title: Knee joint: comprehensive assessment with 3D isotropic resolution fast spin-echo MR imaging--diagnostic performance compared with that of conventional MR imaging at 3.0 T.
abstract: OBJECTIVE
  To determine whether a three-dimensional isotropic resolution fast spin-echo sequence (FSE-Cube) has similar diagnostic performance as a routine magnetic resonance (MR) imaging protocol for evaluating the cartilage, ligaments, menisci, and osseous structures of the knee joint in symptomatic patients at 3.0 T.
  
  
  METHODS
  This prospective, HIPAA-compliant, institutional review board-approved study was performed with a waiver of informed consent. FSE-Cube was added to the routine 3.0-T MR imaging protocol performed in 100 symptomatic patients (54 male patients with a median age of 32 years and 46 female patients with a median age of 33 years) who subsequently underwent arthroscopic knee surgery. All MR imaging studies were independently reviewed twice by two musculoskeletal radiologists. During the first review, the routine MR imaging protocol was used to detect cartilage lesions, ligament tears, meniscal tears, and bone marrow edema lesions. During the second review, FSE-Cube with multiplanar reformations was used to detect these joint abnormalities. With arthroscopic results as the reference standard, the sensitivity and specificity of FSE-Cube and the routine MR imaging protocol in the detection of cartilage lesions, anterior cruciate ligament tears, and meniscal tears were calculated. Permutation tests were used to compare sensitivity and specificity values.
  
  
  RESULTS
  FSE-Cube had significantly higher sensitivity (P = .039) but significantly lower specificity (P = .003) than the routine MR imaging protocol for detecting cartilage lesions. There were no significant differences (P = .183-.999) in sensitivity and specificity between FSE-Cube and the routine MR imaging protocol in the detection of anterior cruciate ligament tears, medial meniscal tears, or lateral meniscal tears. FSE-Cube depicted 96.2% of medial collateral ligament tears, 100% of lateral collateral ligament tears, and 85.3% of bone marrow edema lesions identified on images obtained with the routine MR imaging protocol.
  
  
  CONCLUSIONS
  FSE-Cube has similar diagnostic performance as a routine MR imaging protocol for detecting cartilage lesions, cruciate ligament tears, collateral ligament tears, meniscal tears, and bone marrow edema lesions within the knee joint at 3.0 T.
authors.affiliation: Department of Radiology, University of Wisconsin, Clinical Science Center-E3/311, 600 Highland Ave, Madison, WI 53792, USA. r.kijowski@hosp.wisc.edu
authors.forename: Richard
authors.initials: R
authors.lastname: Kijowski
authors.forename: Kirkland W
authors.initials: KW
authors.lastname: Davis
authors.forename: Michael A
authors.initials: MA
authors.lastname: Woods
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Lindstrom
authors.forename: Arthur A
authors.initials: AA
authors.lastname: De Smet
authors.forename: Garry E
authors.initials: GE
authors.lastname: Gold
authors.forename: Reed F
authors.initials: RF
authors.lastname: Busse
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D016880:Anisotropy; D017352:Echo-Planar Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007718:Knee Injuries / Q000473:pathology*; D007719:Knee Joint / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013113:Spin Labels; D055815:Young Adult
chemical_list: D013113:Spin Labels
references.citation: Radiology. 1996 Jan;198(1):199-204
references.pmid: 8539378
references.citation: Can Assoc Radiol J. 2000 Jun;51(3):182-5
references.pmid: 10914084
references.citation: Invest Radiol. 1993 Feb;28(2):142-5
references.pmid: 8444570
references.citation: AJR Am J Roentgenol. 2005 Jun;184(6):1740-3
references.pmid: 15908523
references.citation: Am J Sports Med. 1989 Jul-Aug;17(4):505-13
references.pmid: 2675649
references.citation: Radiology. 2008 Dec;249(3):1026-33
references.pmid: 19011194
references.citation: J Magn Reson Imaging. 2006 Jul;24(1):168-75
references.pmid: 16758476
references.citation: Skeletal Radiol. 2003 Jul;32(7):396-402
references.pmid: 12719928
references.citation: AJR Am J Roentgenol. 2007 May;188(5):1287-93
references.pmid: 17449772
references.citation: Skeletal Radiol. 1999 Jun;28(6):305-11
references.pmid: 10450876
references.citation: Radiology. 1995 Mar;194(3):825-9
references.pmid: 7862987
references.citation: J Bone Joint Surg Am. 1998 Sep;80(9):1276-84
references.pmid: 9759811
references.citation: AJR Am J Roentgenol. 1996 Nov;167(5):1223-7
references.pmid: 8911185
references.citation: Radiology. 2009 Apr;251(1):185-94
references.pmid: 19221057
references.citation: Acta Radiol. 1998 Mar;39(2):116-9
references.pmid: 9529439
references.citation: AJR Am J Roentgenol. 1998 May;170(5):1215-9
references.pmid: 9574587
references.citation: AJR Am J Roentgenol. 2003 Jul;181(1):280-1; author reply 281-2
references.pmid: 12818878
references.citation: Magn Reson Med. 2008 Sep;60(3):640-9
references.pmid: 18727082
references.citation: Skeletal Radiol. 2007 Dec;36(12):1141-6
references.pmid: 17938917
references.citation: AJR Am J Roentgenol. 1994 May;162(5):1131-5
references.pmid: 8165997
references.citation: Magn Reson Med. 2006 May;55(5):1030-7
references.pmid: 16598719
references.citation: Radiology. 2008 Feb;246(2):526-35
references.pmid: 18227545
references.citation: AJR Am J Roentgenol. 1999 Apr;172(4):1073-80
references.pmid: 10587150
references.citation: Acta Radiol. 2007 Oct;48(8):869-74
references.pmid: 17924218
references.citation: Eur J Radiol. 2006 Jun;58(3):411-5
references.pmid: 16466674
references.citation: AJR Am J Roentgenol. 2002 Nov;179(5):1159-66
references.pmid: 12388492
references.citation: Radiology. 1997 May;203(2):508-12
references.pmid: 9114113
references.citation: Biometrics. 1977 Mar;33(1):159-74
references.pmid: 843571