Diagnostic Performance of Multi-Detector Computed Tomography Arthrography and 3-Tesla Magnetic Resonance Imaging to Diagnose Experimentally Created Articular Cartilage Lesions in Equine Cadaver Stifles

Simple Summary In order to prevent the onset of osteoarthritis, timely detection of cartilage damage is essential. We hypothesized that the diagnostic performance of computed tomography arthrography (CTA) would be superior to that of 3-Tesla MRI when diagnosing cartilage lesions in the stifle joint of horses. A total of 79 cartilage defects were created arthroscopically in 15 cadaver stifles from adult horses, with 68 sites serving as negative controls. A radiologist unaware of the lesion distribution evaluated the images, followed by macroscopic evaluation including measuring lesion surface area, depth, and volume. The sensitivity and specificity of MRI and CTA were calculated and compared between modalities. The sensitivity values of CTA (53%) and MRI (66%) were not significantly different (p = 0.09). However, the specificity of CTA (66%) was significantly greater compared to MRI (52%) (p = 0.04). In conclusion, CTA achieved a similar diagnostic performance compared to high-field MRI in detecting small experimental cartilage lesions. Despite this, CTA showed a higher specificity than MRI; thus, CTA was more accurate in diagnosing normal cartilage. Small lesion size was a discriminating factor for lesion detection. In a clinical setting, CTA may be preferred over MRI due to higher availability and easier image acquisition. Background: The purpose of the study was to determine the diagnostic performance of computed tomographic arthrography (CTA) and 3-Tesla magnetic resonance imaging (MRI) for detecting artificial cartilage lesions in equine femorotibial and femoropatellar joints. Methods: A total of 79 cartilage defects were created arthroscopically in 15 cadaver stifles from adult horses in eight different locations. In addition, 68 sites served as negative controls. MRI and CTA (80-160 mL iodinated contrast media at 87.5 mg/mL per joint) studies were obtained and evaluated by a radiologist unaware of the lesion distribution. The stifles were macroscopically evaluated, and lesion surface area, depth, and volume were determined. The sensitivity and specificity of MRI and CTA were calculated and compared between modalities. Results: The sensitivity values of CTA (53%) and MRI (66%) were not significantly different (p = 0.09). However, the specificity of CTA (66%) was significantly greater compared to MRI (52%) (p = 0.04). The mean lesion surface area was 11 mm(2) (range: 2-54 mm(2)). Greater lesion surface area resulted in greater odds of lesion detection with CTA but not with MRI. Conclusions: CTA achieved a similar diagnostic performance compared to high-field MRI in detecting small experimental cartilage lesions. Despite this, CTA showed a higher specificity than MRI, thus making CTA more accurate in diagnosing normal cartilage. Small lesion size was a discriminating factor for lesion detection. In a clinical setting, CTA may be preferred over MRI due to higher availability and easier image acquisition.

Automated summary

To prevent osteoarthritis, timely detection of cartilage damage is crucial. This study found that computed tomography arthrography (CTA) had superior diagnostic performance compared to 3-Tesla MRI in diagnosing cartilage lesions in the horse stifle joint. While the sensitivity of CTA (53%) and MRI (66%) were similar, CTA demonstrated higher specificity (66%) compared to MRI (52%), making it more accurate in diagnosing normal cartilage. CTA may be preferred in clinical settings due to its higher availability and easier image acquisition.