Document Detail


Three-Tesla magnetic resonance imaging of the meniscus of the knee: What about equivocal errors?
MedLine Citation:
PMID:  20105094     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The significance of borderline magnetic resonance (MR) findings that are equivocal for a tear of the knee meniscus remains uncertain. Given their higher signal-to-noise ratio (SNR) and greater spatial resolution, these equivocal meniscal tears could be expected to be less frequent using a 3.0T MR system. PURPOSE: To investigate the prevalence of equivocal meniscal tears using 3.0T MR, and to study their impact on MR accuracy compared with arthroscopy in the detection of meniscal tears. MATERIAL AND METHODS: The medical records of 100 patients who underwent 3.0T MR imaging and subsequent arthroscopy of the knee were retrospectively reviewed. Two observers interpreted MR images in consensus, and menisci were diagnosed as torn (abnormality on two or more images), equivocal for a tear (abnormality on one image), or intact, using arthroscopy as the standard of reference. The prevalence of equivocal meniscal tears was assessed, and MR accuracy was calculated as follows: first, considering both torn menisci and equivocal diagnoses as positive for a tear; and second, considering only torn menisci as positive for a tear. RESULTS: Evidence of meniscal tears on MR images was equivocal in 12 medial (12%) and three lateral (3%) menisci. Of these equivocal MR diagnoses, tears were found at arthroscopy in eight medial and one lateral meniscus. In our study, the specificity and positive predictive value increased for both the medial and lateral meniscus when only menisci with two or more abnormal images were considered to be torn: from 80% and 89% to 91% and 94% for the medial meniscus, and from 91% and 73% to 93% and 78% for the lateral meniscus, respectively. CONCLUSION: Subtle findings that are equivocal for a tear of the knee meniscus still make MR diagnosis difficult, even at 3.0T. We recommend that radiologists should rather be descriptive in reporting subtle or equivocal MR findings, alerting the clinician of possible meniscal tear.
Authors:
Pieter Van Dyck; Filip M Vanhoenacker; Jan L Gielen; Lieven Dossche; Joost Weyler; Paul M Parizel
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Acta radiologica (Stockholm, Sweden : 1987)     Volume:  51     ISSN:  1600-0455     ISO Abbreviation:  Acta Radiol     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-05     Completed Date:  2010-04-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706123     Medline TA:  Acta Radiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  296-301     Citation Subset:  IM    
Affiliation:
Department of Radiology, University Hospital Antwerp and University of Antwerp, Antwerp (Edegem), Belgium. pieter.van.dyck@uza.be
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Arthroscopy / methods,  statistics & numerical data
Diagnosis, Differential
Diagnostic Errors / statistics & numerical data*
Female
Humans
Knee Injuries / pathology
Magnetic Resonance Imaging / methods*,  statistics & numerical data
Magnetics
Male
Menisci, Tibial / injuries*,  pathology*
Middle Aged
Observer Variation
Predictive Value of Tests
Reproducibility of Results
Retrospective Studies
Sensitivity and Specificity
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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