False-negative meniscal tear in MR imaging using non fat-suppressed techniques.

Area of Science:

• Orthopedics
• Radiology
• Medical Imaging

Background:

• Magnetic resonance (MR) imaging offers high diagnostic accuracy for meniscal tears when images are properly acquired.
• Interpretation errors can lead to false positive or false negative readings, impacting clinical decisions.
• Arthroscopy serves as the gold standard for evaluating meniscal pathology.

Purpose of the Study:

• To determine the prevalence of false-negative results in meniscal MR imaging.
• To identify factors contributing to missed meniscal tears on MR imaging.
• To compare the diagnostic performance of different MR imaging planes and sequences.

Main Methods:

• Retrospective review of 63 patients with matched MR imaging and arthroscopic findings.
• Analysis of MR imaging and arthroscopic data based on imaging planes, sequences, tear location, and meniscus type (medial/lateral).
• Calculation of the number and percentage of false-negative readings for meniscal tears.

Main Results:

• False-negative readings for meniscal tears predominantly occurred in the meniscal body with non-fat-suppressed MR techniques.
• The prevalence of missed tears varied depending on the imaging plane and sequence utilized.
• Sagittal T2-weighted (T2W) sequences exhibited the highest prevalence of undetected meniscal tears.

Conclusions:

• Non-fat-suppressed MR imaging techniques, particularly sagittal T2W sequences, are associated with a higher likelihood of missing meniscal tears.
• Imaging plane and sequence selection are critical factors influencing the detection of meniscal pathology.
• Understanding the prevalence of false negatives can help improve MR imaging protocols for meniscal injuries.