title: Diagnostic Efficacy of 3-T MRI for Knee Injuries Using Arthroscopy as a Reference Standard: A Meta-Analysis.
abstract: OBJECTIVE
  The objectives of our study were to assess the evidence for the diagnostic efficacy of 3-T MRI for meniscal and anterior cruciate ligament (ACL) injuries in the knee using arthroscopy as the reference standard and to compare these results with the results of a previous meta-analysis assessing 1.5-T MRI.
  
  
  METHODS
  The online Cochrane Library, MEDLINE, and PubMed databases were searched using the following terms: MRI AND ((3 OR three) AND (Tesla OR T)) AND knee AND arthroscopy AND (menisc* OR ligament). Patient demographics, patient characteristics, MRI scanning details, and diagnostic results were investigated. The methodologic quality of the included studies was assessed using the revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. A meta-analysis of studies using 3-T MRI was performed, and the results were compared with a previous meta-analysis of studies using 1.5-T MRI.
  
  
  RESULTS
  One hundred one studies were identified by the search strategy, and 13 studies were included in our review. Twelve studies were considered to have level 1b evidence, and one study was considered to have level 2b evidence. All 13 studies had high methodologic integrity and low risk of bias using the QUADAS-2 tool. The studies included 1197 patients with a mean age of 41.9 years. Ten of the 13 studies were eligible for meta-analysis. The mean sensitivity and mean specificity of 3-T MRI for knee injuries by location were as follows: medial meniscus, 0.94 (95% CI, 0.91-0.96) and 0.79 (95% CI, 0.75-0.83), respectively; lateral meniscus, 0.81 (95% CI, 0.75-0.85) and 0.87 (95% CI, 0.84-0.89); and ACL, 0.92 (95% CI, 0.83-0.96) and 0.99 (95% CI, 0.96-1.00). The specificity of 3-T MRI for injuries of the lateral meniscus was significantly lower than that of 1.5-T MRI (p = 0.0013).
  
  
  CONCLUSIONS
  This study does not provide evidence that 3-T scanners have superior diagnostic efficacy for meniscal damage and ACL integrity when compared with previous studies of 1.5-T machines.
authors.affiliation: 1 Department of Orthopaedics, Guy's and St. Thomas' NHS Foundation Trust, Kings Healthcare Partners, Westminster Bridge Rd, London SE1 7EH, UK.
authors.forename: Christian
authors.initials: C
authors.lastname: Smith
authors.affiliation: 1 Department of Orthopaedics, Guy's and St. Thomas' NHS Foundation Trust, Kings Healthcare Partners, Westminster Bridge Rd, London SE1 7EH, UK.
authors.forename: Ciaran
authors.initials: C
authors.lastname: McGarvey
authors.affiliation: 1 Department of Orthopaedics, Guy's and St. Thomas' NHS Foundation Trust, Kings Healthcare Partners, Westminster Bridge Rd, London SE1 7EH, UK.
authors.forename: Ziad
authors.initials: Z
authors.lastname: Harb
authors.affiliation: 1 Department of Orthopaedics, Guy's and St. Thomas' NHS Foundation Trust, Kings Healthcare Partners, Westminster Bridge Rd, London SE1 7EH, UK.
authors.forename: Diane
authors.initials: D
authors.lastname: Back
authors.affiliation: 1 Department of Orthopaedics, Guy's and St. Thomas' NHS Foundation Trust, Kings Healthcare Partners, Westminster Bridge Rd, London SE1 7EH, UK.
authors.forename: Russell
authors.initials: R
authors.lastname: Houghton
authors.affiliation: 1 Department of Orthopaedics, Guy's and St. Thomas' NHS Foundation Trust, Kings Healthcare Partners, Westminster Bridge Rd, London SE1 7EH, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Davies
authors.affiliation: 1 Department of Orthopaedics, Guy's and St. Thomas' NHS Foundation Trust, Kings Healthcare Partners, Westminster Bridge Rd, London SE1 7EH, UK.
authors.forename: Adil
authors.initials: A
authors.lastname: Ajuied
mesh_terms: D000070598:Anterior Cruciate Ligament Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging; D001182:Arthroscopy / Q000379:methods*; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging / Q000295:instrumentation*; D000070600:Tibial Meniscus Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging
keywords: MRI; diagnostic imaging; knee