TY - JOUR
TI - Accuracy of cartilage-specific 3-Tesla 3D-DESS magnetic resonance imaging in the diagnosis of chondral lesions: Comparison with knee arthroscopy
AU - Kohl, S.
AU - Meier, S.
AU - Ahmad, S.S.
AU - Bonel, H.
AU - Exadaktylos, A.K.
AU - Krismer, A.
AU - Evangelopoulos, D.S.
JO - Journal of Orthopaedic Surgery and Research
PY - 2015
VL - 10
TODO - 1
SP - null
PB - BioMed Central Ltd.
SN - 1749-799X
TODO - 10.1186/s13018-015-0326-1
TODO - adolescent;  adult;  aged;  arthroscopy;  articular cartilage;  comparative study;  female;  human;  knee;  male;  middle aged;  nuclear magnetic resonance imaging;  pathology;  prospective study;  standards;  surgery;  three dimensional imaging;  very elderly;  young adult, Adolescent;  Adult;  Aged;  Aged, 80 and over;  Arthroscopy;  Cartilage, Articular;  Female;  Humans;  Imaging, Three-Dimensional;  Knee Joint;  Magnetic Resonance Imaging;  Male;  Middle Aged;  Prospective Studies;  Young Adult
TODO - 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. © 2015 Kohl et al.
ER -