal tears of the knee: preliminary comparison of threedimensional MR reconstruction with two-dimensional MR imaging and arthroscopy. AJR Am J Roentgenol 1993;160:343-345 https://doi.org/10.2214/ajr.160.2.8424347
  15. Quinn SF, Brown TR, Szumowski J. Menisci of the knee: radial MR imaging correlated with arthroscopy in 259 patients. Radiology 1992;185:577-580 https://doi.org/10.1148/radiology.185.2.1410376
  16. Smith DK, Totty WG. The knee after partial meniscectomy: MR imaging features. Radiology 1990;176:141-144 https://doi.org/10.1148/radiology.176.1.2353083
  17. Deutsch AL, Mink JH, Fox JM, Friedman MJ, Howell SM. The postoperative knee. Magn Reson Q 1992;8:23-54
  18. Deutsch AL, Mink JH, Fox JM, Arnoczky SP, Rothman BJ, Stoller DW, et al. Peripheral meniscal tears: MR findings after conservative treatment or arthroscopic repair. Radiology 1990;176:485-488 https://doi.org/10.1148/radiology.176.2.2367665
  19. Farley TE, Howell SM, Love KF, Wolfe RD, Neumann CH. Meniscal tears: MR and arthrographic findings after arthroscopic repair. Radiology 1991;180:517-522 https://doi.org/10.1148/radiology.180.2.2068321
  20. Van Dyck P, Gielen J, D'Anvers J, Vanhoenacker F, Dossche L, Van Gestel J, et al. MR diagnosis of meniscal tears of the knee: analysis of error patterns. Arch Orthop Trauma Surg 2007;127:849-854 https://doi.org/10.1007/s00402-007-0318-7
  21. Noble J, Hamblen DL. The pathology of the degenerate meniscus lesion. J Bone Joint Surg Br 1975;57:180-186
  22. Hodler J, Haghighi P, Pathria MN, Trudell D, Resnick D. Meniscal changes in the elderly: correlation of MR imaging and histologic findings. Radiology 1992;184:221-225 https://doi.org/10.1148/radiology.184.1.1609084
  23. Skaggs DL, Warden WH, Mow VC. Radial tie fibers influence the tensile properties of the bovine medial meniscus. J Orthop Res 1994;12:176-185 https://doi.org/10.1002/jor.1100120205
  24. Hauger O, Frank LR, Boutin RD, Lektrakul N, Chung CB, Haghighi P, et al. Characterization of the "red zone" of knee meniscus: MR imaging and histologic correlation. Radiology 2000;217:193-200 https://doi.org/10.1148/radiology.217.1.r00se36193
  25. Bullough PG, Munuera L, Murphy J, Weinstein AM. The strength of the menisci of the knee as it relates to their fine structure. J Bone Joint Surg Br 1970;52:564-567
  26. Cameron HU, Macnab I. The structure of the meniscus of the human knee joint. Clin Orthop Relat Res 1972;89:215-219
  27. Ferrer-Roca O, Vilalta C. Lesions of the meniscus. Part I: Macroscopic and histologic findings. Clin Orthop Relat Res 1980:289-300
  28. Mow VC, Ratcliffe A, Chem KY, Kelly MA. Structure and function relationship of the meniscus of the knee. In: Mow VC, Aronoczky SP, Jackson DW, eds. Knee meniscus: basis and clinical foundations. New York: Raven Press, 1992:45-47
  29. Takeda Y, Ikata T, Yoshida S, Takai H, Kashiwaguchi S. MRI high-signal intensity in the menisci of asymptomatic children. J Bone Joint Surg Br 1998;80:463-467 https://doi.org/10.1302/0301-620X.80B3.8013
  30. Kornick J, Trefelner E, McCarthy S, Lange R, Lynch K, Jokl P. Meniscal abnormalities in the asymptomatic population at MR imaging. Radiology 1990;177:463-465 https://doi.org/10.1148/radiology.177.2.2217786

피인용 문헌

  1. Evaluation of the relationship between the femoro-tibial angle and meniscal injury vol.4, pp.3, 2017, https://doi.org/10.14744/nci.2017.79847
  2. High-frequency ultrasound, computed tomography and computed tomography arthrography of the cranial cruciate ligament, menisci and cranial meniscotibial ligaments in 10 radiographically normal canine c vol.15, pp.None, 2013, https://doi.org/10.1186/s12917-019-1892-y
  3. Evaluation of the Knees of Asymptomatic Kangoo Jumpers with MR Imaging vol.19, pp.1, 2013, https://doi.org/10.2463/mrms.mp.2018-0094
  4. Intra-substance meniscal changes and their clinical significance: a meta-analysis vol.11, pp.1, 2021, https://doi.org/10.1038/s41598-021-83181-5