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False-negative meniscal tear in MR imaging using non fat-suppressed techniques
S Jaovisidha1, C Pookarnjanamorakot, P Apiyasawat
1Department of Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Abstract:
Magnetic resonance (MR) imaging of menisci has a diagnostic accuracy of more than 90 per cent when the images are properly obtained. Errors in the interpretation of MR images may be related to many problems, resulting in false positive or false negative readings. We conducted this study to evaluate the prevalence of false negative results, using arthroscopy as gold standard. Matched MR imaging (performed before July 1997) and arthroscopic findings of the menisci in 63 consecutive patients were retrospectively reviewed separately by imaging planes and sequences used, by the site of tear, and by the site of meniscus (medial or lateral meniscus). The number and percentage of false-negative results were recorded. We found that with non fat-suppressed MR techniques, missed tear (false negative reading) of both menisci occurred predominantly in the meniscal body. The prevalence depends on imaging plane and sequence used. Among the techniques reviewed, sagittal T2-weighted (T2W) sequence had the highest prevalence of undetected meniscal tear.
Insights
Magnetic resonance (MR) imaging of menisci can miss tears, especially in the meniscal body. Sagittal T2-weighted sequences showed the highest prevalence of undetected meniscal tears in this study.
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.