Isotropic 3D fast spin-echo imaging versus standard 2D imaging at 3.0 T of the knee-image quality and diagnostic performance Abstract The objective of this study was to compare a newly developed fat-saturated intermediate-weighted (IM-w) 3D fast spin-echo (FSE) sequence with standard 2D IM-w FSE sequences regarding image quality and diagnostic performance in assessing abnormal findings of the knee. MR imaging was performed at 3.0 T in 50 patients. Images were assessed independently by three radiologists. Image quality was rated significantly higher (p<0.05) for the 2D versus the 3D FSE sequences. Sensitivity for cartilage lesions was slightly higher for the 3D sequence, but specificity was lower. Low contrast objects were better visualized with 2D sequences, while high contrast objects were better shown with the 3D sequence. Confidence scores were higher for 2D than for 3D sequences, but differences were not significant. In conclusion, isotropic 3D FSE IM-w imaging may enhance standard knee MRI by increased visualization of high contrast lesions; however, 3D FSE image quality was lower.
Although evidence suggests that tester strength limits the magnitude of isometric force that can be measured using a handheld dynamometer (HHD), previous studies have not investigated the actual limits of force magnitude that can be measured by trained testers when a belt is or is not used to stabilize the dynamometer. Therefore, the primary aims of this study were to determine: 1) the magnitude of knee extension forces that could be measured with a HHD with and without belt-stabilization and 2) the relationship between tester characteristics and knee extension strength measured with and without belt-stabilization. The characteristics of 20 trained testers (10 men, 10 women) were determined. Thereafter, they measured isometric knee extension strength using the MicroFET HHD with and without belt-stabilization. Paired t-tests were used to compare maximal knee extension forces under two conditions. Pearson product-moment correlations were calculated to determine the relationship between tester characteristics and knee extension forces measured under the two conditions. Knee extension forces (Newtons) measured using the HHD without belt-stabilization (470.6 ± 179.8) were significantly lower (t= -7.968, p<0.001) than those measured with belt-stabilization (866.9 ± 131.7). Pearson correlations between tester characteristics and knee extension forces measured with no belt-stabilization were all statistically significant (p ≤ 0.002); however, the correlations were not statistically significant under the belt-stabilization condition. The forces that can be measured with a HHD are higher than those suggested by previous researchers. By rectifying limitations imposed by tester strength, use of a belt allows very high knee extension forces to be measured.
Although the 3D FSE sequence performed better in depiction and characterization of cartilage abnormalities than the standard 2D FSE sequence, we currently do not recommend to use it as substitute. For the diagnosis of meniscal defects, however, no significant improvement was found.
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