American Journal of Roentgenology, Vol 161, 821-825, Copyright © 1993 by American Roentgen Ray Society

ARTICLES

MR diagnosis of recurrent tears in the knee: value of intraarticular contrast material

GR Applegate, BD Flannigan, BS Tolin, JM Fox and W Del Pizzo
Valley Presbyterian Magnetic Resonance Center, Van Nuys, CA 91405.

OBJECTIVE. After surgical resection or repair of a torn meniscus, the healed area may have areas of abnormal signal intensity on MR images. Consequently, routine MR imaging is not reliable for detecting recurrent meniscal tears. As a result, we studied the efficacy of MR imaging with intraarticular contrast material (MR arthrography) for detecting recurrent tears of the meniscus. SUBJECTS AND METHODS. Thirty- seven patients who previously had a meniscal tear treated by either meniscal resection or repair had conventional MR imaging and MR arthrography with 40-50 ml of a 1:100 solution of gadopentetate dimeglumine in saline. All patients had arthroscopy shortly after the MR studies. Follow-up arthroscopic surgery was performed within an average of 6.6 weeks after the MR arthrograms. The routine MR images and MR arthrograms were reviewed separately and randomly, and these results were compared with the arthroscopic findings. Meniscal morphology, signal intensity, and the presence of joint fluid tracking into recurrent tears were evaluated. RESULTS. The overall accuracy in diagnosing recurrent meniscal tears in the post-operative meniscus was 66% when conventional MR imaging was used and 88% when MR arthrography was used. In patients who had only minimal meniscal resection, both methods had an accuracy of 89%. In patients who had more extensive meniscal resection, accuracy was 65% with conventional MR imaging and 87% with MR arthrography. In four patients who had only a small meniscal remnant, the accuracy was 50% with routine MR imaging and 100% with MR arthrography. On conventional MR images, the presence of an effusion tracking into a meniscal tear had a sensitivity and positive predictive value of 90% for detection of recurrent meniscal tears; however, the sensitivity was only 41%. CONCLUSION. Our results show that the sensitivity of MR imaging in detecting meniscal tears after surgery varies with the extent of the resection. Sensitivity was considerably improved when intraarticular contrast material was used. MR arthrography should be considered as an alternative to arthroscopy in patients who have had resection or repair of the meniscus.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				G. Andreisek, J. M. Froehlich, J. Hodler, D. Weishaupt, V. Beutler, C. W. A. Pfirrmann, C. Boesch, and D. Nanz Direct MR Arthrography at 1.5 and 3.0 T: Signal Dependence on Gadolinium and Iodine Concentrations--Phantom Study Radiology, June 1, 2008; 247(3): 706 - 716. [Abstract] [Full Text] [PDF]

				R. Crawford, G. Walley, S. Bridgman, and N. Maffulli Magnetic resonance imaging versus arthroscopy in the diagnosis of knee pathology, concentrating on meniscal lesions and ACL tears: a systematic review Br. Med. Bull., December 1, 2007; 84(1): 5 - 23. [Abstract] [Full Text] [PDF]

				A. A. De Smet, D. M. Horak, K. W. Davis, and J. J. Choi Intensity of Signal Contacting Meniscal Surface in Recurrent Tears on MR Arthrography Compared with That of Contrast Material. Am. J. Roentgenol., December 1, 2006; 187(6): W565 - W568. [Abstract] [Full Text] [PDF]

				T. R. McCauley MR Imaging Evaluation of the Postoperative Knee Radiology, January 1, 2005; 234(1): 53 - 61. [Abstract] [Full Text] [PDF]

				M. J. Vives, D. Homesley, M. G. Ciccotti, and M. E. Schweitzer Evaluation of Recurring Meniscal Tears with Gadolinium-Enhanced Magnetic Resonance Imaging: A Randomized, Prospective Study Am. J. Sports Med., November 1, 2003; 31(6): 868 - 873. [Abstract] [Full Text] [PDF]

				T. R. McCauley, A. Elfar, A. Moore, A. H. Haims, P. Jokl, J. K. Lynch, P. A. Ruwe, and L. D. Katz MR Arthrography of Anterior Cruciate Ligament Reconstruction Grafts Am. J. Roentgenol., November 1, 2003; 181(5): 1217 - 1223. [Abstract] [Full Text] [PDF]

				T. Magee, M. Shapiro, J. Rodriguez, and D. Williams MR Arthrography of Postoperative Knee: For Which Patients Is It Useful? Radiology, October 1, 2003; 229(1): 159 - 163. [Abstract] [Full Text] [PDF]

				C. Mutschler, B. C. Vande Berg, F. E. Lecouvet, P. Poilvache, J.-E. Dubuc, B. Maldague, and J. Malghem Postoperative Meniscus: Assessment at Dual-Detector Row Spiral CT Arthrography of the Knee Radiology, September 1, 2003; 228(3): 635 - 641. [Abstract] [Full Text] [PDF]

				L. S. Steinbach, W. E. Palmer, and M. E. Schweitzer Special Focus Session: MR Arthrography RadioGraphics, September 1, 2002; 22(5): 1223 - 1246. [Abstract] [Full Text] [PDF]

				M. P. Recht and J. Kramer MR Imaging of the Postoperative Knee: A Pictorial Essay RadioGraphics, July 1, 2002; 22(4): 765 - 774. [Abstract] [Full Text] [PDF]

				P. S. Lim, M. E. Schweitzer, M. Bhatia, V. Giuliano, P. P. Kaneriya, R. M. Senyk, M. Oliveri, W. Johnson, B. Amster, and L. Parker Repeat Tear of Postoperative Meniscus: Potential MR Imaging Signs Radiology, January 1, 1999; 210(1): 183 - 188. [Abstract] [Full Text]

				L. M. White, M. E. Schweitzer, D. Weishaupt, J. Kramer, A. Davis, and P. H. Marks Diagnosis of Recurrent Meniscal Tears: Prospective Evaluation of Conventional MR Imaging, Indirect MR Arthrography, and Direct MR Arthrography Radiology, February 1, 2002; 222(2): 421 - 429. [Abstract] [Full Text] [PDF]