Diagnostic performance of 3D TSE MRI versus 2D TSE MRI of the knee at 1.5 T, with prompt arthroscopic correlation, in the detection of meniscal and cruciate ligament tears

Chagas-Neto, Francisco Abaeté; Nogueira-Barbosa, Marcello Henrique; Lorenzato, Mário Müller; Salim, Rodrigo; Kfuri-Junior, Maurício; Crema, Michel Daoud

doi:10.1590/0100-3984.2015.0042

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ORIGINAL ARTICLES • Radiol Bras 49 (2) • Mar-Apr 2016 • https://doi.org/10.1590/0100-3984.2015.0042 copy

Diagnostic performance of 3D TSE MRI versus 2D TSE MRI of the knee at 1.5 T, with prompt arthroscopic correlation, in the detection of meniscal and cruciate ligament tears^* * Study conducted in the Division of Radiology, Internal Medicine Department, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRPUSP), Ribeirão Preto, SP, Brazil.

Desempenho diagnóstico da técnica 3D-TSE de RM do joelho comparada com a técnica 2D-TSE em 1,5 T na detecção de rupturas meniscais e ligamentares com correlação artroscópica imediata

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To compare the diagnostic performance of the three-dimensional turbo spin-echo (3D TSE) magnetic resonance imaging (MRI) technique with the performance of the standard two-dimensional turbo spin-echo (2D TSE) protocol at 1.5 T, in the detection of meniscal and ligament tears.

Materials and Methods:

Thirty-eight patients were imaged twice, first with a standard multiplanar 2D TSE MR technique, and then with a 3D TSE technique, both in the same 1.5 T MRI scanner. The patients underwent knee arthroscopy within the first three days after the MRI. Using arthroscopy as the reference standard, we determined the diagnostic performance and agreement.

Results:

For detecting anterior cruciate ligament tears, the 3D TSE and routine 2D TSE techniques showed similar values for sensitivity (93% and 93%, respectively) and specificity (80% and 85%, respectively). For detecting medial meniscal tears, the two techniques also had similar sensitivity (85% and 83%, respectively) and specificity (68% and 71%, respectively). In addition, for detecting lateral meniscal tears, the two techniques had similar sensitivity (58% and 54%, respectively) and specificity (82% and 92%, respectively). There was a substantial to almost perfect intraobserver and interobserver agreement when comparing the readings for both techniques.

Conclusion:

The 3D TSE technique has a diagnostic performance similar to that of the routine 2D TSE protocol for detecting meniscal and anterior cruciate ligament tears at 1.5 T, with the advantage of faster acquisition.

Keywords:
Knee; Menisci; Anterior cruciate ligament; Magnetic resonance imaging; Arthroscopy

MRI parameter	Sagittal 2D TSE	Coronal 2D TSE	Axial 2D TSE	Sagittal source 3D TSE
Repetition time (ms)	2342	2342	3045	2500
Echo time (ms)	50	50	50	35
Matrix (pixels)	224 × 176	224 × 176	224 × 176	300 × 258
Field of view (cm)	16	16	16	18
Slice thickness (mm)	4	4	4	0.6 × 0.6 × 0.7
Echo train (n)	14	14	14	65
Excitations (n)	4	4	4	1
Bandwidth (kHz)	395	386	429	255
Acquisition time	2 min 43 sec^* * Total 2D TSE multiplanar acquisition time: 8 minutes 13 seconds.	2 min 30 sec^* * Total 2D TSE multiplanar acquisition time: 8 minutes 13 seconds.	3 min^* * Total 2D TSE multiplanar acquisition time: 8 minutes 13 seconds.	5 min^† † Total 3D TSE single sagittal plane acquisition time: 5 minutes (approximately 40% less than in

Reader	Technique	Medial meniscus	Lateral meniscus	ACL tears
Reader	Technique	tears (n = 24)	tears (n = 13)	(n = 28)
1	2D MRI	20	7	26
1	3D MRI	20	7	27
2	2D MRI	20	7	26
2	3D MRI	21	8	25

	2D: both readers combined			3D: both readers combined
	Sensitivity	Specificity	Accuracy	Sensitivity	Specificity	Accuracy	Overall 2D vs. 3D agreement
MRI feature	% [95% CI]	% [95% CI]	% [95% CI]	% [95% CI]	% [95% CI]	% [95% CI]	Kappa [95% CI]
Anterior cruciate ligament	93 [83–98]	85 [62–97]	91 [82–99]	93 [83–98]	80 [56–94]	89 [80–98]	0.83 [0.70–0.97]
Medial meniscus	83 [70–93]	71 [51–87]	79 [67–91]	85 [72–94]	68 [48–84]	79 [67–91]	0.89 [0.77–0.99]
Lateral meniscus	54 [33–73]	92 [81–98]	79 [67–91]	58 [37–77]	82 [69–91]	74 [63–94]	0.74 [0.58–0.92]

MRI feature	Interobserver agreement
	2D TSE	3D TSE VISTA
	Kappa [95% CI]	Kappa [95% CI]
Anterior cruciate ligament	0.80 [0.61–0.99]	0.73 [0.48–0.95]
Medial meniscus	0.89 [0.75–1.00]	0.77 [0.58–0.98]
Lateral meniscus	0.56 [0.26–0.86]	0.52 [0.24–0.88]

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[1] Mailing Address: Dr. Francisco Abaeté Chagas-Neto. Avenida Washington Soares, 1321, Edson Queiroz. Fortaleza, CE, Brazil, 60811-905. E-mail: fabaeteneto@gmail.com.