The Role of Diffusion-weighted Magnetic Resonance Imaging in the Evaluation of Anterior Cruciate and Posterior Cruciate Ligament Tears

2019 ◽  
Vol 1 ◽  
pp. 97-100
Author(s):  
Vijinder Arora ◽  
Sonali Malik ◽  
Kunwarpal Singh
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Cruciate Ligament ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Conventional Mri ◽  
Anterior Cruciate

Objective: The objective of our study was to determine the role of diffusion-weighted (DW) magnetic resonance imaging (MRI) in diagnosing and differentiating between complete and partial anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) tears and to compare it with conventional MRI sequences. Materials and Methods: We conducted a prospective study for a period of 2 years from October 2017 to October 2019 on 30 patients with clinically suspected ACL/PCL injuries of the knee. MRI of the knee joint was performed using conventional, and DW sequences and the findings on both the sequences were assessed independently and compared with the intraoperative or follow-up MRI findings. Results: As per operative and follow-up MRI findings, the sensitivity and specificity of conventional MRI were 60% and 33.33% with a positive and negative predictive value of 47.37% and 45.45%, respectively. On the other hand, the sensitivity and specificity of DW MRI were 70.00% and 33.33% with a positive and negative predictive value of 51.22% and 52.13%, respectively. P = 0.417 was statistically not significant. Conclusion: According to our study, adding DW sequence to conventional MR sequences yielded comparable results in diagnosis and differentiation between complete and partial ACL and PCL tears.

scholarly journals Assessment of Anterior Cruciate Ligament Graft Maturity With Conventional Magnetic Resonance Imaging: A Systematic Literature Review

2019 ◽  
Vol 7 (6) ◽  
pp. 232596711984901 ◽  
Author(s):  
Pieter Van Dyck ◽  
Katja Zazulia ◽  
Céline Smekens ◽  
Christiaan H.W. Heusdens ◽  
Thomas Janssens ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Systematic Review ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Resonance Imaging ◽  
Acl Graft ◽  
Conventional Mri ◽  
Anterior Cruciate

Background: Magnetic resonance imaging (MRI) signal intensity (SI) measurements are being used increasingly in both clinical and research studies to assess the maturity of anterior cruciate ligament (ACL) grafts in humans. However, SI in conventional MRI with weighted images is a nonquantitative measure dependent on hardware and software. Purpose: To conduct a systematic review of studies that have used MRI SI as a proxy for ACL graft maturity and to identify potential confounding factors in assessing the ACL graft in conventional MRI studies. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was conducted by searching the MEDLINE/PubMed, Scopus, and Cochrane Library electronic databases according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to identify studies that examined the healing of the intra-articular portion of the ACL graft by assessing SI on MRIs. Results: A total of 34 studies were selected for inclusion in this systematic review. The MRI acquisition techniques and methods to evaluate the ACL graft SI differed greatly across the studies. No agreement was found regarding the time frames of SI changes in MRI reflecting normal healing of the ACL tendon graft, and the graft SI and clinical outcomes after ACL reconstruction were found to be poorly correlated. Conclusion: The MRI acquisition and evaluation methods used to assess ACL grafts are very heterogeneous, impeding comparisons of SI between successive scans and between independent studies. Therefore, quantitative MRI-based biomarkers of ACL graft healing are greatly needed to guide the appropriate time of returning to sports after ACL reconstruction.

scholarly journals Diagnostic accuracy of magnetic resonance imaging in detecting anterior cruciate ligament injuries

2017 ◽  
Vol 26 (3) ◽  
pp. 218-23
Author(s):  
Ashfaq Ahmed ◽  
Muhammad A. Razzaque ◽  
Muhammad Kaleem ◽  
Atiq U. Zaman ◽  
Rizwan Akram ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Ligament Injury ◽  
Resonance Imaging ◽  
Anterior Cruciate

Background: The anterior cruciate ligament (ACL) stabilizes the joint during hyperextension and prevents anterior translation over femur. The objective of this study was to determine the diagnostic accuracy of magnetic resonance imaging (MRI) in detecting ACL injury by taking arthroscopy as gold standard in patients with traumatic knee injury.Methods: Patients fulfilling the study criteria were treated with clinical examination, MRI and then arthroscopy at the Department of Orthopedics and Spine in the Ghurki Trust Teaching Hospital, Lahore. The accuracy, sensitivity and specificity of MRI in diagnosing  the anterior cruciate ligament injury were calculated based on arthroscopic findings. All the data were analyzed using SPSS 17.0 version.Results: A total 185 patients were included. 91.1% were males and 8.9% were females with Mean age of 28.25±0.433. The accuracy of MRI in diagnosing the anterior cruciate ligament was 91.89%, with sensitivity of 93.33%, specificity of 85.71%, positive predictive value of 96.55% and the negative predictive value  of 75%.Conclusion: MRI is accurate and non-invasive modality for the assessment of ligamentous injuries. It can be used as a first line investigation to patients with suspicion of ACL injury.

scholarly journals Timing of magnetic resonance imaging affects the accuracy and interobserver agreement of anterolateral ligament tears detection in anterior cruciate ligament deficient knees

2020 ◽  
Vol 32 (1) ◽  
Author(s):  
Audrey Xinyun Han ◽  
Tien Jin Tan ◽  
Tiep Nguyen ◽  
Dave Yee Han Lee
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Interobserver Agreement ◽  
Cruciate Ligament ◽  
Anterolateral Ligament ◽  
Resonance Imaging ◽  
Mri Scans ◽  
Anterior Cruciate

Abstract Purpose We aimed to identify the anterolateral ligament (ALL) tears in anterior cruciate ligament (ACL)-deficient knees using standard 1.5-Tesla magnetic resonance imaging (MRI). Methods We included all patients who underwent primary ACL reconstruction at our center between 2012 and 2015. Exclusion criteria included patients with multiple ligament injuries, lateral collateral ligament, posterolateral corner, and infections, and patients who underwent MRI more than 2 months after their injury. All patients (n = 148) had ACL tears that were subsequently arthroscopically reconstructed. The magnetic resonance (MR) images of the injured knees performed within 2 months of injury were reviewed by a musculoskeletal radiologist and an orthopedic surgeon. The patients were divided into two groups. The first group of patients had MRI performed within 1 month of injury. The second group of patients had MRI performed 1–2 months after the index injury. Both assessors were blinded and the MR mages were read separately to assess the presence of ALL, presence of a tear and the location of the tear. Based on their readings, interobserver agreement (kappa statistic (K)), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were compared. Results The ALL was identified in 100% of the patients. However, there was a discrepancy of up to 15% in the identification of tear of the ALL. In the first group in which MRI scans were performed within 1 month of injury, the ALL tear was identified by the radiologist in 92% of patients and by the surgeon in 90% of patients (Κ = 0.86). In the second group in which MRI scans were performed within 1–2 months of the injury, the ALL tear was identified by the radiologist in 78% of patients and by the surgeon in 93% of patients (K = 0.62). Conclusion The ALL can be accurately identified on MRI, but the presence and location of ALL tear and its location cannot be reliably identified on MRI. The accuracy in identification and characterization of a tear was affected by the interval between the time of injury and the time when the MRI was performed. Level of evidence Diagnostic, level IIIb, retrospective.

scholarly journals Clinical, Magnetic Resonance Imaging, and Arthroscopic Correlation in Anterior Cruciate Ligament and Meniscal Injuries of the Knee

2018 ◽  
Vol 24 (1) ◽  
pp. 52-56
Author(s):  
Patel Ishani ◽  
Chandru Vijay ◽  
Nekkanti Supreeth ◽  
Renukarya Ravishankar ◽  
Reddy Vishnu Vardhan ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Medial Meniscus ◽  
Cruciate Ligament ◽  
Lateral Meniscus ◽  
Resonance Imaging ◽  
Clinical Magnetic Resonance Imaging ◽  
Anterior Cruciate

Background The aim of this study is to compare and correlate the clinical, magnetic resonance imaging (MRI), and arthroscopy findings in anterior cruciate ligament (ACL) and meniscal injuries of the knee. Methods This was a prospective study of 30 cases of ACL and meniscal injuries of the knee admitted between September 2014 and May 2016, who underwent clinical examination, MRI, and arthroscopy of the knee. Results In our study of 30 cases, there were 26 male and four female patients with age ranging from 18 years to 60 years, with most patients in between 21 years and 30 years. Clinical examination had sensitivity of 90.91%, specificity of 100%, and accuracy of 93.33% for ACL, sensitivity of 83.33%, specificity of 77.78%, and accuracy of 80% for medial meniscus, and sensitivity of 75%, specificity of 77.27%, and accuracy of 76.67% for lateral meniscus. MRI had sensitivity of 95.45%, specificity of 87.5%, and accuracy of 93.33% for ACL, sensitivity of 91.67%, specificity of 55.56%, and accuracy of 70% for medial meniscus, and sensitivity of 62.5%, specificity of 72.73%, and accuracy of 70% for lateral meniscus. Conclusion In conclusion, the present study supports that clinical diagnosis is of primary necessity, as the positive predictive value is high for all the lesions. MRI is an additional diagnosing tool for ligament and meniscal injuries of the knee. Routine use of MRI to confirm the diagnosis is not indicated, as the positive predictive value is low, but can be used to exclude pathology, as the negative predictive value is high for all the lesions.

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