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Meniscal tears: role of axial MRI alone and in combination with other imaging planes
Nefise Cagla Tarhan1, Christine B Chung, Aurea Valeria Rosa Mohana-Borges
1Department of Radiology, VA Medical Center, University of California San Diego, 3350 La Jolla Village Dr., San Diego, CA 92161, USA.
Objective:
The purpose of this study was to determine the reliability of standard axial MR images alone in the diagnosis of meniscal tears of the knee and in combination with other imaging planes.
Materials And Methods:
Sixty-two patients (55 men, seven women; age range, 23-68 years) with a prior MRI examination who underwent arthroscopic surgery of the knee during a 1-year period were included in the study group. Images were independently reviewed for identification of meniscal tears by two musculoskeletal radiologists blinded to arthroscopic findings. Sequences for meniscal evaluation included axial fat-saturated fast spin-echo proton density, coronal fat-saturated fast spin-echo proton density, and sagittal fast spin-echo proton density with 4- to 5-mm slice thicknesses. Imaging groups for evaluation were axial, coronal, sagittal, axial and sagittal, axial and coronal, and coronal and sagittal. Observers reported a confidence level for the presence or absence of meniscal tear in all imaging groups based on a 5-point scale. Statistical analysis considered medial and lateral menisci separately.
Results:
Forty patients had medial meniscal tears, and 16 had lateral meniscal tears at arthroscopy. For medial and lateral meniscal tears, the accuracy (79% and 71%, respectively) of imaging in the axial plane was comparable to other imaging groups but the mean confidence levels (2.82 and 3.00, respectively) were low. In one patient, the axial plane alone correctly showed that no tear was present. No statistically significant difference was observed between imaging plane groups of both menisci in the diagnosis of meniscal tears (p > 0.05). The axial plane increased the accuracy of sagittal and coronal planes of lateral meniscus when combined.
Conclusion:
In standard knee MRI examinations, the axial imaging plane may be valuable for the detection and characterization of meniscal tears.
Insights
Standard axial MRI images alone are reliable for diagnosing knee meniscal tears, comparable to other planes. Combining axial views with sagittal and coronal planes enhances lateral meniscus tear detection accuracy.
Area of Science:
- Orthopedic imaging
- Musculoskeletal radiology
- Diagnostic accuracy
Background:
- Meniscal tears are common knee injuries requiring accurate diagnosis.
- Magnetic Resonance Imaging (MRI) is a primary diagnostic tool for knee pathology.
- The diagnostic utility of different MRI planes for meniscal tears is an area of ongoing research.
Purpose of the Study:
- To evaluate the reliability of standard axial MRI sequences for diagnosing knee meniscal tears.
- To assess the added value of axial MRI planes when combined with coronal and sagittal planes.
Main Methods:
- Sixty-two patients with knee arthroscopy were retrospectively analyzed.
- Musculoskeletal radiologists independently reviewed axial, coronal, and sagittal MRI sequences.
- Diagnostic performance and confidence levels were assessed for various imaging plane combinations.
Main Results:
- Axial MRI plane accuracy for medial (79%) and lateral (71%) meniscal tears was comparable to other planes.
- Confidence levels for tear detection were lower with the axial plane alone.
- Combining axial plane imaging improved the accuracy for detecting lateral meniscus tears.
Conclusions:
- Standard axial MRI sequences demonstrate reliability in diagnosing knee meniscal tears.
- The axial imaging plane is a valuable component in standard knee MRI examinations for meniscal tear detection and characterization.
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