Kompendium 2020 Forschung & Klinik

TOP-Studien
54
Figure 2: Sagittal proton-density-weighted turbo spin-echo image without fat saturation (A) and
coronal proton-density-weighted turbo spin-echo image with fat saturation of a 31-year-old
female patient 29 months after MACI of a grade IV cartilage lesion of the medial femoral condyle
of the right knee with an overall MOCART 2.0 knee score of 80 points.
chondral bone“ was changed to the variable „subchondral changes“ and now
incorporates the assessment of the presence of bone-marrow edema-like
marrow signal, which can be further subdivided into minor and severe, as
well as the presence of subchondral cysts and osteonecrosis like signals.
Dr. Markus Schreiner
Author:
Markus Schreiner has been a
resident at the Department of
Orthopedics and Trauma Surgery
at the Medical University
of Vienna since 2016 and is a
member of the biomedical MRimaging
Cluster of orthopedic
disorders. Since 2019 he has
coordinated the scientific collaborations
between the Orthopedic
department and the High
Field MR Centre (Prof. Siegfried
Trattnig) at the Medical University
of Vienna, together with
Sebastian Apprich M.D.
Within the biomedical MRimaging
cluster, his research
focuses on the development
and implementation of MR
imaging techniques used for
qualitative and quantitative assessment
of cartilage, tendons,
and intervertebral discs as well
as clinical projects on cartilage
repair surgery.
Evaluation of the MOCART 2.0
The new MOCART 2.0 knee score was then used by two senior radiologists
and two junior radiologists with little or no previous exposure to musculoskeletal
radiology to assess the MRI examination of 24 patients after MACT. All
MRI imaging studies were performed on 3T MR systems with dedicated knee
coils. The average age of the included 24 patients (11 female, 13 male) was
34.8 ± 10.9 years. The median postoperative follow-up interval was 2.3 years.
Median lesion size was 3.8cm2, ranging from 0.9. to 12cm.
When designing the MOCART 2.0 knee score, special emphasis was put on
reproducibility. To ensure that scorings would be consistent between readers
and therefore studies, an atlas was developed alongside the score, which
contains example images for every possible scoring of the MOCART 2.0. knee
score. To assess whether use of this additional resource would provide any
additional value, the inexperienced readers assessed all imaging studies for
a second time after a four-week interval, with the difference that for the second
reading, access to the atlas of the MOCART 2.0. knee score was granted.
The expert readers demonstrated almost perfect overall intrarater
(ICC=0.88, p