MR imaging pattern of tibial subchondral bone structure: considerations of meniscal coverage and integrity
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SCIENTIFIC ARTICLE
MR imaging pattern of tibial subchondral bone structure: considerations of meniscal coverage and integrity Aticha Ariyachaipanich 1,2,3 & Emel Kaya 1,4 & Sheronda Statum 1,5 & Reni Biswas 1,5 & Betty Tran 1,5 & Won C. Bae 1,5 & Christine B. Chung 1,5 Received: 30 April 2020 / Revised: 4 June 2020 / Accepted: 10 June 2020 # This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2020
Abstract Objectives To compare regional differences in subchondral trabecular structure using high-resolution MRI in meniscus-covered/ meniscus-uncovered tibia in cadaveric knees with intact/torn menisci. Materials and methods 3D proton density CUBE MRI of 6 cadaveric knees without significant osteoarthritis (OA) was acquired, 0.25-mm resolution. Menisci were evaluated and classified intact or torn. MR data were transferred to ImageJ program to segment tibial 3D volume of interest (VOI). Data was subdivided into meniscus-covered/meniscus-uncovered regions. Segmented VOI was classified into binary data, trabeculae/bone marrow. The trabecular bone data was used to measure MR biomarkers (apparent subchondral plate–connected bone density (adapted from spine MR), apparent trabecular bone volume fraction, apparent mean trabecular thickness, apparent connectivity density, and structure model index (SMI)). Mean value of parameters was analyzed for the effects of meniscal tear/tibial coverage. Results Nine torn menisci and 3 intact menisci were present. MR measures of bone varied significantly due to meniscal coverage/tear. Subchondral plate–connected bone density under covered meniscus regions increased from 10.9 to 23.5% with meniscal tear. Values increased in uncovered regions, 19.3% (intact) and 32.4% (torn). This reflects higher density when uncovered (p = 0.048) with meniscal tear (p = 0.007). Similar patterns were found for trabecular bone fraction (coverage p < 0.001, tear p = 0.047), trabecular thickness (coverage p = 0.03), connectivity density (coverage p = 0.002), and SMI (coverage p = 0.015). Conclusion Quantitative trabecular bone evaluation emphasizes intrinsic structural differences between meniscus-covered/meniscus-uncovered tibias. Results offer insight into bone adaptation with meniscal tear and support the hypothesis that subchondral bone plate–connected bone density could be important in early subchondral bone adaptation. Keywords Knee . Osteoarthritis . Meniscal tear . Trabeculae . Morphometry . MRI
Introduction
* Christine B. Chung [email protected] 1
Department of Radiology, University of California-San Diego, La Jolla, CA, USA
2
Department of Radiology, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
3
Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
4
Radiology Department, Istanbul Bilim University, Istanbul, Turkey
5
Department of Radiology, VA San Diego Healthcare System, San Diego, CA, USA
Meniscal tears are commonly encountered pathology in osteoarth
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