T1ρ magnetic resonance imaging for detection of early cartilage changes in knees of asymptomatic collegiate female impact and nonimpact athletes

Abstract

Objective: To determine if T1ρ magnetic resonance imaging (T1ρ MRI) could assess early articular cartilage changes in knees of asymptomatic female collegiate athletes. It was hypothesized that impact cohort would demonstrate greater changes than nonimpact cohort.

Design: An institutional review board-approved prospective cohort study. Blinded MRI analyses.

Setting: Participants from collegiate athletic program. Imaging at university hospital, February 2008 to July 2009.

Participants: Inclusion criteria were female collegiate athletes in athletic season and asymptomatic. Exclusion criteria were previous/current knee injuries/surgeries. Twenty-one female NCAA Division I athletes, 11 impact (basketball players) and 10 nonimpact (swimmers) participants were consented and imaged with 3.0-T MRI (Siemens) and T1ρ sequence (University of Pennsylvania). One patient was removed (injury diagnosis). Final roster was 10 impact and 10 nonimpact participants. No difference in cohort body mass index, height, or weight.

Main outcome measures: Average T1ρ relaxation times (ART) for patellar and femoral cartilage to analyze defined regions and depth and modified International Cartilage Repair Society classification.

Results: Statistical analyses showed that ART of radial zone of central third weight-bearing region of cartilage in basketball players was significantly greater (P = 0.041) than swimmers and ART of the superficial zone in basketball players was significantly less (P = 0.003) than that of swimmers. For both groups, the ART of superficial zones were significantly greater than that of radial zones (P < 0.001). Four impact athletes showed macroscopic changes (none in nonimpact cohort).

Conclusions: T1ρ MRI detected early changes in articular cartilage of asymptomatic collegiate female impact athletes, with significant differences between cohorts in radial zone of central third weight-bearing region and superficial zones ART. Both cohorts showed increased ART in superficial zone. Four impact athletes showed macroscopic changes.

Clinical relevance: This study demonstrates a quantitative MRI sequence able to detect signal differences in articular cartilage in asymptomatic athletes.

FIGURE 1.

A flow chart of the computational process for postimaging data analysis of medial and lateral femoral cartilage imaged in the sagittal plane (A) and patellar cartilage imaged in the axial plane (B). Color bars represent values from 0 to 100.

FIGURE 2.

Three-dimensional mesh plot of femoral articular cartilage (A) and patellar articular cartilage (B) showing distinct regional and zonal differences of T1ρ relaxation times. Color bar represents T1ρ relaxation times from 0 to 100 ms.

FIGURE 3.

Average T1ρ relaxation times of patellar cartilage zones in impact (basketball players) and nonimpact (swimmers) athletes. Avg, average; SF, superficial.

FIGURE 4.

Average T1ρ relaxation times of lateral femoral cartilage zones in impact (basketball players) and nonimpact (swimmers) athletes. Avg, average; SF, superficial.

FIGURE 5.

Average T1ρ relaxation times of medial femoral cartilage zones in impact (basketball players) and nonimpact (swimmers) athletes. Avg, average; SF, superficial. Asterisk indicates significant difference at P < 0.05.