How sensitive and specific is 1.5 Tesla MRI for diagnosing injuries in patients with knee dislocation?

Derby, Emma; Imrecke, Julia; Henckel, Johann; Hirschmann, Anna; Amsler, Felix; Hirschmann, Michael T.

doi:10.1007/s00167-015-3857-4

Cited by 14 publications

(29 citation statements)

References 30 publications

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“…The value of MRI for diagnosing isolated ligament injuries has been widely demonstrated, however, in terms of multi-ligament injuries, the accuracy of MRI is controversial. Derby et al [ 8 ] found that MRI was sensitive in detecting injuries of cruciate and collateral ligaments, but not reliable in diagnosing injury to the meniscus or posterolateral corner (PLC). Twaddle et al [ 9 ] demonstrated that MRI is not reliable for revealing injuries of the lateral collateral ligament (LCL) and PLC.…”

Section: Introductionmentioning

confidence: 99%

The accuracy of MRI in diagnosing and classifying acute traumatic multiple ligament knee injuries

Liu

Hou

Zhan

et al. 2022

BMC Musculoskelet Disord

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Background Magnetic resonance imaging (MRI) is widely used for the evaluation of knee injuries, however, the accuracy of MRI in classifying multiple ligament knee injuries (MLKIs) remains unknown. This study aimed to investigate the accuracy of MRI in diagnosing and classifying acute traumatic MLKIs, we hypothesize that MRI had high accuracy in detecting and classifying MLKIs. Methods The clinical data of 97 patients who were diagnosed with acute traumatic MLKIs and managed by multi-ligament reconstruction between 2012 and 2020 were retrospectively reviewed. The MR images were read by two experienced radiologists and results were compared with intraoperative findings, which were considered as the reference for the identification of injured structures. The value of MRI in detecting injuries of anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), lateral collateral ligament (LCL), and meniscus was evaluated by calculating the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, and kappa coefficients analysis. The value of MRI in classifying MLKIs was evaluated by calculating the agreement between MRI and intraoperative findings. Results For detecting the specific injured structures in MLKIs, MRI had high sensitivity (90.7% for ACL, 90.4% for PCL, and moderate specificity (63.6% for ACL, 50% for PCL) in detecting cruciate ligament injuries, moderate sensitivity (79.1% for MCL, 55.6% for LCL) and specificity (46.7% for MCL, 68.4% for LCL) in detecting collateral ligament injuries, fair sensitivity (61.5%) and low specificity (39.4%) in the diagnosis of injuries to the meniscus. For classifying the MIKIs, MRI had a moderate agreement with intraoperative findings in classifying KD-V (kappa value = 0.57), poor agreement in the KD-I (kappa value = 0.39) and KD-IIIM (kappa value = 0.31), meaningless in the KD-II and KD-IIIL (kappa value < 0). The overall agreement between MRI and intraoperative findings in classifying MLKIs was poor (kappa value = 0.23). Conclusions MRI is valuable in early detection and diagnosis of acute MLKIs, however, the accuracy of MRI in classifying MLKIs is limited. The management of MLKIs should be based on intraoperative findings, physical examinations, and comprehensive imaging results.

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Section: Introductionmentioning

confidence: 99%

The accuracy of MRI in diagnosing and classifying acute traumatic multiple ligament knee injuries

Liu

Hou

Zhan

et al. 2022

BMC Musculoskelet Disord

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“…There are a large number of studies comparing MRI findings with arthroscopic examination for other big joints. 17,[30][31][32][33] The reported sensitivity and specificity of MRI for assessing ligament injuries around the major joints were 9 to 100% and 38 to 100%, respectively. Therefore, in addition to MRI findings, the history of the patient, and physical and radiological findings, arthroscopic examination is important for assessing the extent of the injury and optimizing the surgical treatment of ligament injuries around the thumb MCPJ.…”

Section: Discussionmentioning

confidence: 99%

“…36 Finally, this study included acute (<4 weeks after injury) and chronic (>4 weeks after injury) injuries, which may not reflect the true accuracy of the MRI. 30…”

Section: Discussionmentioning

confidence: 99%

Efficiency of magnetic resonance imaging for diagnosing unstable ligament injuries around the thumb metacarpophalangeal joint: A comparison to arthroscopy

Shin

Kim

et al. 2020

J Orthop Surg (Hong Kong)

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Purpose: This study aimed to assess the accuracy of MRI in identifying ulnar collateral ligament (UCL), radial collateral ligament (RCL), and volar plate (VP) injuries of the metacarpophalangeal joint (MCPJ) of the thumb by comparing with diagnostic arthroscopy. Methods: A total of 56 consecutive patients (56 thumbs) who underwent arthroscopy of MCPJ of thumb were enrolled. MRI findings reviewed by consensus reading of two blinded radiologists were compared with arthroscopic examination. Statistical data, including sensitivity, specificity, accuracy, were analyzed. Additionally, the performance characteristics between 3.0-tesla (39 thumbs) and 1.5-tesla (17 thumbs) MRI and acute (≤4 weeks after injury) and chronic (>4 weeks) injuries were compared. Results: Of the 56 thumbs, 38 thumbs (67.9%) showed complete correspondence between MRI and arthroscopic findings. The sensitivity, specificity and accuracy of MRI for detecting UCL injuries were 78.8%, 87.0%, and 82.1%, respectively. The sensitivity, specificity and accuracy of MRI for detecting RCL injuries were 85.7%, 91.4%, and 85.7%, respectively. The sensitivity, specificity, and accuracy of MRI for detecting VP injuries were 89.5%, 89.2%, and 81.0%, respectively. 3.0-tesla MRI showed higher correspondence with arthroscopic observation (76.9%) than 1.5-tesla MRI (47.1%) (p = 0.028). For acute injuries, 78.4% showed complete correspondence between MRI and arthroscopic findings, whereas 47.4% with chronic injuries revealed complete agreement (p = 0.019). Conclusion: Overall, MRI is moderately effective in evaluating ligamentous lesions around MCPJ of thumb, but MRI is more sensitive in diagnosing acute injuries. Furthermore, 3.0-tesla MRI can provide results with better accuracy for diagnosing ligamentous lesions around MCPJ of thumb. However, the sensitivity and the specificity are not applicable to all ligament injuries, but only the severe one which would agree for surgical options.

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“…However, there were several limitations in this analysis 1 : differences in the inclusion criteria and exclusion criteria for patients 2 ; different patients with previous disease and treatments were unavailable 3 ; all the included studies were from English articles, which may be the source of bias 4 ; the fluency of technicians between different studies varied 5 ; difference in the MRI FS 6 ; pooled data were used for analysis; and individual patients' data was unavailable, which limited us to perform more comprehensive analysis. However, there was no significant publication bias of the included studies.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of MRI Diagnosis of Meniscal Tears of the Knee: A Meta-Analysis and Systematic Review

et al. 2019

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This study aimed to evaluate the overall diagnostic value of magnetic resonance imaging (MRI) in patients with suspected meniscal tears. PubMed, Cochrane, Embase database updated to November 2017 were searched by the index words to identify qualified studies, including prospective cohort studies and cross-sectional studies. Literature was also identified by tracking using reference lists. Heterogeneity of the included studies was reviewed to select proper effects model for pooled weighted sensitivity, specificity, and diagnostic odds ratio (DOR). Summary receiver operating characteristic (SROC) analyses were performed for meniscal tears. A total of 17 studies were involved in this meta-analysis to explore the diagnostic accuracy of MRI for meniscal tears. The global sensitivity and specificity of MRI of meniscal tears were 92.0% (95% confidence interval [CI]: 88.0–95.0%) and 90.0% (95% CI: 85.0–95.0%) in medial meniscal tears, and 80.0% (95% CI: 66.0–89.0%) and 95.0% (95% CI: 91.0–97.0%) in lateral meniscal tears, respectively. Moreover, the global positive and negative likelihood ratio of MRI of meniscal tears were 10.33 (95% CI: 6.04–17.67) and 0.09 (95% CI: 0.05–0.14) in medial meniscal tears; 16.48 (95% CI: 8.81–30.83) and 0.21 (95% CI: 0.12–0.37) in lateral meniscal tears, respectively. The global DOR was 81.69 (95% CI: 37.94–175.91) in medial meniscal tears and 56.59 (95% CI: 22.51–142.28) in lateral meniscal tears. The results of area under the SROC indicated high accuracy in medial meniscal tears (area under the curve [AUC] = 0.97, 95% CI: 0.95–0.98) and lateral meniscal tears (AUC = 0.96, 95% CI: 0.94–0.97). This review presents a systematic review and meta-analysis to evaluate the diagnostic accuracy of MRI of meniscal tears. Moderate-to-strong evidence suggests that MRI appears to be associated with higher diagnostic accuracy for detecting medial and lateral meniscal tears.

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How sensitive and specific is 1.5 Tesla MRI for diagnosing injuries in patients with knee dislocation?

Abstract: Diagnostic study, Level II.

Cited by 14 publications

References 30 publications

The accuracy of MRI in diagnosing and classifying acute traumatic multiple ligament knee injuries

The accuracy of MRI in diagnosing and classifying acute traumatic multiple ligament knee injuries

Efficiency of magnetic resonance imaging for diagnosing unstable ligament injuries around the thumb metacarpophalangeal joint: A comparison to arthroscopy

Accuracy of MRI Diagnosis of Meniscal Tears of the Knee: A Meta-Analysis and Systematic Review

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