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Objetivo: O curto tempo de relaxamento T2 da cartilagem limita a sua visualização em RM convencional. Este estudo teve como objetivo avaliar a eficácia da técnica Black Bone na avaliação da cartilagem da rótula, em comparação com a técnica ponderada em densidade protónica com supressão de gordura (DP FS). Métodos: O estudo incluiu 55 participantes que realizaram RM do joelho entre março e dezembro de 2024, com indicação clínica. As imagens foram avaliadas por dois observadores, com base em critérios qualitativos (ruído, artefatos, detalhe, contraste e uniformidade) utilizando a escala semiquantitativa WORMS (Whole Organ Magnetic Resonance Imaging Score). A consistência inter e intraobservador foi analisada utilizando o coeficiente de correlação intraclasse (ICC). Resultados: Na avaliação qualitativa, a técnica DP FS apresentou scores totais médios superiores (14,34 ± 2,20) face à Técnica Black Bone (13,48 ± 1,90), com maior concordância interobservador (ICC = 0,428 vs. 0,188). A técnica Black Bone apresentou baixa consistência entre observadores, maior variabilidade nos critérios de detalhe e contraste, mas melhores resultados em artefactos e uniformidade. Na análise semiquantitativa com a escala WORMS, evidenciaram-se scores mais elevados com a DP FS, com diferença estatisticamente significativa. (p < 0,001). Conclusão: Ambas as técnicas apresentaram elevada reprodutibilidade intraobservador, sendo a DP FS superior na avaliação da cartilagem da rótula. Embora a Black Bone não tenha demonstrado melhor desempenho global, revelou potencial como complemento em protocolos específicos de RM, devido à sua homogeneidade e menor suscetibilidade a artefatos. Este estudo representa uma contribuição relevante por explorar, pela primeira vez, a técnica Black Bone na avaliação da cartilagem da rótula.
ABSTRACT Objective: The short T2 relaxation time of cartilage limits its visualization on conventional MRI. This study aimed to evaluate the efficacy of the Black Bone technique in assessing patellar cartilage, compared to proton density-weighted fat-suppressed (PD-FS) imaging. Methods: The study included 55 participants who underwent knee MRI between March and December 2024 for clinical indications. Images were evaluated by two observers based on qualitative criteria (noise, artifacts, detail, contrast, and uniformity) using the semiquantitative WORMS (Whole-Organ Magnetic Resonance Imaging Score) scale. Inter- and intra-observer consistency was analyzed using the intraclass correlation coefficient (ICC). Results: In qualitative assessment, PD-FS showed higher mean total scores (14.34 ± 2.20) compared to the Black Bone technique (13.48 ± 1.90), with greater inter-observer agreement (ICC = 0.428 vs. 0.188). The Black Bone technique demonstrated low inter-observer consistency, greater variability in detail and contrast criteria, but better performance in artifacts and uniformity. In the semiquantitative analysis using the WORMS scale, PD-FS showed higher scores, with a statistically significant difference (p < 0.001). Conclusion: Both techniques demonstrated high intra-observer reproducibility, with PD-FS being superior for patellar cartilage assessment. Although Black Bone did not show overall superior performance, it showed potential as a complementary tool in specific MRI protocols due to its homogeneity and lower susceptibility to artifacts. This study represents a significant contribution by exploring, for the first time, the use of the Black Bone technique in patellar cartilage evaluation.
ABSTRACT Objective: The short T2 relaxation time of cartilage limits its visualization on conventional MRI. This study aimed to evaluate the efficacy of the Black Bone technique in assessing patellar cartilage, compared to proton density-weighted fat-suppressed (PD-FS) imaging. Methods: The study included 55 participants who underwent knee MRI between March and December 2024 for clinical indications. Images were evaluated by two observers based on qualitative criteria (noise, artifacts, detail, contrast, and uniformity) using the semiquantitative WORMS (Whole-Organ Magnetic Resonance Imaging Score) scale. Inter- and intra-observer consistency was analyzed using the intraclass correlation coefficient (ICC). Results: In qualitative assessment, PD-FS showed higher mean total scores (14.34 ± 2.20) compared to the Black Bone technique (13.48 ± 1.90), with greater inter-observer agreement (ICC = 0.428 vs. 0.188). The Black Bone technique demonstrated low inter-observer consistency, greater variability in detail and contrast criteria, but better performance in artifacts and uniformity. In the semiquantitative analysis using the WORMS scale, PD-FS showed higher scores, with a statistically significant difference (p < 0.001). Conclusion: Both techniques demonstrated high intra-observer reproducibility, with PD-FS being superior for patellar cartilage assessment. Although Black Bone did not show overall superior performance, it showed potential as a complementary tool in specific MRI protocols due to its homogeneity and lower susceptibility to artifacts. This study represents a significant contribution by exploring, for the first time, the use of the Black Bone technique in patellar cartilage evaluation.
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Palavras-chave
Ressonância magnética Joelho Cartilagem Black bone Densidade de protões Magnetic resonance Knee Cartilage Proton density MRATeS