Added value of thin axial MR cuts in the diagnosis of several meniscal tears: how far are they reliable?

Abstract

Background: The purpose of the study is to assess the added value of thin-cut (1 mm) axial magnetic resonance (MR) fat-saturated proton density (FS PD) weighted images (WIs) in the diagnosis of different types of meniscal tears. The study was conducted between January 2016 and August 2017 at a major private center group. This study included 28 patients with clinical suspicion of meniscal tear of age between 30 and 48 years including 19 males and 9 females. Axial 1-mm FS PD WIs were performed in addition to the conventional MR sequences. The type and classification of the meniscal tear were then diagnosed by a group of highly experienced musculoskeletal radiologists. The group assessed the morphology and classification of tears. The diagnosis was then confirmed by arthroscopy as a gold-standard reference. Results: Meniscal tears were found in 23 out of 28 patients. Twenty-seven meniscal tears were found in the 23 patients: 2 root attachment radial tears (6.9%), 8 radial tears (27.6%), 7 longitudinal [vertical] tears (24%), 3 horizontal tears (10%), 5 displaced bucket handle tears (17%), 1 case of flab tear (3.4%), 1 case of meniscal fraying (3.4%), and 2 lesions which were diagnosed as artifacts and confirmed negative for tears by arthroscopy (6.8%). Diagnostic performance was as follows: sensitivity 96.3%, positive predictive value 100%, accuracy 96.6%, prevalence 93%, specificity 100%, and negative predictive value 66.67%. Conclusion: The study declared high diagnostic performance of thin-cut fat-saturated PD WIs in the diagnosis of different types of meniscal tears regarding their classifications and morphology which is crucial for further management.