Contribution of thin-slice (1 mm) axial proton density MR images for identification and classification of meniscal tears: correlative study with arthroscopy

Gökalp, Gökhan; Nas, Ömer Fatih; Demirağ, Burak; Yazıcı, Zeynep; Savcı, Gürsel

doi:10.1259/bjr/74041910

Cited by 13 publications

(6 citation statements)

References 21 publications

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“…For sagittal PD WIs, the sensitivity was 90.62% and specificity 70.73% for the medial meniscal tears while for the lateral meniscus the sensitivity was 72.73% and specificity 77.1%. For axial images, the sensitivity was 97.3% for the medial meniscal tears and 84% specificity while for the lateral meniscal tears sensitivity was 95.65% and specificity 80.56% [11].…”

Section: Discussionmentioning

confidence: 92%

Added value of thin axial MR cuts in the diagnosis of several meniscal tears: how far are they reliable?

Elkhalek

Kawi

Nasr

2019

Egypt J Radiol Nucl Med

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Background: The purpose of the study is to assess the added value of thin-cut (1 mm) axial magnetic resonance (MR) fat-saturated proton density (FS PD) weighted images (WIs) in the diagnosis of different types of meniscal tears. The study was conducted between January 2016 and August 2017 at a major private center group. This study included 28 patients with clinical suspicion of meniscal tear of age between 30 and 48 years including 19 males and 9 females. Axial 1-mm FS PD WIs were performed in addition to the conventional MR sequences. The type and classification of the meniscal tear were then diagnosed by a group of highly experienced musculoskeletal radiologists. The group assessed the morphology and classification of tears. The diagnosis was then confirmed by arthroscopy as a gold-standard reference. Results: Meniscal tears were found in 23 out of 28 patients. Twenty-seven meniscal tears were found in the 23 patients: 2 root attachment radial tears (6.9%), 8 radial tears (27.6%), 7 longitudinal [vertical] tears (24%), 3 horizontal tears (10%), 5 displaced bucket handle tears (17%), 1 case of flab tear (3.4%), 1 case of meniscal fraying (3.4%), and 2 lesions which were diagnosed as artifacts and confirmed negative for tears by arthroscopy (6.8%). Diagnostic performance was as follows: sensitivity 96.3%, positive predictive value 100%, accuracy 96.6%, prevalence 93%, specificity 100%, and negative predictive value 66.67%. Conclusion: The study declared high diagnostic performance of thin-cut fat-saturated PD WIs in the diagnosis of different types of meniscal tears regarding their classifications and morphology which is crucial for further management.

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Section: Discussionmentioning

confidence: 92%

Added value of thin axial MR cuts in the diagnosis of several meniscal tears: how far are they reliable?

Elkhalek

Kawi

Nasr

2019

Egypt J Radiol Nucl Med

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“…This has been shown to provide increased sensitivity and specificity regarding the diagnosis and classification of meniscal tears of the knee and likewise may prove effective for the management of OLT. 22 Additionally, recent developments in 3D MRI sequences with slice thicknesses of 0.5 mm have provided a novel modality for highly accurate 3D reconstructions, comparable to CT, while offering superior resolution of articular cartilage and its attachment to the underlying subchondral bone. 23-25 However, the use of thin-sliced 3D MRI for evaluation of OLT, specifically, has yet to be investigated.…”

Section: Discussionmentioning

confidence: 99%

Comparing the Efficacy of True-Volume Analysis Using Magnetic Resonance Imaging With Computerized Tomography and Conventional Methods of Evaluation in Cystic Osteochondral Lesions of the Talus: A Pilot Study

King

Walley

Stauch

et al. 2020

Foot & Ankle Specialist

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Background: Osteochondral lesions of the talus (OLT) often require advanced imaging if they prove to be refractory to preliminary microfracture. Orthopedic surgeons may misinterpret the size and morphology of the OLT when evaluating through conventional methods. The purpose of this study was to evaluate MRI as a modality for calculating true-volumes and compare its utility to that of CT true-volume and conventional methods of measuring lesion size. Methods: With IRB approval, an institutional radiology database was queried for patients with cystic OLT that had undergone and failed microfracture and had compatible CT and MR scans between 2011 and 2016. Five lesions, previously analyzed and described in the literature using CT true-volume, were selected. 10 orthopedic surgeons independently estimated the volume of these 5 OLT via standard MRI. Next, 3D reconstructions were created and morphometric true-volume (MTV) analysis measurements of each OLT were generated. The percent change in volumes from CT and MR was compared based upon MTVs determined from 3D reconstructive analysis. Results: The volume calculated using conventional methods in CT and MR scans grossly overestimated the size by of the OLT by 285-864% and 56-374% respectively when compared to 3D true-volume analysis of those CT and MR scans. Conclusions: This study demonstrates that true-volume is more accurate for calculating lesion size than conventional methods. Additionally, when comparing MRI and CT, thin slice CT true-volume is superior to MRI true-volume. True-volume calculation improves accuracy with CT and MRI and should be recommended for use in revision OLT cases. Levels of Evidence: Level III: Case control study

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“…8 In 2011, a study by G. Gokalp et al on the contribution of thin-slice(1 mm) axial proton density MR images for the identification and classification of meniscal tears in correlation with arthroscopy, showed that thinner sections can better reveal the signal-surface contact and tear morphology. 9 Yoon et al 10 performed TSE PDW MRI with 1mm thickness and observed inadequate tissue contrast because of the presence of a certain degree of image degradation during the multi-planar reconstruction process owing to nonisotropic images.…”

Section: )mentioning

confidence: 99%

“…But the advantage of axial imaging for the assessment of vertical and vertical-horizontal tears are to be considered as, clinically the horizontal tears are usually not easily repairable while longitudinal tears are often repairable and radial tears may be repairable depending on its location. 9 In our study, we are assessing the value of axial MR reconstructed images, alone and in combination with other imaging planes, for the diagnosis of meniscal tears of the knees, keeping arthroscopy as the gold standard for the diagnosis of the same.…”

mentioning

confidence: 99%

Characterization of Meniscal Tear Morphology on Reconstructed MR Axial Images and Correlation With Arthroscopy

Radhakrishnan¹,

Babu²,

Sabareeswaran³

et al. 2018

jebmh

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BACKGROUND MRI is a highly accurate imaging modality for diagnosing meniscal tears. Pre-operatively, surgeons need information not only on the presence of the meniscal tears but also on their morphological characteristics, in order to decide the most appropriate surgical method. MR Axial images of the menisci have been observed to help in identification and characterization of the meniscal tear, though they are under-used. MATERIALS AND METHODS A prospective observational study of 73 menisci in 63 patients, with prior MRI examination and who underwent arthroscopic surgery of knee over a period of 2 years was conducted. Images were reviewed by an MSK radiologist for the identification of meniscal tears, who was blinded to the arthroscopic findings. The routine MRI sequences along with reconstructed axial images acquired from sagittal PDFS images were used for the evaluation. The images were analysed in 5 different groups which included Coronal, Sagittal, Coronal and Sagittal, Axial, and Axial and Sagittal. A 3-point scale was used to report the confidence level for the diagnosis of meniscal tear in each imaging group. The results were then statistically analysed using McNemar test to calculate the sensitivity, specificity and accuracy for detection and characterization of meniscal tears in the different imaging planes, considering the arthroscopic findings as the gold standard. RESULTS The specificity, sensitivity, and accuracy in the characterization of meniscal tears were increased with the inclusion of reconstructed axial images in combination with other imaging modalities. This imaging plane did not need added image acquisition time, but the interpretation of the tear morphology was little difficult due to poor image quality and needed regular practice. The axial plane was extremely helpful in the correct diagnosis of radial tears and root tears. We saw no statistically significant difference between the imaging groups of medial and lateral menisci in the diagnosis of tears (p>0.05). CONCLUSION The detection and characterization of meniscal tear morphology is more accurate using the reconstructed axial imaging plane, alongside the sagittal and coronal planes.

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Contribution of thin-slice (1 mm) axial proton density MR images for identification and classification of meniscal tears: correlative study with arthroscopy

Cited by 13 publications

References 21 publications

Added value of thin axial MR cuts in the diagnosis of several meniscal tears: how far are they reliable?

Added value of thin axial MR cuts in the diagnosis of several meniscal tears: how far are they reliable?

Comparing the Efficacy of True-Volume Analysis Using Magnetic Resonance Imaging With Computerized Tomography and Conventional Methods of Evaluation in Cystic Osteochondral Lesions of the Talus: A Pilot Study

Characterization of Meniscal Tear Morphology on Reconstructed MR Axial Images and Correlation With Arthroscopy

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