Evaluation of postoperative menisci with MR arthrography and routine conventional MRI

Abstract Objective The diagnosis of a recurrent tear can be more difficult in the postoperative meniscus. The purpose of our study was to determine the accuracy of conventional magnetic resonance imaging (MRI) and MRI with intraarticular contrast material [magnetic resonance (MR) arthrography] for d...

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Published in:	Clinical imaging Vol. 32; no. 3; pp. 212 - 219
Main Authors:	Cılız, Deniz, Cılız, Asim, Elverici, Eda, Sakman, Bülent, Yüksel, Enis, Akbulut, Oya
Format:	Journal Article
Language:	English
Published:	New York, NY Elsevier Inc 01-05-2008 Elsevier Elsevier Limited
Subjects:	Adult Arthrography - methods Arthroscopic surgery Arthroscopy Arthroscopy - methods Biological and medical sciences Chi-Square Distribution Endoscopy Female Follow-Up Studies Gadolinium DTPA - pharmacology Humans Image Enhancement - methods Injections, Intra-Articular Injury Severity Score Investigative techniques, diagnostic techniques (general aspects) Knee Knee Injuries - diagnosis Knee Injuries - surgery Knee meniscus Knee MR arthrography Magnetic Resonance Imaging - methods Male Medical sciences Menisci, Tibial - diagnostic imaging Menisci, Tibial - pathology Menisci, Tibial - surgery Middle Aged MR imaging Osteoarticular system. Muscles Postoperative Care - methods Probability Prospective Studies Radiodiagnosis. Nmr imagery. Nmr spectrometry Radiology Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Sensitivity and Specificity Treatment Outcome Knee Arthroscopic surgery MR imaging Knee MR arthrography Knee meniscus Postoperative Nuclear medicine Nuclear magnetic resonance imaging Arthroscopy Treatment Surgery Radiology Medical imagery Endoscopy Semilunar cartilage Biomedical engineering MR arthrography
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Summary:	Abstract Objective The diagnosis of a recurrent tear can be more difficult in the postoperative meniscus. The purpose of our study was to determine the accuracy of conventional magnetic resonance imaging (MRI) and MRI with intraarticular contrast material [magnetic resonance (MR) arthrography] for detecting recurrent meniscal tears after surgery. Materials and Methods Seventy-two patients who had arthroscopic surgery for meniscal tear and still got complaints were selected prospectively for MR arthrography and conventional MRI. Routine knee protocols with appropriate surface coil were used on 0.5 T MRI system. A 1:100 gadolinium–saline solution 30–40 ml was injected intraarticulary for MR arthrography. Of 72 patients, 45 had repeated arthroscopy for comparison of the results. The morphology of the meniscus as seen on MR images was characterized according to meniscal repair an the degree of meniscal resection into three groups. (1) less than 25% of the meniscal resection, (2) more than 25% meniscal resection, (3) meniscal repair. With routine conventional MR images, we grouped patients according to the signal intensity of menisci as Grade 1, Grade 2, Grade 3, and tear. Results The prevalence of recurrent meniscal tears in our study group was [68% (37/72 tears)]. In the diagnosis of recurrent meniscal tear, conventional MRI and MR arthrography had sensitivities of 54.0% and 94.5%, respectively; specificities of 75.0% and 87.5%, respectively; and accuracy of 57.7% and 93.4%, respectively. The accuracy of the conventional MRI studies was significantly less than that of the MR arthrography group ( P <.05). Conclusion Our study results indicate high overall accuracy for MR arthrography in the diagnosis of recurrent or residual meniscal tears. When meniscal resection is minimal, the right diagnosis could be obtained with conventional MRI. MR arthrography is necessary for patients with meniscal resection of more than 25% and who do not have sufficient joint effusion.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Article-1 ObjectType-Feature-2
ISSN:	0899-7071 1873-4499
DOI:	10.1016/j.clinimag.2007.09.008