Yıl 2019, Cilt 3, Sayı 1, Sayfalar 64 - 69 2019-01-27

Menisküs yırtıklarının tanısında manyetik rezonans görüntülemenin tanısal değeri: Retrospektif kohort çalışma
The value of magnetic resonance imaging in diagnosing meniscal tears: A retrospective cohort study

Almıla Coşkun Bilge [1] , Nil Tokgöz [2] , Hakan Dur [3] , Murat Uçar [4]

76 109

Amaç: Tanısal artroskopi, menisküs yırtıklarının tanısında kullanılan invaziv ve pahalı bir yöntemdir. Çalışmamızın amacı; diz manyetik rezonans görüntülemenin, menisküs yırtıklarının tanısında tanısal değerini ve gereksiz tanısal artroskopinin önlenmesindeki rolünü belirlemektir.

Yöntemler: Çalışmaya, menisküs yaralanması nedeniyle diz manyetik rezonans görüntüleme ve artroskopi yapılan toplam 105 hasta dahil edildi. 59 hasta 1,5 Tesla manyetik rezonans tarayıcı kullanarak, 46 hasta ise 3,0 Tesla manyetik rezonans tarayıcı kullanılarak incelendi.

Manyetik rezonans görüntüleme bulguları, kas iskelet sistemi manyetik rezonans görüntülemede deneyimli iki radyolog tarafından iş istasyonlarında retrospektif olarak değerlendirildi. Menisküs yırtıkları; ön boynuz, gövde veya arka boynuz yırtıkları olarak raporlandırıldı. Menisküs yırtıkları, cerrahi sınıflama kullanılarak sınıflandırıldı. Her hastanın manyetik rezonans görüntüleri, değerlendirilip fikir birliği sağlandı ve artroskopi tanısı ile karşılaştırıldı.

Bulgular: Artroskopide, 106 dizin 96'sında menisküs yırtığı tespit edildi. Menisküs yırtığı tanısında, altın standart olarak artroskopi kullanılarak, manyetik rezonans görüntülemenin duyarlılık, özgüllük ve doğruluk değerleri sırasıyla; %85,71 (%95 CI: 77,84-91,61), %93  (%95 CI: 86,11-97,14) ve %89,15 (%95 CI: 84,17-93) bulundu. Menisküs yırtığı tanısında manyetik rezonans görüntülemenin tanısal değerleri yüksek bulundu.

Sonuç: Manyetik rezonans görüntüleme, menisküs yırtığı tanısında etkili bir görüntüleme yöntemidir. 3,0 Tesla manyetik rezonans görüntülemede imajların çözünürlüğü daha yüksek olsa da, rutin menisküs yırtığı tanısında 1,5 Tesla manyetik rezonans görüntüleme yeterlidir.

Aim: Diagnostic arthroscopy is an invasive and an expensive method using for the diagnosis of meniscal tears. The aim of this study was to determine the value of knee magnetic resonance imaging in the diagnosis of meniscal tears and its role in the prevention of unnecessary diagnostic arthroscopy.

Methods: A total of 105 patients who underwent knee magnetic resonance imaging and arthroscopy due to meniscus injury were included in the study. Fifty-nine patients were examined using a 1.5 Tesla magnetic resonance scanner and 46 were examined using a 3.0 Tesla magnetic resonance scanner. Magnetic resonance imaging findings were evaluated retrospectively in workstations by two radiologists experienced in musculoskeletal magnetic resonance imaging. Meniscal tears were reported as anterior horn tear, corpus tear or posterior horn tear. Meniscal tears were classified by using surgical classification. Each patient’s magnetic resonance images were evaluated with a consensus and compared with the arthroscopic diagnosis.

Results: Meniscal tears were detected in 96 out of 106 knees on arthroscopy. By using arthroscopy as the gold standard for diagnosis of meniscal tears, the sensitivity, specificity, and accuracy values of the magnetic resonance imaging evaluation were found as 85.71% (95% CI: 77.84-91.61), 93% (95% CI: 86.11-97.14) and 89.15% (95% CI: 84.17-93), respectively. These values of magnetic resonance imaging were found high in the diagnosis of meniscal tears. 

Conclusion: Magnetic resonance imaging is an effective imaging method in the diagnosis of meniscal tears. Although the resolution of 3.0 Tesla magnetic resonance imaging is higher, 1.5 Tesla magnetic resonance imaging is sufficient in routine meniscus tear diagnosis.

  • 1. Reicher MA, Bassett LW, Gold RH. High-resolution magnetic resonance imaging of the knee joint: Pathologic correlations. AJR Am J Roentgenol. 1985;145:903-9. DOI: https://doi.org/10.2214/ajr.145.5.903
  • 2. Monllau JC, León A, Cugat R, Ballester J. Ring-shaped lateral meniscus. Arthroscopy. 1998;14(5):502-4. DOI: https://doi.org/10.1016/S0749-8063(98)70079-9
  • 3. Yaqoob J, Alam MS, Khalid N. Diagnostic accuracy of magnetic resonance imaging in assessment of meniscal and ACL tear: Correlation with arthroscopy. Pak J Med Sci. 2015;31(2):263-8. DOI: https://doi.org/10.12669/pjms.312.6499
  • 4. Subhas N, Sakamoto FA, Mariscalco MW, Polster JM, Obuchowski NA, Jones MH. Accuracy of MRI in the diagnosis of meniscal tears in older patients. AJR Am J Roentgenol. 2012;198:575-80. DOI: https://doi.org/10.2214/AJR.11.7226
  • 5. Phelan N, Rowland P, Galvin R, O’Byrne JM. A systematic review and meta analysis of the diagnostic accuracy of MRI for suspected ACL and meniscal tears of the knee. Knee Surg Sports Traumatol Arthrosc. 2016;24:1525-39. DOI: https://doi.org/10.1007/s00167-015-3861-8
  • 6. Kijowski R, Davis KW, Blankenbaker DG, Woods MA, Rio AMD, De Smet A. Evaluation of the menisci of the knee joint using three-dimensional isotropic resolution fast spin-echo imaging: diagnostic performance in 250 patients with surgical correlation. Skeletal Radiol. 2012;41(2):169-78. DOI: https://doi.org/10.1007/s00256-011-1140-4
  • 7. Feucht MJ, Bigdon S, Bode G, Salzmann GM, Dovi-Akue D, Südkamp NP, et al. Associated tears of the lateral meniscus in anterior cruciate ligament injuries: risk factors for different tear patterns. J Orthop Surg Res. 2015;10:34. DOI: https://doi.org/10.1186/s13018-015-0184-x
  • 8. Laoruengthana A, Jarusriwanna A. Sensitivity and specificity of magnetic resonance imaging for knee injury and clinical application for the Naresuan University Hospital. J Med Assoc Thai. 2012;95(10):151–7.
  • 9. Khan HA, Ahad H, Sharma P, Bajaj P, Hassan N, Kamal Y. Correlation between magnetic resonance imaging and arthroscopic findings in the knee joint. Trauma Mon. 2015;20(1):e186352. DOI: https://doi.org/10.5812/traumamon.18635
  • 10. Ruwe PA, Wright J, Randall RL, Lynch JK, Jokl P, McCarthy S. Can MR imaging effectively replace diagnostic arthroscopy? Radiology. 1992;183(2):335–9. DOI: https://doi.org/10.1148/radiology.183.2.1561332
  • 11. Bui-Mansfield LT, Youngberg RA, Warme W, Pitcher JD, Nguyen PL. Potential cost savings of MR imaging obtained before arthroscopy of the knee: evaluation of 50 consecutive patients. AJR Am J Roentgenol. 1997;168(4):913–8. DOI: https://doi.org/10.2214/ajr.168.4.9124139
  • 12. Cheung LP, Li KCP, Hollett MD, Bergman AG, Herfkens RJ. Meniscal tears of the knee: Accuracy of detection with Fast Spin-Echo MR imaging and arthroscopic correlation in 293 patients. Radiology. 1997;203:508–12. DOI: https://doi.org/10.1148/radiology.203.2.9114113
  • 13. Grossman JW, De Smet AA, Shinki K. Comparison of accuracy rates of 3T and 1.5T MRI of the knee in the diagnosis of meniscal tear. AJR Am J Roentgenol. 2009;193:509–14. DOI: https://doi.org/10.2214/AJR.08.2101
  • 14. Sampson MJ, Jackson MP, Moran CJ, Moran R, Eustace SJ, Shine S. Three Tesla MRI for the diagnosis of meniscal and anterior cruciate ligament pathology: a comparison to arthroscopic findings. Clin Radiol. 2008;63:1106–11. DOI: https://doi.org/10.1016/j.crad.2008.04.008
  • 15. Magee T, Williams D. 3.0-T MRI of meniscal tears. AJR Am J Roentgenol. 2006;187:371–5. DOI: https://doi.org/10.2214/AJR.05.0487
  • 16. Schoth F, Kraemer N, Niendorf T, Hohl C, Gunther RW, Krombach GA. Comparison of image quality in magnetic resonance imaging of the knee at 1.5 and 3.0 Tesla using 32-channel receiver coils. Eur Radiol. 2008;18:2258–64. DOI: https://doi.org/10.1007/s00330-008-0972-3
  • 17. Wong S, Steinbach L, Zhao J, Stehling C, Ma CB, Link TM. Comparative study of imaging at 3.0 T versus 1.5 T of the knee. Skeletal Radiol. 2009;38:761–9. DOI: https://doi.org/10.1007/s00256-009-0683-0
  • 18. Smith C, McGarvey C, Harb Z, Back D, Houghton R, Davies A, et al. Diagnostic Efficacy of 3-T MRI for Knee Injuries Using Arthroscopy as a Reference Standard: A Meta-Analysis. AJR Am J Roentgenol. 2016;207:369–77. DOI: https://doi.org/10.2214/AJR.15.15795
  • 19. Van Dyck P, Vanhoenacker FM, Lambrecht V, Wouters K, Gielen JL, Dossche L, et al. Prospective Comparison of 1.5 and 3.0-T MRI for Evaluating the Knee Menisci and ACL. J Bone Joint Surg Am. 2013;95:916–24. DOI: https://doi.org/10.2106/JBJS.L.01195
  • 20. Nouri N, Bouaziz MC, Riahi H, Mechri M, Kherfani A, Ouertatani M, et al. Traumatic Meniscus and Cruciate Ligament Tears in Young Patients: A Comparison of 3T Versus 1.5T MRI. J Belg Soc Radiol. 2017;101:1–10. DOI: https://doi.org/10.5334/jbr-btr.1158
  • 21. De Smet AA. How I Diagnose Meniscal Tears on Knee MRI. AJR Am J Roentgenol. 2012;199:481–99. DOI: https://doi.org/10.2214/AJR.12.8663
  • 22. Kandathil J, Singapore SG. Meniscal tears on 3T MR: Patterns, pearls and pitfalls. Paper presented at: 2010 The European Congress of Radiology; March 4-8, 2010; Vienna, Austria. DOI: https://doi.org/10.1594/ecr2010/C-2221
  • 23. Vanhoenacker F, De Vos N, Van Dyck P. Common Mistakes and Pitfalls in Magnetic Resonance Imaging of the Knee. J Belg Soc Radiol. 2016;100(1):99. DOI: https://doi.org/10.5334/jbr-btr.1206
  • 24. Nguyen JC, De Smet AA, Graf BK, Rosas HG. MR Imaging–based Diagnosis and Classification of Meniscal Tears. Radiographics. 2014;34:981–99. DOI: https://doi.org/10.1148/rg.344125202
  • 25. Felli L, Garlaschi G, Muda A, Tagliafico A, Formica M, Zanirato A, et al. Comparison of clinical, MRI and arthroscopic assessments of chronic ACL injuries, meniscal tears and cartilage defects. Musculoskelet Surg. 2016;100:231–8. DOI: https://doi.org/10.1007/s12306-016-0427-y
  • 26. De Smet A, Blankenbaker DG, Kijowski R, Graf BK, Shinki K. MR diagnosis of posterior root tears of the lateral meniscus using arthroscopy as the reference standard. AJR Am J Roentgenol. 2009;192:480–6. DOI: https://doi.org/10.2214/AJR.08.1300
  • 27. Ahmed AF, Azeem AA, Eladawy A, Abdeen M. MRI as an accurate tool for the diagnosis and characterization of different knee joint meniscal injuries. The Egyptian Journal of Radiology and Nuclear Medicine. 2017;48:953–60. DOI: https://doi.org/10.1016/j.ejrnm.2017.06.013
  • 28. Schnaiter JW, Roemer F, McKenna-Kuettner A, Patzak HJ, May MS, Janka R, et al. Diagnostic accuracy of an MRI protocol of the knee accelerated through parallel imaging in correlation to arthroscopy. Rofo. 2018;190:265 –72. DOI: https://doi.org/10.1055/s-0043-119038
  • 29. Chambers S, Cooney A, Caplan N, Dowen D, Kader D. The accuracy of magnetic resonance imaging (MRI) in detecting meniscal pathology. J R Nav Med Serv. 2014;100:157 – 60.
  • 30. Lefevre N, Naouri JF, Herman S, Gerometta A, Klouche S, Bohu Y. A current review of the meniscus imaging: proposition of a useful tool for its radiologic analysis. Radiol Res Pract. 2016;2016:8329296. DOI: https://doi.org/10.1155/2016/8329296
  • 31. İncesu L, Dabak N, Belet Ü, El M, Gülman B. Comparison of magnetic resonance imaging and arthroscopic findings in knee joint pathologies. Turkiye Klinikleri J Med Res. 1997;15:21–25.
  • 32. Goossens P, Keijsers E, van Geenen RJC, Zijta A, van den Broek M, Verhagen AP, et al. Validity of the Thessaly test in evaluating meniscal tears compared with arthroscopy: a diagnostic accuracy study. J Orthop Sports Phys Ther. 2015;45(1):18–24. DOI: https://doi.org/10.2519/jospt.2015.5215
  • 33. Rosas HG, De Smet A. Magnetic resonance imaging of the meniscus. Top Magn Reson Imaging. 2009;20:151 –73. DOI: https://doi.org/10.1097/RMR.0b013e3181d657d1
  • 34. Behairy NH, Dorgham MA, Khaled SA. Accuracy of routine magnetic resonance imaging in meniscal and ligamentous injuries of the knee: comparison with arthroscopy. Int Orthop. 2009;33:961–7. DOI: https://doi.org/10.1007/s00264-008-0580-5
  • 35. Crawford R, Walley G, Bridgman S, Maffulli N. Magnetic resonance imaging versus arthroscopy in the diagnosis of knee pathology, concentrating on meniscal lesions and ACL tears: a systematic review. Br Med Bull. 2007;84:5–23. DOI: https://doi.org/10.1093/bmb/ldm022
  • 36. Matava MJ, Eck K, Totty W, Wright RW, Shively RA. Magnetic resonance imaging as a tool to predict meniscal reparability. Am J Sports Med. 1999;27:436–43. DOI: https://doi.org/10.1177/03635465990270040601
Birincil Dil en
Konular Tıp
Dergi Bölümü Araştırma makalesi
Yazarlar

Orcid: 0000-0002-0371-4194
Yazar: Almıla Coşkun Bilge (Sorumlu Yazar)
Kurum: Gazı University
Ülke: Turkey


Orcid: 0000-0003-2812-1528
Yazar: Nil Tokgöz
Kurum: Gazı University
Ülke: Turkey


Orcid: 0000-0001-5535-0911
Yazar: Hakan Dur
Kurum: Gazı University
Ülke: Turkey


Orcid: 0000-0003-2650-0065
Yazar: Murat Uçar
Kurum: Gazı University
Ülke: Turkey


Bibtex @araştırma makalesi { josam515244, journal = {Journal of Surgery and Medicine}, issn = {}, eissn = {2602-2079}, address = {Fatih Başak}, year = {2019}, volume = {3}, pages = {64 - 69}, doi = {10.28982/josam.515244}, title = {The value of magnetic resonance imaging in diagnosing meniscal tears: A retrospective cohort study}, key = {cite}, author = {Coşkun Bilge, Almıla and Tokgöz, Nil and Dur, Hakan and Uçar, Murat} }
APA Coşkun Bilge, A , Tokgöz, N , Dur, H , Uçar, M . (2019). The value of magnetic resonance imaging in diagnosing meniscal tears: A retrospective cohort study. Journal of Surgery and Medicine, 3 (1), 64-69. DOI: 10.28982/josam.515244
MLA Coşkun Bilge, A , Tokgöz, N , Dur, H , Uçar, M . "The value of magnetic resonance imaging in diagnosing meniscal tears: A retrospective cohort study". Journal of Surgery and Medicine 3 (2019): 64-69 <http://dergipark.gov.tr/josam/issue/42845/515244>
Chicago Coşkun Bilge, A , Tokgöz, N , Dur, H , Uçar, M . "The value of magnetic resonance imaging in diagnosing meniscal tears: A retrospective cohort study". Journal of Surgery and Medicine 3 (2019): 64-69
RIS TY - JOUR T1 - The value of magnetic resonance imaging in diagnosing meniscal tears: A retrospective cohort study AU - Almıla Coşkun Bilge , Nil Tokgöz , Hakan Dur , Murat Uçar Y1 - 2019 PY - 2019 N1 - doi: 10.28982/josam.515244 DO - 10.28982/josam.515244 T2 - Journal of Surgery and Medicine JF - Journal JO - JOR SP - 64 EP - 69 VL - 3 IS - 1 SN - -2602-2079 M3 - doi: 10.28982/josam.515244 UR - http://dx.doi.org/10.28982/josam.515244 Y2 - 2019 ER -
EndNote %0 Journal of Surgery and Medicine The value of magnetic resonance imaging in diagnosing meniscal tears: A retrospective cohort study %A Almıla Coşkun Bilge , Nil Tokgöz , Hakan Dur , Murat Uçar %T The value of magnetic resonance imaging in diagnosing meniscal tears: A retrospective cohort study %D 2019 %J Journal of Surgery and Medicine %P -2602-2079 %V 3 %N 1 %R doi: 10.28982/josam.515244 %U 10.28982/josam.515244
ISNAD Coşkun Bilge, Almıla , Tokgöz, Nil , Dur, Hakan , Uçar, Murat . "Menisküs yırtıklarının tanısında manyetik rezonans görüntülemenin tanısal değeri: Retrospektif kohort çalışma". Journal of Surgery and Medicine 3 / 1 (Ocak 2019): 64-69. http://dx.doi.org/10.28982/josam.515244