title: Meniscal tears: role of axial MRI alone and in combination with other imaging planes.
abstract: OBJECTIVE
  The purpose of this study was to determine the reliability of standard axial MR images alone in the diagnosis of meniscal tears of the knee and in combination with other imaging planes.
  
  
  METHODS
  Sixty-two patients (55 men, seven women; age range, 23-68 years) with a prior MRI examination who underwent arthroscopic surgery of the knee during a 1-year period were included in the study group. Images were independently reviewed for identification of meniscal tears by two musculoskeletal radiologists blinded to arthroscopic findings. Sequences for meniscal evaluation included axial fat-saturated fast spin-echo proton density, coronal fat-saturated fast spin-echo proton density, and sagittal fast spin-echo proton density with 4- to 5-mm slice thicknesses. Imaging groups for evaluation were axial, coronal, sagittal, axial and sagittal, axial and coronal, and coronal and sagittal. Observers reported a confidence level for the presence or absence of meniscal tear in all imaging groups based on a 5-point scale. Statistical analysis considered medial and lateral menisci separately.
  
  
  RESULTS
  Forty patients had medial meniscal tears, and 16 had lateral meniscal tears at arthroscopy. For medial and lateral meniscal tears, the accuracy (79% and 71%, respectively) of imaging in the axial plane was comparable to other imaging groups but the mean confidence levels (2.82 and 3.00, respectively) were low. In one patient, the axial plane alone correctly showed that no tear was present. No statistically significant difference was observed between imaging plane groups of both menisci in the diagnosis of meniscal tears (p > 0.05). The axial plane increased the accuracy of sagittal and coronal planes of lateral meniscus when combined.
  
  
  CONCLUSIONS
  In standard knee MRI examinations, the axial imaging plane may be valuable for the detection and characterization of meniscal tears.
authors.affiliation: Department of Radiology, VA Medical Center, University of California San Diego, 3350 La Jolla Village Dr., San Diego, CA 92161, USA.
authors.forename: Nefise Cagla
authors.initials: NC
authors.lastname: Tarhan
authors.forename: Christine B
authors.initials: CB
authors.lastname: Chung
authors.forename: Aurea Valeria Rosa
authors.initials: AV
authors.lastname: Mohana-Borges
authors.forename: Tudor
authors.initials: T
authors.lastname: Hughes
authors.forename: Donald
authors.initials: D
authors.lastname: Resnick
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D000070600:Tibial Meniscus Injuries; D013997:Time Factors