Accuracy measures of 1.5-tesla MRI for the diagnosis of ACL, meniscus and articular knee cartilage damage and characteristics of false negative lesions: a level III prognostic study

Autor: Gideon Mann, Iftach Hetsroni, Ron Ben-Elyahu, Michael Ringart, Meir Nyska, Jonathan E. J. Koch, Basel Khateeb, Nissim Ohana
Rok vydání: 2021
Předmět:
Cartilage
Articular
medicine.medical_specialty
lcsh:Diseases of the musculoskeletal system
Adolescent
Physical examination
Meniscus (anatomy)
Menisci
Tibial
Sensitivity and Specificity
5-tesla
030218 nuclear medicine & medical imaging
Arthroscopy
Young Adult
03 medical and health sciences
0302 clinical medicine
Rheumatology
Fracture fixation
medicine
Humans
Orthopedics and Sports Medicine
Meniscocapsular lesion
Lateral meniscus
medicine.diagnostic_test
business.industry
Anterior Cruciate Ligament Injuries
030229 sport sciences
Articular cartilage damage
musculoskeletal system
Prognosis
Articular knee cartilage
Magnetic Resonance Imaging
Tibial Meniscus Injuries
medicine.anatomical_structure
False-negative MRI
Orthopedic surgery
Ramp lesion
Radiology
lcsh:RC925-935
business
Medial meniscus
Research Article
Zdroj: BMC Musculoskeletal Disorders
BMC Musculoskeletal Disorders, Vol 22, Iss 1, Pp 1-9 (2021)
ISSN: 1471-2474
DOI: 10.1186/s12891-021-04011-3
Popis: Background MRI is the most accurate imaging modality for diagnosing knee pathologies. However, there is uncertainty concerning factors predicting false negative MRI, such as meniscal tear patterns as well as patient factors. The aims of this study were to report 1.5-Tesla MRI accuracy of ACL, meniscus and articular cartilage damage and characterize false negative lesions. Methods Two hundred eighteen consecutive knee arthroscopies performed in our institution between 2013 and 2016 and their respective prospectively-collected MRI reports were reviewed. Inclusion criteria were age > 15 years-old, primary arthroscopy, 1.5-Tesla MRI performed at the same institution, and time interval MRI-surgery Results The highest accuracy was observed in medial meniscus and in ACL findings. For the medial meniscus sensitivity, specificity, agreement, and Kappa coefficient were 77, 92, 86%, and 0.7, and for the ACL these measures were 82, 97, 87%, and 0.73. MRI accuracy was lower in the lateral meniscus and articular cartilage with Kappa coefficient 0.42 and 0.3, respectively. More specifically, short peripheral tears in the posterior horn of the medial meniscus were characteristic of false negative findings compared to true positive findings of the MRI (p r = − 0.21, p = 0.002) and for articular cartilage damage (r = − 0.45, p Conclusion 1.5-Tesla MRI will accurately diagnose ACL and medial meniscal tears and can reliably complete the diagnostic workup following physical examination, particularly in young adults. This modality however is not reliable for diagnosing short peripheral tears at the posterior horn of the medial meniscus and partial thickness articular cartilage lesion of the femoral condyles. For these lesions, definitive diagnosis may require cartilage-specific MRI sequences or direct arthroscopic evaluation. Level of evidence Prognostic study, Level III.
Databáze: OpenAIRE
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