Joon-Yong Jung MD, Presenter: Nothing to Disclose

Won-Hee Jee MD, Abstract Co-Author: Nothing to Disclose

Michael Y. Park MD, Abstract Co-Author: Nothing to Disclose

So-Yeon Lee, Abstract Co-Author: Nothing to Disclose

Jung-Man Kim, Abstract Co-Author: Nothing to Disclose

To compare the accuracy between 3D isotropic fat-suppressed (FS) turbo spin-echo sequence (TSE-SPACE) and 2D conventional magnetic resonance (MR) imaging at 3.0 T in determining the meniscal tear types

Seventy-six patients who underwent MRI using 3.0 T imager and arthroscopy were included. In addition to 2D conventional sequences, 3D TSE-SPACE was obtained to produce multiplanar FS intermediate-weighted images with 0.6-mm isotropic resolution. Each set of images from two different methods was separately analyzed at a 3-week interval by two reviewers and correlated with arthroscopic drawings. Meniscal tears were classified into seven types (horizontal, longitudinal, radial, root, flap, oblique, and complex tears) and separate lesions in the same or opposite meniscus were individually counted. For every type of meniscal tears, sensitivity, specificity and accuracy between two methods and interobserver agreements by κ coefficients between two readers were calculated.

Arthroscopy revealed 36 radial, 32 horizontal, 24 flap, 14 longitudinal, 8 root, 2 oblique, and 2 complex tears. Mean sensitivity, specificity and accuracy on 2D conventional sequences versus FS intermediate-weighted TSE-SPACE by two readers were as follows: for radial tears 68%, 90% and 84% vs 77%, 93% and 90%; for flap tears 57%, 97% and 83% vs 65%, 97% and 92%; for longitudinal tears 50%, 97% and 92% vs 72%, 96% and 94%; for horizontal tears 85%, 91% and 90% vs 78%, 87 and 85%; for root tears 93%, 99%, and 98% vs 81%, 99% and 98%. Interobserver agreements on 2D conventional sequences versus FS intermediate-weighted TSE-SPACE were as follows: for radial tears κ=0.62 vs κ=0.77; for flap tears κ=0.59 vs κ=0.67; for longitudinal tears κ=0.54 vs κ=0.69; for horizontal tears κ=0.78 vs κ=0.51; and for root tears κ=0.93 vs κ=0.70. When retrospectively correlated with arthroscopic drawings, axial-reformatted FS intermediate-weighted TSE-SPACE images and arthroscopic drawings were almost identical in 94% (34/36) of radial and 92% (22/24) of flap tears.

For radial and flap tears, 3D FS intermediate-weighted TSE-SPACE was more accurate than 2D conventional sequences at 3.0 T, particularly on axial reformatted images.

Radial and flap tears which are primary candidates for partial menisectomy can be identified easily on 3D isotropic FS intermediate-weighted SPACE, particularly on axial reformatted images.

Jung, J, Jee, W, Park, M, Lee, S, Kim, J, Meniscal Tear Configurations: Categorization with 3D Isotropic Turbo Spin-Echo SPACE Sequence Compared with 2D Conventional MR Imaging at 3.0 T.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9014356.html