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The Journal of Bone and Joint Surgery, Vol 70, Issue 2 192-198, Copyright © 1988 by Journal of Bone and Joint Surgery, Inc
The accuracy of selective magnetic resonance imaging compared with the findings of arthroscopy of the knee
DW Polly, JJ Callaghan, RA Sikes, JM McCabe, K McMahon and CG Savory
Orthopaedic Service, Walter Reed Army Medical Center, Washington, D.C. 20307-5001.
The results of selective magnetic resonance imaging of the knee were
compared with those of arthroscopy in a prospective series of fifty
patients. A specifically designed protocol for imaging, producing T1
sagittal images interleaved at four millimeters while the patient's foot
was in 20 degrees of external rotation, was utilized. This technique,
called selective magnetic resonance imaging, yielded excellent
visualization of the posterior cruciate ligament, medial meniscus, and
lateral meniscus in all patients. However, in only 76 per cent of the
patients was the anterior cruciate ligament well visualized. Compared with
arthroscopy, the sensitivity, specificity, and accuracy of selective
magnetic resonance imaging were, respectively, 95.8, 100, and 98 per cent
for tears of the medial meniscus; 66.7, 95.1, and 90 per cent for tears of
the lateral meniscus; undefined, 100, and 100 per cent for tears of the
posterior cruciate ligament; and 100, 96.9, and 97.3 per cent for tears of
the anterior cruciate ligament, when that ligament was well visualized. Our
selective sequence can be performed in fifteen minutes at a cost that is
comparable with that of arthrography. It is totally non-invasive and
requires no exposure to ionizing radiation. Selective magnetic resonance
imaging can be a safe and valuable adjunct to the clinical evaluation of
the knee and an aid to efficient preoperative planning.
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