Jin-Young Jung MD, Presenter: Nothing to Disclose

Young Cheol Yoon MD, Abstract Co-Author: Nothing to Disclose

Hye Lin Kim, Abstract Co-Author: Nothing to Disclose

To compare the diagnostic performance and image quality of isotropic 3D fast spin echo (FSE), isotropic 3D balanced fast field echo (bFFE) and 2D standard MR sequences for evaluation of the internal knee derangement in symptomatic patients at 3.0 T.

The authors retrospectively reviewed 100 knee MR images in 100 symptomatic patients who underwent both isotropic 3D and 2D standard MR examinations of the knee at 3.0 T and subsequent arthroscopic surgery. The isotropic 3D MR images were obtained with a FSE intermediate-weighted sequence with fat saturation (PD FS-VISTA sequence) and a bFFE sequence with multiplanar reformation, by a reconstruction voxel size of 0.5 X 0.5 X 0.5 mm. Two radiologists retrospectively and independently evaluated the three methods, at three different sessions, for the chondral lesion, the anterior/posterior cruciate ligament tear, and the medial/lateral meniscus tear. The subjective image quality and MR artifacts of the three methods were also evaluated by the two readers independently. With arthroscopic results as the reference standard, the sensitivity and specificity of the three methods were calculated. Statistical analysis was performed to compare the diagnostic performance, the subjective image quality and MR artifacts of the three methods and to calculate interobserver agreement.

The sensitivity, specificity, and accuracy of three methods were higher than 85 % for all lesions. The sensitivity of 3D PD FS-VISTA sequence and 2D standard sequences tended to be higher, not significant, than that of 3D bFFE sequence. There was no significant difference in specificity and diagnostic accuracy between the three methods. Interobserver agreement was excellent for evaluation of all lesions (ĸ value>0.85). The 3D PD FS-VISTA sequence demonstrated the best subjective image quality and the least MR artifact, followed by 2D standard sequences and 3D bFFE sequence (p<0.05).

The isotropic 3D PD FS-VISTA sequence tended to be more sensitive than other sequences for evaluation of the internal knee derangement with the best subjective image quality and the least MR artifact.

The isotropic 3D FSE sequence can demonstrate more lesions with better image quality with less MR artifact and this sequence is recommended when evaluating the internal knee derangement.

Jung, J, Yoon, Y, Kim, H, Internal Knee Derangement Assessed with Isotropic 3D MR: The First Clinical Results with Direct Comparison Using Isotropic Fast Spin Echo, Balanced FFE, and Standard 2D Sequences.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12027969.html