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Diagnosis of discoid lateral meniscus of the knee on MR imaging
Nobuhiko Samoto1, Masakazu Kozuma, Toshio Tokuhisa
1Department of Orthopaedic Surgery, Fukuoka Red Cross Hospital, 3-1-1 Okusu, Minami-Ku, Fukuoka 815-0082, Japan. n-samoto@mx2.tiki.ne.jp
Abstract:
To establish the quantitative MR diagnostic criteria for discoid lateral meniscus, MR imaging of 60 knees with arthroscopically confirmed discoid lateral menisci and 134 knees with semilunar lateral menisci were analyzed. Following four quantitative parameters were measured. (1) Meniscal width (MW): The minimum meniscal width on the coronal slice. (2) Ratio of the meniscus to the tibia (RMT): The ratio of minimum meniscal width to maximum tibial width on the coronal slice. (3) Percent coverage of the meniscus (PCM): The ratio of the sum of the width of the anterior and posterior horns to the meniscal diameter on the sagittal slice showing the maximum meniscal diameter. (4) Continuity of the anterior and posterior horns (CAPH): The number of consecutive sagittal slices showing continuity between the anterior and posterior horns of the meniscus on the sagittal slice. The cut-off values of each parameter to discriminate between the discoid and semilunar meniscus were calculated based on a univariate logistic regression analysis. The sensitivity and specificity were also calculated for each of 4 parameters and combinations of these parameters. The cut-off value was 15 mm for the MW, 20% for the RMT, 75% for the PCM, and 3 slices for the CAPH. The sensitivity and specificity of the four parameters ranged between 87% and 50% and between 99% and 92%, respectively. The most accurate diagnostic criterion was either the RMT > or = 20% or the PCM > or = 75%, and the sensitivity and specificity were 95% and 97%, respectively, even when torn menisci were included.
Insights
Quantitative MRI criteria can accurately diagnose discoid lateral meniscus. The ratio of meniscus to tibia (RMT) and percent coverage of the meniscus (PCM) showed high sensitivity and specificity.
Area of Science:
- Orthopedic imaging
- Radiology
- Biomedical engineering
Background:
- Discoid lateral meniscus is a congenital anomaly.
- Accurate diagnosis is crucial for appropriate treatment.
- Current diagnostic methods may lack quantitative precision.
Purpose of the Study:
- To establish quantitative magnetic resonance (MR) diagnostic criteria for discoid lateral meniscus.
- To determine the sensitivity and specificity of these criteria.
Main Methods:
- MR imaging analysis of 60 knees with discoid lateral menisci and 134 knees with semilunar lateral menisci.
- Measurement of four quantitative parameters: meniscal width (MW), ratio of meniscus to tibia (RMT), percent coverage of the meniscus (PCM), and continuity of anterior and posterior horns (CAPH).
- Logistic regression analysis to determine cut-off values and diagnostic accuracy.
Main Results:
- Established cut-off values: MW ≥ 15 mm, RMT ≥ 20%, PCM ≥ 75%, CAPH ≥ 3 slices.
- The most accurate criteria were RMT ≥ 20% or PCM ≥ 75%, yielding 95% sensitivity and 97% specificity.
- These criteria remained accurate even with torn menisci.
Conclusions:
- Quantitative MR parameters, particularly RMT and PCM, provide reliable diagnostic criteria for discoid lateral meniscus.
- These MR criteria offer high sensitivity and specificity for accurate diagnosis.