title: Clinical value of routine use of thin-section 3D MRI using 3D FSE sequences with a variable flip angle technique for internal derangements of the knee joint at 3T.
abstract: OBJECTIVE
  To determine the clinical value of routine use of thin-section 3D MRI using 3D FSE sequences with a variable flip angle technique for internal derangements of the knee joint at 3T.
  
  
  METHODS
  Thirty-four knees in 34 patients suspected of having internal derangements of the knee joint were included. Following standard 2D MRI protocol including sagittal PDWI, T1WI and T2*WI, coronal fat-suppressed PDWI, and axial fat-suppressed PDWI with 3-4mm thicknesses, fat-suppressed and water-excitation PDWI using 3D FSE sequences with a variable flip angle technique with 0.6mm thickness were obtained in coronal plane and the three major planes with 1mm thickness (3D MRI) was reformatted. The standard 2D MRI protocol and reformatted 3D MRI protocol (three sagittal 2D sequence images plus 3D MRI) were independently analyzed by two radiologists concerning presence or absence of lesions in the menisci, cartilage, and ligament. Interobserver agreements in both the MRI protocols were assessed by weighted-kappa coefficients. Regarding diagnostic accuracy, areas under the receiver operating characteristic curves (Az values) of both the MRI protocols were compared.
  
  
  RESULTS
  Thirty-eight meniscal lesions, 39 cartilage lesions, and 20 ligamentous lesions were surgically detected. Excellent interobserver agreements (kappa=0.91-0.98) were seen in both the MRI protocols, with a slightly better tendency in the reformatted 3D MRI protocol. Average Az values in detection of the meniscal, cartilage, and ligamentous lesions were significantly higher in the reformatted 3D MRI protocol than in the standard 2D MRI protocol (p<0.01 or p<0.001).
  
  
  CONCLUSIONS
  Routine use of reformatted thin-section 3D MRI using 3D FSE sequences with a variable flip angle technique may improve diagnostic accuracy and confidence in detection of internal derangements of the knee joint.
authors.affiliation: Department of Radiology, Toho University Sakura Medical Center, Sakura, Japan.
authors.forename: Hideyasu
authors.initials: H
authors.lastname: Kudo
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Inaoka
authors.forename: Noriko
authors.initials: N
authors.lastname: Kitamura
authors.forename: Tomoya
authors.initials: T
authors.lastname: Nakatsuka
authors.forename: Shusuke
authors.initials: S
authors.lastname: Kasuya
authors.forename: Rumiko
authors.initials: R
authors.lastname: Kasai
authors.forename: Mitsuyuki
authors.initials: M
authors.lastname: Tozawa
authors.forename: Koichi
authors.initials: K
authors.lastname: Nakagawa
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Terada
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002648:Child; D003955:Diagnostic Tests, Routine / 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*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: 3 T; Fast spin echo; Knee; MRI; Three-dimensional