Suphaneewan Jaovisidha MD*, Warapat Virayavanich MD*, Patarawan Woratanarat MD**, Pimjai Siriwongpairat MD*
Affiliation : * Department of Radiology, Ramathibodi Hospital School of Medicine, Mahidol University, Bangkok, Thailand ** Department of Orthopedics, Ramathibodi Hospital School of Medicine, Mahidol University, Bangkok, Thailand
Objective : To study and diagnose meniscal tear of the knee using 3-Tesla (3-T) magnetic resonance imaging
(MRI) compared with arthroscopy
Material and Method: One hundred twenty eight consecutive patients who underwent MRI of the knee using
a 3-T magnet between April 2007 and Nov 2008 were included in this study. The inclusion criteria were the
patients  who  had  (i)  subsequent  knee  arthroscopy,  (ii)  available  medical  records,  and  (iii)  no  history
of  meniscal  surgery.  Their  MR  images  were  retrospectively  reviewed  by  two  radiologists  with  consensus
agreement.  The  diagnostic  values  for  diagnosing  meniscal  tears  were  evaluated  and  compared  to  the
arthroscopic  results
Results : Thirty-two patients (64 menisci) were included; 26 males and 6 females, mean age was 36.4 years
(range 19-62). The mean interval between MRI and arthroscopy was 93 days. To diagnose tear of medial,
lateral,  and  both  menisci;  the  sensitivity  was  100%,  90%,  100%;  the  specificity  was  77%,  73%,  50%;
the  accuracy  was  91%,  78%,  84%;  the  positive  predictive  value  (PPV)  was  86%,  60%,  81%;  and  the
negative predictive value (NPV) was 100%, 94%, 100%, respectively. False positive MR findings were found
predominantly at the posterior horn and at the peripheral third of the menisci. By dividing the patients into 2
groups  according  to  the  mean  MRI-arthroscopy  interval  (<  93  and  >  93  days):  increased  sensitivity  and
NPV of detecting lateral meniscal tear; increased specificity, accuracy, and PPV of both meniscal tear was
observed in the longer duration group, but there was no statistical significance in the present study
Conclusion : The present results with 3-T MRI revealed high sensitivity and NPV comparable to the literature,
thus supporting previous studies that if a meniscal tear is not seen on 3-T MRI, it is highly unlikely to be
present. False positive MR findings found predominantly at the posterior horn and at the peripheral third of
the menisci. The longer the MRI-arthroscopy interval yielded increased diagnosing values of meniscal tear
but there is no statistical significance in the present study.
Keywords : Knee, Arthroscopy, Meniscus, Meniscal tear, MRI, 3-Tesla, Sports medicine, Trauma
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