title: Usefulness of the quantitative evaluation of diffusion-weighted mri in the diagnosis of anterior cruciate ligament tears.
abstract: To evaluate the usefulness of the diffusion-weighted imaging (DWI) in the diagnosis of anterior cruciate ligament (ACL) tear using the contrast-to-noise ratio (CNR) and apparent diffusion coefficient (ADC) values according to the different b values.
  
  
  
  Institutional review board approval was acquired. We evaluated 74 patients (M:F = 43:31, mean age of 44 years) who underwent 3.0 Tesla knee MR with DWI because of the possibility of ACL tear due to trauma. Region of interest measurements were performed. We (two radiologists) measured the signals of the DWI and derived ADC values on the oblique sagittal DWI with b values of 0, 600, and 1000. The diagnostic accuracies of the conventional MR image and each DWI with an ADC value with a different b value were evaluated. The CNR and ADC values were compared using the Mann-Whitney U-test. The diagnostic performances of the various imaging methods were evaluated using the sensitivity, specificity, and accuracy for differentiating between normal and ACL injury as determined by the use of conventional MRI with additional DWIs with McNemar test. The arthroscopic or clinical findings were used as the reference standard.
  
  
  
  The mean CNRs of ligament tears with b values of 600 and 1000 were significantly higher than those of normal ligament (22 versus 7 and 9 versus 4, P value < 0.05). The sensitivities and the accuracies of the DWI were significantly lower than the conventional MRIs (P value < 0.001).
  
  
  
  The CNRs of the torn ACL with each b value (600 and 1000) were significantly higher those of than normal ligament, although the ADC values of the torn ligament were not different from normal ligament. Addition of the DWI to the conventional MRI did not improve diagnostic performance. J. Magn. Reson. Imaging 2016;44:1116-1122.
authors.affiliation: Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital.
authors.forename: Hee Jin
authors.initials: HJ
authors.lastname: Park
authors.affiliation: Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital. radiology11@daum.net.
authors.forename: So Yeon
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital.
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Rho
authors.affiliation: Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital.
authors.forename: Mi Sung
authors.initials: MS
authors.lastname: Kim
authors.affiliation: Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital.
authors.forename: Heon Ju
authors.initials: HJ
authors.lastname: Kwon
authors.affiliation: Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital.
authors.forename: Eun Chul
authors.initials: EC
authors.lastname: Chung
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D000070598:Anterior Cruciate Ligament Injuries / Q000000981:diagnostic imaging* / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted; D059629:Signal-To-Noise Ratio; D055815:Young Adult
keywords: MR; anterior cruciate ligament; apparent diffusion coefficient; diffusion; tear