Comparison of Volumetric Fat Suppressed Proton Density and Standard Routine MR Sequences in the Evaluation of Meniscal Tears

Abstract

Abstract Background: The knee joint is the most common joint liable for injuries with knee MRI being the most preferred imaging modality for the assessment of knee pain. The com-monest indications are the evaluation of the meniscal lesions, and ligamentous injuries. Arthroscopy is considered the gold standard tool for the assessment of knee derangement, although knee MR exami-nation has shown significant influence upon the clinicians' management decisions. Current standard two dimensional MR protocol is time consuming with limitations of these sequences that have to be considered. Volumetric fat suppressed proton density sequence is used with the advantage of faster acquisition in comparison with standard routine sequences. The volumetric PD FS sequence can demonstrate similar diagnostic results to that of the standard three planes sequences in the assessment of internal knee derangement especially as regards meniscal injuries. Aim of Study: To assess the diagnostic accuracy of volu-metric fat suppressed proton density sequence versus standard two dimensional (2D) sequences at 1.5T MR in the evaluation of meniscal tears. Patients and Methods: The study included 81 patients presenting with suspected post traumatic meniscal injury. Patients were referred to the Kasr Al-Aini Hospital Radiology Department between February 2018 and January 2019 after full clinical examination to evaluate their knee joints using MRI. Results: In our study the results showed typical concord-ance between standard two dimensional (2D) three planes sequences and volumetric fat suppressed proton density sequence in the detection of medial and lateral meniscal tears after using arthroscopy as the gold standard. Both sequences showed sensitivity=95.92%, specificity=100%, Positive Pre-dictive Value (PPV)=100%, Negative Predictive Value (NPV) =94.12% and accuracy=97.53% for Medial Meniscal (MM) tears as well as sensitivity=75%, specificity=100% PPV=100%, NPV=94.2% and accuracy=95.06% for Lateral Meniscal (LM) tears. Conclusion: The volumetric fat suppressed proton density sequence had shorter acquisition time and delivered similar high diagnostic accuracy to the standard 2D sequences in diagnosing meniscal tears.