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Contrast-enhanced MRI of the menisci of the knee using ultrashort echo time (UTE) pulse sequences: imaging of the red and white zones

¹ The Cardiac Magnetic Resonance Unit, Royal Brompton Hospital, Sydney Street, London SW3 6NP, ² The Department of Surgery and the ³ Imaging Sciences Department, MRC Clinical Sciences Centre, Imperial College Faculty of Medicine, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK and the ⁴ Department of Radiology, University of California, San Diego, USA

Correspondence: Dr G M Bydder, Department of Radiology, UCSD Medical Center, 200 West Arbor Drive, San Diego, CA 92103-8756, USA

The objective of this study was to demonstrate the red and white zones of the meniscus of the knee using MRI. Ultrashort echo time (UTE) pulse sequences with an initial TE of 0.08 ms and later echoes at 5.95 ms, 11.08 ms and 17.70 ms were used to image the meniscus of the knee in two normal subjects before and after intravenous administration of gadodiamide. Difference images were formed by subtraction of later echo images from the first. The difference images showed obvious enhancement in an area consistent in location and dimensions with the red zone of the meniscus. Regions of interest placed within this area, central to it (corresponding to the white zone), and peripheral to it (corresponding to perimeniscal tissue) all showed increases in signal intensity after intravenous contrast administration. The greatest change in signal intensity in these regions of interest was seen with the shortest TE and in perimeniscal tissue on the original images. The increase in signal intensity was greatest in the red zone on the difference images. Using UTE pulse sequences and difference images derived from them, it is possible to visualize enhancement selectively in the red zone of the meniscus. Less obvious but significant changes in signal intensity were also present in the white zone.