Before surgery, 277 menisci in 144 knees were examined with magnetic resonance (MR) imaging. They were then examined directly with arthroscopy or arthrotomy. Menisci were graded on a scale of 1-3 according to the character of the intrameniscal MR imaging signal. At surgery, 137 of 154 (89%) menisci exhibiting only grade 1 or grade 2 signal were found to be normal. One hundred sixteen of 123 (94%) menisci exhibiting intrameniscal signal communicating with a meniscal articular surface (grade 3 signal) had tears. If only a grade 3 signal is considered consistent with meniscal tears, then MR findings and surgical findings agreed in 91.3% of menisci. MR imaging can separate surgically significant from nonsignificant meniscal lesions and is useful in the noninvasive preoperative screening of suspected meniscal tears.

In 242 of 3,000 patients who underwent magnetic resonance (MR) imaging of the knee between September 1986 and August 1987, original MR imaging reports were compared with subsequent arthroscopic reports to determine the value of MR imaging in the evaluation of suspected meniscal and complete tears of the anterior cruciate ligament. The overall accuracy for the menisci was 93% (sensitivity, 95%; specificity, 91%) with a false-negative rate of 4.8%. For the anterior cruciate ligament the overall accuracy was 95%. T2-weighted sequences were associated with greater sensitivity, specificity, and accuracy than were T1 sequences; the false-negative rate was 0% in the T2-weighted group. MR imaging of the knee is an extremely accurate means for noninvasive assessment of the integrity of the menisci and anterior cruciate ligament, and the accuracy exceeds that usually reported for arthrography.

The influence of women's age on the results of in vitro fertilization (IVF) was analyzed in 1801 women undergoing the procedure. Advancing age was found to be related to significant reduced success rates from an average of 30.1% per transfer below the age of 36 years to 15.9% per transfer at 37 years or more (P less than 0.001). The decrease was related to a reduction in oocyte production (five at 25 years or less, four below the age of 40 years, three at 40 years or more, and two in the 43 to 47-year group) and probably due to reduced implantation. It is concluded that a woman's age must be considered an important prognostic factor when IVF is suggested.

The aim of this study was to investigate whether equally high-quality embryos derived from standard in vitro fertilization (IVF) or from intracytoplasmic sperm injection (ICSI) differ in pregnancy potential. We evaluated all consecutive cycles from January 1996 to December 1997, in which only high-quality embryos were transferred. A total of 171 IVF and 148 ICSI cycle procedures, conducted in 153 and 130 women respectively, met with the inclusion criteria. A higher clinical pregnancy rate was recorded for the IVF group than the ICSI group (35% versus 29% respectively), although the difference did not achieve statistical significance. This result was detected despite the significantly higher mean age of the IVF patients compared with the ICSI patients (35 +/- 4.9 years and 33 +/- 5.2 years respectively). Controlling for the effect of patient age using linear regression analysis yielded a significantly higher clinical pregnancy rate for IVF therapy. In conclusion, IVF is associated with a significantly higher clinical pregnancy rate than ICSI even when high-quality, morphologically comparable embryos are utilized.