Diagnostics of degenerative meniscal tears at 3-Tesla MRI compared to arthroscopy as reference standard.
BACKGROUND
The goal of this study was to evaluate the diagnostic performance of 3-Tesla MRI for the assessment of degenerative meniscal tears in clinical practice.


METHODS
In patients with chronic knee pain, a negative history of acute trauma and a mean age of 52 years, 3-Tesla MRI were performed a few days prior to arthroscopy. In 86 menisci, diagnostic values of 3-Tesla MRI for the detection of degenerative tears were evaluated using arthroscopy as reference standard. The MRI classification, for meniscus diagnostics, described by Crues was used.


RESULTS
At arthroscopy, all tears identified (19 horizontal, 7 complex, 3 radial) were degenerative as confirmed by histological examination. MRI grade II lesions had a prevalence of 24% and a rate of 24% of missed tears, whereas grade I lesions were not associated with a torn meniscus at arthroscopy. For meniscal tears, (grade III) sensitivity and specificity of 3-Telsa MRI was 79 and 95% for both menisci, 86 and 100% for the medial meniscus, and 57 and 92% for the lateral meniscus. The best diagnostic performance was found for complex tears, horizontal tears showed relatively good results, poor results were documented for radial tears.


CONCLUSIONS
For the medial meniscus, where horizontal and complex tears were more prevalent, 3-Tesla MRI shows a higher accuracy than for the lateral meniscus. Particularly with regard to the medial meniscus, 3-Tesla MRI could be effectively used when a degenerative tear is suspected. Nevertheless, in regard to a remarkable number of false positive and false negative findings the diagnostic value of a 3-Tesla MRI investigation should not be overestimated.
von Engelhardt
L V
LV
Klinik für Orthopädie und Unfallchirurgie, Rheinische Friedrich-Wilhelms-Universität Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany. larsvictor@gmx.de
Schmitz
A
A
Pennekamp
P H
PH
Schild
H H
HH
Wirtz
D C
DC
von Falkenhausen
F
F
D001182:Arthroscopy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery; D008875:Middle Aged; D012680:Sensitivity and Specificity; D000070600:Tibial Meniscus Injuries