title: Accuracy of cartilage-specific 3-Tesla 3D-DESS magnetic resonance imaging in the diagnosis of chondral lesions: comparison with knee arthroscopy.
abstract: BACKGROUND
  Arthroscopy is considered as "the gold standard" for the diagnosis of traumatic intraarticular knee lesions. However, recent developments in magnetic resonance imaging (MRI) now offer good opportunities for the indirect assessment of the integrity and structural changes of the knee articular cartilage. The study was to investigate whether cartilage-specific sequences on a 3-Tesla MRI provide accurate assessment for the detection of cartilage defects.
  
  
  METHODS
  A 3-Tesla (3-T) MRI combined with three-dimensional double-echo steady-state (3D-DESS) cartilage specific sequences was performed on 210 patients with knee pain prior to knee arthroscopy. Sensitivity, specificity, and positive and negative predictive values of magnetic resonance imaging were calculated and correlated to the arthroscopic findings of cartilaginous lesions. Lesions were classified using the modified Outerbridge classification.
  
  
  RESULTS
  For the 210 patients (1260 cartilage surfaces: patella, trochlea, medial femoral condyle, medial tibia, lateral femoral condyle, lateral tibia) evaluated, the sensitivities, specificities, positive predictive values, and negative predictive values of 3-T MRI were 83.3, 99.8, 84.4, and 99.8 %, respectively, for the detection of grade IV lesions; 74.1, 99.6, 85.2, and 99.3 %, respectively, for grade III lesions; 67.9, 99.2, 76.6, and 98.2 %, respectively, for grade II lesions; and 8.8, 99.5, 80, and 92 %, respectively, for grade I lesions.
  
  
  CONCLUSIONS
  For grade III and IV lesions, 3-T MRI combined with 3D-DESS cartilage-specific sequences represents an accurate diagnostic tool. For grade II lesions, the technique demonstrates moderate sensitivity, while for grade I lesions, the sensitivity is limited to provide reliable diagnosis compared to knee arthroscopy.
authors.affiliation: Department of Orthopaedic Surgery, Inselspital, University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland. sandro.kohl@gmail.com.
authors.forename: Sandro
authors.initials: S
authors.lastname: Kohl
authors.affiliation: Department of Orthopaedic Surgery, Inselspital, University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland. simon.meier@insel.ch.
authors.forename: Simon
authors.initials: S
authors.lastname: Meier
authors.affiliation: Department of Orthopaedic Surgery, Inselspital, University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland. sufiansamy@gmail.com.
authors.forename: Sufian S
authors.initials: SS
authors.lastname: Ahmad
authors.affiliation: Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, University of Bern, Freiburgstrasse, Bern, CH-3010, Switzerland. herald.bonel@insel.ch.
authors.forename: Harald
authors.initials: H
authors.lastname: Bonel
authors.affiliation: Department of Emergency Medicine, Inselspital, University of Bern, Freiburgstrasse, Bern, CH-3010, Switzerland. aristomenis.exadaktylos@insel.ch.
authors.forename: Aristomenis K
authors.initials: AK
authors.lastname: Exadaktylos
authors.affiliation: Department of Orthopaedic Surgery, Inselspital, University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland. anna.krismer@insel.ch.
authors.forename: Anna
authors.initials: A
authors.lastname: Krismer
authors.affiliation: Department of Orthopaedic Surgery, Inselspital, University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland. ds.evangelopoulos@gmail.com.|3rd Department of Orthopaedic Surgery, KAT Hospital, University of Athens, Athens, Greece. ds.evangelopoulos@gmail.com.
authors.forename: Dimitrios Stergios
authors.initials: DS
authors.lastname: Evangelopoulos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy / Q000592:standards*; D002358:Cartilage, Articular / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000592:standards*; D007719:Knee Joint / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000592:standards*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult