Diagnostic Efficacy of Fat-Suppressed 3D Volume Isotropic Turbo Spin-Echo Acquisition Imaging Versus Conventional 2D Sequences in the Detection of Cruciate and Meniscal Tears Using a 3-Tesla Magnetic Resonance Imaging Scanner: A Comparative Study

TL;DR

This study compares 3D and 2D MRI techniques for detecting knee ligament and meniscal tears, finding that the 3D method is more accurate and faster.

Contribution

The study introduces evidence that fat-suppressed 3D VISTA MRI improves diagnostic accuracy and reduces scan time for knee injuries compared to conventional 2D MRI.

Findings

FS 3D VISTA showed higher sensitivity and specificity for detecting ACL, PCL, and meniscal tears than 2D FSE MRI.

FS 3D VISTA reduced scan time by 40%-50% compared to conventional 2D sequences.

Abstract

Introduction

Accurate and early detection of internal derangements of the knee, such as tears of the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), and menisci, is essential for guiding treatment. Fat-suppressed (FS) three-dimensional (3D) volume isotropic turbo spin echo acquisition (VISTA) magnetic resonance imaging (MRI) provides isotropic spatial resolution and high-quality multiplanar reformations, which may offer diagnostic advantages over conventional two-dimensional (2D) fast spin-echo (FSE) sequences. We hypothesized that FS 3D VISTA would demonstrate improved diagnostic performance, with an expected increase in sensitivity and specificity of approximately 10%-15% compared to 2D FSE MRI.

Objective

The primary aim of the study was to compare and evaluate the diagnostic accuracy of FS 3D VISTA and conventional 2D FSE MRI sequences in identifying ACL, PCL, and meniscal tears in patients with suspected internal knee derangement. In addition to overall accuracy, secondary objectives included assessing the sensitivity and specificity of each protocol, and determining the practical advantages of FS 3D VISTA in terms of tear characterization and reduced scan time.

Methods

A prospective observational study was conducted as a pilot study among 30 symptomatic patients, aged 15-60 years, undergoing knee MRI using both imaging protocols. Two experienced musculoskeletal radiologists evaluated all images independently. Diagnostic accuracy, sensitivity, and specificity were assessed using arthroscopic correlation as the reference standard.

Results

FS 3D VISTA demonstrated superior sensitivity and specificity across ACL, PCL, and meniscal tear detection compared to 2D FSE MRI. FS 3D VISTA also reduced scan time significantly, with an estimated acquisition duration of 6-8 minutes versus 12-15 minutes for the 2D FSE protocol, reflecting a potential time savings of 40%-50%.

Conclusion

FS 3D VISTA MRI at 3-tesla (3T) improves the accuracy and efficiency of cruciate ligament and meniscal tear detection, compared to conventional 2D FSE. Its superior spatial resolution and time efficiency support its incorporation into routine knee MRI protocols.