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Eur J Radiol ; 70(1): 155-64, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-18289819

RESUMO

OBJECTIVE: To analyze the spectrum of findings in indirect MR-arthrography following osteochondral autograft transfer system (OATS) and crushed bone graft using a magnetic resonance imaging (MRI) scoring and grading system in relation to histology as the standard of reference. MATERIALS AND METHODS: Iatrogenic lesions were set at ovine condylar facets (n=6/group), treated with OATS or crushed bone graft. 1.5 T MRI was performed 6 months after surgery using PD-weighted (w fat saturated (fs) fast spin echo (FSE), T1-w 2D, and 3D fs gradient echo (GE) sequences 30 min. after i.v. Gd-DTPA administration and passive joint exercise. The repair tissue was evaluated by two independent radiologists. The MR findings were compared to histology. RESULTS: In all cases, MRI and histologic grading correlated well and showed significant superior repair in OATS at 6 months (p<0.05), reproducing the original articular contour and a good subchondral restoration. FsT1-w3DGE proved most appropriate identifying characteristic post-operative findings: the OATS group demonstrated bone marrow edema at the donor site and the graft/host interface showed significant enhancement in indirect MR-arthrography, indicating fibrocartilage. After crushed bone graft, we found an irregular structure and significant contrast uptake, consistent with remnants of bone grafts surrounded by inflammatory tissue. CONCLUSION: Indirect MR-arthrography is an accurate, non-invasive monitoring tool following OATS and crushed bone graft as the MRI scoring and grading system allows a reliable evaluation of normal and pathological osteochondral repair with a high histologic correlation.


Assuntos
Substitutos Ósseos/uso terapêutico , Transplante Ósseo/instrumentação , Cartilagem Articular/cirurgia , Colágeno/uso terapêutico , Fraturas de Cartilagem/patologia , Fraturas de Cartilagem/cirurgia , Imageamento por Ressonância Magnética/métodos , Animais , Transplante Ósseo/métodos , Cartilagem Articular/lesões , Cartilagem Articular/patologia , Membranas Artificiais , Ovinos , Estatística como Assunto , Resultado do Tratamento
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