Evaluation of the postoperative meniscus of the knee: a study comparing conventional arthrography, conventional MR imaging, MR arthrography with iodinated contrast material, and MR arthrography with gadolinium-based contrast material

Abstract

Intra-articular fluid is advantageous in the evaluation of patients with a suspected meniscal retear. MR arthrography with gadolinium-based contrast material is the most accurate imaging method for the diagnosis of meniscal retears.

MR Imaging Evaluation of the Postoperative Knee

“…A dilution ranging from 1:250 to 1:100 has been shown to provide highquality images (3)(4)(5)(6)(7)(8). Precontrast images are generally not needed (3,4). Direct MR arthrography is preferred to indirect MR arthrography because of the distention of the joint achieved with direct injection, which is not achieved with indirect arthrography (3)(4)(5).…”

“…MR arthrography can be performed with direct injection of the joint with a dilute solution containing gadolinium or with indirect intravenous injection of contrast material. In my practice, direct MR arthrography is performed in almost all patients who have undergone prior meniscal surgery or ACL graft reconstruction, because the distention of the joint with intraarticular contrast material improves evaluation of the meniscus (3)(4)(5)(6) and may improve evaluation of ACL graft integrity (7). In patients who have not undergone meniscal or ACL surgery or in whom the site of symptoms is separate from the site of prior surgery, we sometimes will perform conventional MR imaging without injection of contrast material.…”

“…A dilution ranging from 1:250 to 1:100 has been shown to provide highquality images (3)(4)(5)(6)(7)(8). Precontrast images are generally not needed (3,4).…”

“…Precontrast images are generally not needed (3,4). Direct MR arthrography is preferred to indirect MR arthrography because of the distention of the joint achieved with direct injection, which is not achieved with indirect arthrography (3)(4)(5). MR imaging is performed in all three planes with a combination of short and long echo time conventional spin-echo (SE) and fast SE sequences.…”

Magnetic Resonance Imaging of the Postoperative Meniscus

“…[80][81][82][83][84][85][86] However, as discussed by others, 87-90 the authors routinely begin with conventional MR imaging to screen the postoperative knee, for the following reasons:…”