Abstract
BackgroundThis work was conducted to assess the diagnostic efficiency of isotropic three-dimensional VISTA-fast spin echo versus standard two-dimensional fast spin echo at 1.5 T MRI, in the assessment of internal knee derangement in symptomatic patients, aiming to obtain similar diagnostic accuracy in a shorter time span, with reduction of partial volume artifacts by thin continuous sections.ResultsThis was a non-randomized control study including 39 patients (32 male and 7 females, mean age 37 years old). A correlative study was done utilizing MRI standard 2D FSE (protocol A) versus 3D-VISTA-FSE (protocol B) for medial meniscus (MM) and lateral meniscus (LM), as well as anterior cruciate ligament ACL lesions, comparing the MRI results with the findings of arthroscopy as the gold standard. Both protocols depicted medial meniscus lesions with accuracy, specificity, and sensitivity (97.44%, 96.30%, and 100% respectively), lateral meniscus lesions with accuracy, specificity, and sensitivity (97.44%, 100%, and 50% respectively), and ACL lesions with accuracy, specificity, and sensitivity (100%, 100%, and 100% respectively), while there were no PCL lesions depicted through the study population. Comparing the time factor between both protocols revealed protocol A to consume 13.7 min, while protocol B consumed 6.6 min.ConclusionThree-dimensional isotropic VISTA-FSE sequence, although having similar accuracy in diagnosing cruciate and meniscal lesions as the standard sequences, facilitates thin-section data acquisition and multi-planar image reformation in standard and non-standard planes, without intersection gaps that are crucial for the detection and dissection of compound structures; also, it allows a shorter time span, which is more advantageous for patients, particularly the traumatized and emergency patients.
Highlights
This work was conducted to assess the diagnostic efficiency of isotropic three-dimensional Volume isotropic turbo spin-echo acquisition (VISTA)-fast spin echo versus standard two-dimensional fast spin echo at 1.5 T Magnetic resonance imaging (MRI), in the assessment of internal knee derangement in symptomatic patients, aiming to obtain similar diagnostic accuracy in a shorter time span, with reduction of partial volume artifacts by thin continuous sections
The purpose of this study was to demonstrate the added value, diagnostic accuracy, and superiority of isotropic three-dimensional (3D) fast spin echo over standard two-dimensional (2D) fast spin echo at 1.5 T MR sequences in the interpretation of meniscal and cruciate ligament lesions in symptomatic patients
The standard of reference Knee arthroscopy was considered the gold standard technique. Diagnostic performance of both protocols Comparative study was performed between MRI protocol A versus protocol B for different meniscal and cruciate ligament lesions, and compared with arthroscopic findings (Table 2)
Summary
This work was conducted to assess the diagnostic efficiency of isotropic three-dimensional VISTA-fast spin echo versus standard two-dimensional fast spin echo at 1.5 T MRI, in the assessment of internal knee derangement in symptomatic patients, aiming to obtain similar diagnostic accuracy in a shorter time span, with reduction of partial volume artifacts by thin continuous sections. The regular MRI technique for evaluation of internal derangements of the knee utilizes two-dimensional (2D) fast spin echo (FSE) sequence, because of its higher contrast and signal-to-noise ratio This sequence is satisfactory in evaluating joint abnormalities such as ligamentous injuries, fibro-cartilage damage, and meniscal tears [2]. Multi-planar reformatting can be applied in all necessary planes, including the standard orthogonal planes, within only a few seconds It can be helpful for the detection and diagnosis of complex or abnormally positioned internal structures of the knee. This imaging sequence have better diagnostic performance in detecting small radial and root tears of the menisci than conventional 2D images [5]. This was presumably due to a smaller interslice gap and the ability to reconstruct images along the structures of concern [2]
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