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DOI:10.2214/AJR.07.2945
AJR 2008; 191:81-85
© American Roentgen Ray Society

Original Research

Radial Tear of the Medial Meniscal Root: Reliability and Accuracy of MRI for Diagnosis

So Yeon Lee1, Won-Hee Jee1 and Jung-Man Kim2

1 Department of Radiology, Kangnam St. Mary's Hospital, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul 137-701, South Korea.
2 Department of Orthopedic Surgery, Kangnam St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.

Received July 26, 2007; accepted after revision October 3, 2007.

 
Address correspondence to W. H. Jee (whjee{at}catholic.ac.kr).


Abstract
Top
 Abstract
Introduction
 Materials and Methods
 Results
 Discussion
 References
 
OBJECTIVE. The purpose of this study was to determine the reliability and accuracy of MRI in the diagnosis of radial tears of the medial meniscal root.

MATERIALS AND METHODS. The MR images of 192 patients who underwent arthroscopy and MRI of the knee from July 2003 through March 2006 were retrospectively reviewed. MR images were independently scored by two observers for the presence of radial tear of the medial meniscal root. Interobserver agreement in detection of these tears was assessed with kappa values. The differences in areas under the receiver operating characteristic curves were assessed with a univariate z-score test.

RESULTS. Arthroscopy revealed that 29 patients had radial tears of the medial meniscal root. The sensitivity, specificity, and accuracy of MRI for one reader were 90% (26/29), 94% (154/163), and 94% (180/192) and for the other reader were 86% (25/29), 95% (155/163), and 94% (180/192). Interobserver agreement for radial tears of the medial meniscal root was very high ({kappa} = 0.93). The areas under the receiver operating characteristic curves for each reader were 0.97 and 0.96, which were not significantly different. There was no significant difference in detection of medial meniscal root tears on T2-weighted coronal images compared with the overall interpretation for both readers. Other image sequences had significantly different sensitivity or specificity for one or both readers (McNemar statistic).

CONCLUSION. MRI of the knee is reliable and accurate for detection of radial tears of the medial meniscal root. Coronal T2-weighted imaging is the most useful MRI sequence.

Keywords: knee • meniscal root • meniscus • MRI


Introduction
Top
 Abstract
 Introduction
Materials and Methods
 Results
 Discussion
 References
 
Tears of the medial meniscal root result in medial meniscal extrusion and accelerated development of medial compartment osteoarthritis [1–4]. Tears of the posterior meniscal root can be easily missed because of inconsistent clinical symptoms and can be overlooked without thorough arthroscopic examination [3, 5]. Radial tears of the medial meniscal root are amenable to repair, unless the extruded meniscus becomes fixed in a retracted position [3, 5–8], in which case partial meniscectomy can relieve the mechanical symptoms. Thus MRI diagnosis of radial tear of the medial meniscal root is important for preoperative planning. To our knowledge there has been no radiologic report regarding the accuracy of MRI in the diagnosis of radial tears of the medial meniscal root in which MRI findings have been compared with arthroscopic findings. The purpose of our study was to determine the reliability and accuracy of MRI in the detection of radial tear of the medial meniscal root.


Materials and Methods
Top
 Abstract
 Introduction
 Materials and Methods
Results
 Discussion
 References
 
Patients
Our ethics committee did not require approval or informed consent for this retrospective study. The study population consisted of 192 patients consecutively registered at our institution from July 2003 through March 2006 who underwent MRI and then underwent arthroscopy. All arthroscopic procedures were performed by the same experienc ed orthopedic surgeon. Patients who had undergone previous knee joint surgery (n = 9) and children younger than 16 years (n = 6) were excluded. The average time between MRI examination and knee arthroscopy was 192 days (range, 0–400 days). The patient group included 79 men and 113 women (mean age, 51 years; range, 16–89 years) and 105 right and 87 left knees.

MRI
MRI was performed with a 1.5-T MRI system (TwinSpeed, GE Healthcare) with a phased-array surface coil (Knee Array, Medrad). Fast spin-echo pulse sequences were used to obtain fat-suppressed intermediate images (TR/TE, 3,000–4,300/16–22) in the axial plane. Double-echo fast spin-echo pulse sequences were used to obtain coronal intermediate MR images (3,000–4,300/16–32) and T2-weighted MR images (3,000–4,300/76–108) without fat suppression. Sagittal T1-weighted and fast spin-echo T2-weighted images were acquired at 450–600/10–21 and 3,000–4,300/76–108. Sagittal 3D fat-suppressed spoiled gradient-recalled echo images were acquired at 40/6 with a 40° flip angle. MRI parameters were field of view, 14–15 cm; matrix size, 256 x 256; section thick ness, 3 mm for sagittal and coronal planes, 3.5 mm in axial plane, and 1.5 mm for 3D fat-suppressed spoiled gradient-recalled echo images; intersection gap, 0.5 mm; echo-train length, 8 (equivalent to echo-train length of 4 for each echo).

Evaluation of MR Images
MR images were analyzed on the high-resolution (2,048 x 2,560 matrix, 10-bit viewable gray scale) monitors of a PACS. MR images were retrospectively reviewed and independently scored by two observers for the presence of a radial tear at the posterior root of the medial meniscus. Radial tear of the medial meniscal root was defined as a radial tear of the posterior medial meniscal tibial attachment in the intercondylar notch (Fig. 1). The diagnostic criteria used by the readers to diagnose radial tear of the medial meniscal root on individual sequences were the presence of an area of diffuse high signal intensity in posterior medial meniscal root on a sagittal image and of linear or bandlike vertical areas of high signal intensity extending through the posterior medial meniscal root on a coronal or axial image. The presence of tears was assessed with a five-level confidence score: 0, definitely absent; 1, probably absent; 2, equivocal; 3, probably present; 4, definitely present. An overall confidence score based on all imaging series was obtained by each reader. Interpretation of the individual sequences was performed with the other imaging sequences available to each reviewer. Readers were blinded to the clinical information and the results at arthroscopy. MRI findings were considered negative for radial tear of the medial meniscal root if the overall confidence score was 0–2 and positive if the score was 3–4.


Figure 1
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  		Fig. 1 —Superior-view drawing denotes tibial insertion sites of menisci in relation to cruciate ligaments. Black arrow indicates posterior root of medial meniscus; white arrow, posterior root of lateral meniscus; black arrowhead, anterior root of medial meniscus; white arrowhead, anterior root of lateral meniscus. MM = medial meniscus, LM = lateral meniscus, P = posterior cruciate ligament, A = anterior cruciate ligament.

 

After correlation with arthroscopic reports, MR images of patients with radial tears of the medial meniscal root and cases of false-positive and false-negative diagnoses were re-reviewed by the two readers in consensus. The original incorrect diagnoses were categorized as being due to unavoidable errors, errors in interpretation, or errors made because of equivocal MRI findings of tear according to De Smet et al. [9]. Unavoidable errors were a tear found at arthroscopy but not identified on MR images even at repeated review or an unequivocal tear seen on MR images but not detected at arthroscopy.

Statistical Analysis
The sensitivity, specificity, accuracy, and positive and negative predictive values of MRI were determined for each reader with the arthroscopic findings as the standard of reference. Interobserver agreement in detec tion of radial tear of the medial meniscal root with MRI was assessed with kappa value. The kappa value can be interpreted as poor ({kappa} = 0), slight ({kappa} = 0.0–0.2), fair ({kappa} = 0.21–0.40), moderate ({kappa} = 0.41–0.60), substantial ({kappa} = 0.61–0.80), and almost perfect ({kappa} = 0.81–1.00) [10]. For evalu ation of the overall performance of each reader, receiver operating characteristic (ROC) curves for each reader were obtained with an ROC analysis program. Differences in areas under the ROC curves were assessed with a uni variate z-score test (ROCKIT, Kurt Rossmann Laboratories for Image Research). Interpretation based on each imaging sequence alone was compared with the overall interpretation based on all imaging sequences for each reader. Differences in sensitivity and specificity for interpretations based on different imaging series were tested for significance with the McNemar statistic.


Results
Top
 Abstract
 Introduction
 Materials and Methods
 Results
Discussion
 References
 
Diagnostic Performance
Arthroscopy showed that 29 patients (15% of the study population) had radial tears of the medial meniscal root. This group comprised four men and 25 women with a mean age of 63 years (range, 41–80 years) and included 13 right and 16 left knees. The average interval between the MR examination and arthroscopy for this group was 138 days (range, 0–400 days). The sensitivity and specificity of MRI for the first reader were 90% (26/29) and 94% (154/163) and for the second reader were 86% (25/29) and 95% (155/163) (Table 1). The kappa value for interobserver variability was 0.93 for overall diagnosis with MRI. The areas under the ROC curves for each reader were 0.97 and 0.96, which were not significantly different (Fig. 2).


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  		TABLE 1: MRI and Surgical Correlation (n = 192)

 

Figure 2
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  		Fig. 2 —Receiver operating characteristic curves show reader confidence in detecting radial tears of medial meniscal root. Points show true-positive and false-positive fractions at each level of confidence for each reader.

 

In the detection of radial tears of the medial meniscal root, both readers had no significant difference (p = 1.000) between interpretation of T2-weighted coronal images and overall interpretation (Fig. 3A, 3B, 3C, 3D) (Table 2). Interpretation based on the sagittal T2-weighted images alone resulted in significantly lower sensitivity values for both readers (p < 0.005). Specificity for detection of radial tears of the medial meniscal root was significantly lower for both readers using sagittal T1-weighted images alone and using intermediate coronal images alone (p < 0.001). Specificity for detection of radial tears of the medial meniscal root was significantly lower for one reader using axial fat-suppressed intermediate images compared with the overall interpretation (p < 0.05).


Figure 3
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  		Fig. 3A —55-year-old woman with medial meniscal root radial tear correctly interpreted on MR images. Sagittal T1-weighted (TR/TE, 600/10) (A) and T2-weighted (3,000/85; echo-train length, 8) (B) images show diffuse high signal intensity (arrow) in posterior medial meniscal root.

 

Figure 4
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  		Fig. 3B —55-year-old woman with medial meniscal root radial tear correctly interpreted on MR images. Sagittal T1-weighted (TR/TE, 600/10) (A) and T2-weighted (3,000/85; echo-train length, 8) (B) images show diffuse high signal intensity (arrow) in posterior medial meniscal root.

 

Figure 5
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  		Fig. 3C —55-year-old woman with medial meniscal root radial tear correctly interpreted on MR images. Coronal intermediate (3,000/32; echo-train length, 4) (C) and T2-weighted (3,000/81, echo-train length, 4) (D) images show bandlike area of high signal intensity (arrow) in posterior medial meniscal root.

 

Figure 6
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  		Fig. 3D —55-year-old woman with medial meniscal root radial tear correctly interpreted on MR images. Coronal intermediate (3,000/32; echo-train length, 4) (C) and T2-weighted (3,000/81, echo-train length, 4) (D) images show bandlike area of high signal intensity (arrow) in posterior medial meniscal root.

 

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  		TABLE 2: Mean Accuracy of Individual MRI Pulse Sequences for Two Readers

 

Error Analysis
The first reader made nine false-positive and three false-negative interpretations. The second reader made eight false-positive and four false-negative interpretations. Seven false-positive and three false-negative interpretations were made by both readers. The causes of 10 false-positive diagnoses were errors due to equivocal MRI findings (n = 5), errors in interpretation (n = 3), and unavoidable error (n = 2). According to the two-slice-touch rule, a meniscus is considered torn if two or more MR images have abnormal findings [11]. When this rule was applied to five false-positive diagnoses due to equivocal MRI findings, only one case showed distortion or increased signal intensity on the meniscal surface on two or more MR images. Five false-positive diagnoses attributable to equivocal MRI findings can be considered errors in interpretation because a tear was considered present with equivocal findings. In these cases the correct diagnosis was difficult even in retrospective review by the same readers. The causes of four false-negative diagnoses were unavoidable error (n = 3) and errors in interpretation (n = 1). Thus common causes of error were unavoidable errors and errors due to equivocal MRI findings, although all types of errors might have contributed.

In one case of false-positive diagnosis, MR images were interpreted as radial tears of the medial meniscal root by both readers, even in repeated review, but no tear was found in the medial meniscal root at arthroscopy. Instead, a complex tear was found in the posterior horn of the medial meniscus at arthroscopy (Fig. 4A, 4B, 4C, 4D). In one case of false-negative diagnosis, MR images were interpreted as showing a horizontal tear in the posterior horn of the medial meniscus extending to the posterior meniscal root. The same interpretation was made at repeated review by both readers (Fig. 5A, 5B, 5C, 5D). At arthroscopy radial tear of the medial meniscal root was found to coexist with a horizontal tear in the posterior horn of the medial meniscus. At arthroscopy for horizontal tear in the posterior horn of the medial meniscus extending to the meniscal root, the meniscus cannot be pulled out during probing through the site of the tear. In the case of medial meniscal root radial tear coexisting with a horizontal tear in the posterior horn of medial meniscus, however, the meniscus can be pulled out. During thorough arthroscopic examination, radial tears of the medial meniscal root also can be detected. Errors in interpretation were a complex tear in the posterior horn of the medial meniscus and a radial tear of the medial meniscal root, which was detected only at repeated review.


Figure 7
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  		Fig. 4A —40-year-old woman with false-positive findings. Sagittal T1-weighted (TR/TE, 600/10) (A) and T2-weighted (3,000/85; echo-train length, 8) (B) images show diffuse area of high signal intensity (arrow) in posterior medial meniscal root.

 

Figure 8
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  		Fig. 4B —40-year-old woman with false-positive findings. Sagittal T1-weighted (TR/TE, 600/10) (A) and T2-weighted (3,000/85; echo-train length, 8) (B) images show diffuse area of high signal intensity (arrow) in posterior medial meniscal root.

 

Figure 9
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  		Fig. 4C —40-year-old woman with false-positive findings. Coronal intermediate image (3,000/26; echo-train length, 4) shows very thick bandlike area of high signal intensity (arrow) in posterior medial meniscal root. Another bandlike area of high signal intensity is present in medial aspect.

 

Figure 10
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  		Fig. 4D —40-year-old woman with false-positive findings. Coronal T2-weighted image (3,000/89; echo-train length, 4) shows ill-defined focal area of high signal intensity (arrow) in posterior medial meniscal root. Another bandlike area of high signal intensity is present in medial aspect. MR images were interpreted as radial tear of medial meniscal root and another tear in posterior horn of medial meniscus. Arthroscopy revealed complex tear in posterior horn of medial meniscus instead of medial meniscal root radial tear.

 

Figure 11
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  		Fig. 5A —60-year-old man with false-negative findings. Sagittal T1-weighted (TR/TE, 600/10) (A) and T2-weighted (3,000/85; echo-train length, 8) (B) images show diffuse area of high signal intensity (arrow) in posterior medial meniscal root.

 

Figure 12
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  		Fig. 5B —60-year-old man with false-negative findings. Sagittal T1-weighted (TR/TE, 600/10) (A) and T2-weighted (3,000/85; echo-train length, 8) (B) images show diffuse area of high signal intensity (arrow) in posterior medial meniscal root.

 

Figure 13
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  		Fig. 5C —60-year-old man with false-negative findings. Coronal intermediate image (3,000/25; echo-train length, 4) shows horizontally oriented area of high signal intensity (arrow) in posterior horn of medial meniscus extending to medial meniscal root.

 

Figure 14
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  		Fig. 5D —60-year-old man with false-negative findings. Coronal T2-weighted image (3,000/88; echo-train length, 4) shows horizontal area of high signal intensity (arrow) in posterior horn of medial meniscus without definite extension to medial meniscal root. MR images were interpreted as showing horizontal tear in posterior horn of medial meniscus extending to meniscal root. At arthroscopy, radial tear of medial meniscal root was found to coexist with horizontal tear in posterior horn of medial meniscus.

 

Discussion
Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
References
 
The posterior meniscal roots are critical attachment sites of the medial and lateral menisci to the central tibial plateau and are adjacent to the tibial insertions of the anterior and posterior cruciate ligaments [1–4, 12]. The medial meniscus takes more force during weight bearing than does the lateral meniscus. The posterior horn and the body of the medial meniscus take most of the force applied to the medial compartment of the knee and are the least mobile parts [2, 13]. Without firm insertion of the tibia, the medial meniscus tends to subluxate medially and lose some of its tension, affecting the ability of the meniscus to absorb and dissipate loads through hoop stresses [1–4]. In this study, radial tears of the medial meniscal root were more common (86%) in women, as described in a previous report [14].

There have been conflicting reports [1, 2, 5, 8, 14] of the incidence of medial meniscal root tears. Approximately 15% of our patient group had radial tears of the medial meniscal root. Although partial meniscectomy is performed for most meniscal tears, this procedure does not restore the normal function of the meniscus. There have been reports [3–6] of repair of radial tears of the meniscal root. Without thorough examination, medial meniscal root tears can be overlooked during arthroscopy if the torn margins of the posterior horn are close to the tibial insertion site [5]. Therefore, MRI diagnosis of radial tear of the meniscal root is important.

After Tuckman et al. [15] described the difficulty of MRI diagnosis of radial tears of the meniscal root, these tears were described in several reports [1–4, 14]. To our knowledge, however, there has been no radiologic report on the accuracy of MRI compared with arthroscopic findings in the diagnosis of radial tears of the medial meniscal root. In one report [14] in the orthopedics literature, unusually low diagnostic sensitivity (66.3%) was found for prospective interpretation of MR images of 49 arthroscopically confirmed medial meniscal root tears. Because that report [14] was based on prospective MRI interpretation by one radiologist during 1996–1999, particular attention might not have been paid to medial meniscal root tears.

After negotiating a learning curve on radial tears of the meniscal root, trained musculoskeletal radiologists can achieve high diagnostic accuracy with MRI. We found very high interobserver agreement and similar areas under the ROC curves for the two readers. In this study, the sensitivity of MRI for the diagnosis of medial meniscal root radial tears was 90% and 86% for the two readers, which is similar to the sensitivity in previous reports [16, 17], although meniscal radial tears were not subclassified to radial tears of the meniscal root in those reports. Magee et al. [16] reported that the sensitivity of MRI for meniscal radial tears was 68% (19 of 28 radial tears) and increased to 89% with additional use of coronal fat-saturated T2-weighted or proton density– weighted sequences. Harper et al. [17] reported similar results for 17 (89%) of 19 meniscal radial tears correctly diagnosed with MRI.

Sagittal T1-weighted and intermediate images are thought to be the most accurate MRI sequences for the diagnosis of meniscal tears with routine knee MRI. For radial tears of the medial meniscal root, however, interpretation with the coronal T2-weighted sequence was the most accurate in this study.

This study had several limitations. The interval between MRI examination and arthroscopy was long for some patients. Bias might have been introduced in the comparison of the individual imaging sequences because interpretation with the individual sequences was performed with the other imaging sequences available. If a separate blinded reading had been used to compare the sequences, the conclusion about coronal T2-weighted images would be more convincing. The findings at arthroscopy might have been biased by the availability of clinical MRI reports. The fraction of false-negative interpretations cannot be accurately evaluated because of substantial selection bias caused by excluding patients not scheduled for arthroscopy. Arthroscopic findings were used as the standard. Arthroscopic errors were minimized in this study because all patients underwent arthroscopy performed by the same experienced orthopedic surgeon. The usefulness of findings associated with medial meniscal root tears was dampened without control groups.

In conclusion, MRI of the knee is a reliable and accurate diagnostic study for the detection of radial tears of the medial meniscal root, and coronal T2-weighted imaging is the most useful MRI sequence for diagnosis.


References
Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 

  1. Costa CR, Morrison WB, Carrino JA. Medial meniscus extrusion on knee MRI: is extent associated with severity of degeneration or type of tear? AJR 2004; 183:17 –23[Abstract/Free Full Text]
  2. Lerer DB, Umans HR, Hu MX, Jones MH. The role of meniscal root pathology and radial meniscal tear in medial meniscal extrusion. Skeletal Radiol 2004;33 : 569–574[Medline]
  3. Jones AO, Houang MT, Low RS, Wood DG. Medial meniscus posterior root attachment injury and degeneration: MRI findings. Australas Radiol 2006; 50:306 –313[CrossRef][Medline]
  4. Schlossberg S, Umans H, Flusser G, Difelice GS, Lerer DB. Bucket handle tears of the medial meniscus: meniscal intrusion rather than meniscal extrusion. Skeletal Radiol 2007;36 : 29–34[Medline]
  5. Petersen W, Zantop T. Avulsion injury to the posterior horn of the lateral meniscus: technique for arthroscopic refixation [in German]. Unfallchirurg 2006;109 : 984–987[CrossRef][Medline]
  6. Pagnami MJ, Cooper DE, Warren RF. Extrusion of the medial meniscus. Arthroscopy 1991;7 : 297–300[Medline]
  7. Engelsohn E, Umans H, Difelice GS. Marginal fractures of the medial tibial plateau: possible association with medial meniscal root tear. Skeletal Radiol 2007;36 : 73–76[CrossRef][Medline]
  8. Ahn JH, Wang JH, Yoo JC, Noh HK, Park JH. A pull out suture for transection of the posterior horn of the medial meniscus: using a posterior trans-septal portal. Knee Surg Sports Traumatol Arthrosc 2007; 15:1510 –1513[CrossRef][Medline]
  9. De Smet AA, Tuite MJ, Norris MA, Swan JS. MR diagnosis of meniscal tears: analysis of causes of errors. AJR1994; 163:1419 –1423[Abstract/Free Full Text]
  10. Crewson PE. Reader agreement studies. AJR2005; 184:1391 –1397[Free Full Text]
  11. De Smet AA, Tuite MJ. Use of the "two-slice-touch" rule for the MRI diagnosis of meniscal tears. AJR2006; 187:911 –914[Abstract/Free Full Text]
  12. Brody JM, Hulstyn MJ, Fleming BC, Tung GA. The meniscal roots: gross anatomic correlation with 3-T MRI findings. AJR2007; 188:[web]W446 –W450[Abstract/Free Full Text]
  13. Vedi V, Williams A, Tennant SJ, Spouse E, Hunt DM, Gedroyc WM. Meniscal movement: an invivo study using dynamic MRI. J Bone Joint Surg Br 1999; 81:37 –41[CrossRef][Medline]
  14. Bin SI, Kim JM, Shin SJ. Radial tears of the posterior horn of the medial meniscus. Arthroscopy 2004;20 : 373–378[Medline]
  15. Tuckman GA, Miller WJ, Remo JW, Fritts HM, Rozansky MI. Radial tears of the menisci: MR findings. AJR1994; 163:395 –400[Abstract/Free Full Text]
  16. Magee T, Shapiro M, Williams D. MR accuracy and arthroscopic incidence of meniscal radial tears. Skeletal Radiol2002; 31:686 –689[CrossRef][Medline]
  17. Harper KW, Helms CA, Lambert HS 3rd, Higgins LD. Radial meniscal tears: significance, incidence, and MR appearance. AJR2005; 185:1429 –1434[Abstract/Free Full Text]

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