Association of layer-specific knee cartilage T2-relaxation measurements with age, sex and cartilage morphology at 1.5-T MRI

Abstract Objective This study aimed to establish normal knee cartilage T2-values at 1.5-Tesla, assess the influence of age and sex on T2-values, and compares T2-times between subjects with and without morphological cartilage changes. Materials and methods A sagittal 2D T2-weighted multi-slice multi-echo sequence (MSME) sequence with automatic generation of a color-coded T2-map was acquired at 1.5-Tesla in 929 volunteers (ages 28–89) from the Study-of-Health-in-Pomerania TREND-1 cohort. Knee morphology was assessed with the modified Noyes Score in eight cartilage regions. T2 measurements were performed manually in seven cartilage regions, including superficial and deep cartilage layers. Results Subjects with normal cartilage morphology (300 subjects) showed significant T2-value differences across cartilage regions ( p ≤ 0.001), with higher values in femoral cartilage and superficial layers. T2-values increased with age ( p ≤ 0.001), and women had higher T2-values in the femoral, tibial, and medial femorotibial compartments. The subjects with evidence of pathological cartilage morphology changes (629 subjects) had higher T2-values compared to the subjects with structurally normal knee cartilage in MRI ( p ≤ 0.001). Conclusions This study provides population-based 1.5-Tesla knee cartilage T2-values, showing age-related increases and higher values in superficial and femoral layers. Pathological cartilage morphology was associated with elevated T2-values. Key Points Question This study examines early cartilage degeneration by establishing normal T2-values and analyzing how demographics and morphological cartilage changes impact these values . Findings T2-times were higher in superficial femoral cartilage but lower in retropatellar, tibial cartilage, and deep layers, increasing with age and pathological cartilage changes . Clinical relevance This study establishes normal T2-values for knee cartilage at 1.5-Tesla, identifies age- and sex-related variations, and associates elevated T2-values to morphological cartilage changes, enhancing cartilage health understanding and early diagnostic precision . Graphical Abstract