THE ROLE OF MRI IN THE DIAGNOSIS OF CRUCIATE LIGAMENT TEARS: A RADIOLOGIC-ARTHROSCOPIC CORRELATION STUDY
Main Article Content
Keywords
Anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), MRI, diagnostic accuracy, arthroscopy, knee injuries
Abstract
Background
Cruciate ligament tears, particularly of the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL), are common knee injuries requiring accurate diagnosis for optimal management. Magnetic Resonance Imaging (MRI) is the gold standard for non-invasive evaluation, but its diagnostic performance for partial tears and associated injuries warrants further validation.
Objectives
Assess the diagnostic accuracy of MRI (1.5-Tesla) in detecting complete and partial ACL/PCL tears, using arthroscopy as the reference standard.
Methods
A prospective cross-sectional study was conducted on 60 patients with clinically suspected cruciate ligament injuries. MRI findings (T1, T2-weighted, and PD sequences) were independently analyzed by two blinded radiologists and correlated with arthroscopic results. Statistical analysis included sensitivity, specificity, PPV and NPV
Results
MRI demonstrated high accuracy for complete ACL tears (sensitivity: 94%, specificity: 92%) and PCL tears (sensitivity: 96%, specificity: 94%). Partial tears showed lower sensitivity (85%).
Conclusion
MRI is a highly reliable tool for diagnosing complete cruciate ligament tears, with excellent correlation to arthroscopy. However, partial tears remain a diagnostic challenge. The frequent detection of associated injuries underscores MRI’s role in comprehensive knee assessment. Future studies should explore advanced MRI techniques (e.g., 3-Tesla) to improve partial tear diagnosis.
References
[2] Muhle C, Ahn JM, Dieke C, et al. Diagnosis of ACL and meniscal injuries: MR imaging of the knee. Eur Radiol 2009;19(1):146–61.
[3] Koh JS, Lee YS, Lee SH, et al. Anterior cruciate ligament tear: prospective evaluation of diagnostic accuracy of middle- and high-field-strength MR imaging at 1.5 and 0.5 T. Radiology 1995;197(3):748–53.
[4] Maheshwari SG, Kuber R, Lamghare P, et al. Anterior cruciate ligament (ACL) injury: correlation with MRI morphometry. Egypt J Radiol Nucl Med 2023;54(1):130.
[5] Namiri NK, Flament I, Astuto B, et al. Deep learning for hierarchical severity staging of anterior cruciate ligament injuries from MRI. Radiology: Artificial Intelligence 2020;2(4):e190207.
[6] Surendran PK, Suresh S, Suresh S, et al. Accuracy of magnetic resonance imaging in predicting anterior cruciate ligament tear location and tear type. J Clin Diagn Res 2021;15(4):RC01-4.
[7] Hodler J, Haghighi P, Trudell D, et al. The cruciate ligaments of the knee: correlation between MR appearance and gross and histologic findings in cadaveric specimens. AJR Am J Roentgenol 1992;159(2):357–60.
[8] Akisue T, Kurosaka M, Yoshiya S, et al. Magnetic resonance imaging of posterior cruciate ligament injuries. Radiology 1994;190(2):455-8.
[9] Johnson DL, Bradley JP. ACL injury diagnosis: MRI vs. clinical tests. Am J Sports Med 2019;47(5):1120-8.
[10] Nguyen A. Challenges in diagnosing partial ACL tears on MRI. Clin Imaging 2021;70:45-52.
[11] Walter WR. MRI diagnostics in sports-related knee injuries. Radiographics 2016;36(3):703-23.
[12] Arendt EA, Dick R. Knee injury patterns among men and women in collegiate basketball and soccer. NCAA data and review of literature. Am J Sports Med 1995;23(6):694-701.
[13] Hewett TE, Myer GD, Ford KR, et al. Biomechanical measures of neuromuscular control and valgus loading of the knee predict ACL injury risk in female athletes. Am J Sports Med 2005;33(4):492–501.
[14] Brophy RH, Wright RW, Matava MJ. Anterior cruciate ligament injury and reconstruction: what's new? J Bone Joint Surg Am 2010;92(18):2933-42.
[15] De Smet AA, Graf BK. Meniscal tears missed on MR imaging: relationship to meniscal tear patterns and anterior cruciate ligament tears. AJR Am J Roentgenol 1994;162(4):905-11.
[16] Kaplan PA, Walker CW, Kilcoyne RF, et al. Bone contusions of the knee: a commonly associated finding with anterior cruciate ligament rupture. Skeletal Radiol 1999;28(7):396-402.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr. Dev Ravishankar
Additional Professor, Department of Radiodiagnosis, Sree Uthradom Thirunal Academy of Medical Sciences, Vattapara, Thiruvanathapuram, Kerala, India.
Dr. Anand G. Lathika
Assistant Professor, Department of Radiodiagnosis, Sree Uthradom Thirunal Academy of Medical Sciences, Vattapara, Thiruvanathapuram, Kerala, India.
Dr. Vinoo Jacob
Professor & HOD, Department of Radiodiagnosis, Sree Uthradom Thirunal Academy of Medical Sciences, Vattapara, Thiruvanathapuram, Kerala, India.
Dr. Anoop S. Pillai
Professor, Department of Orthopaedics, Sree Uthradom Thirunal Academy of Medical Sciences, Vattapara, Thiruvanathapuram, Kerala, India.
Dr. Riya Mariam Jacob
Junior Resident, Department of Radiodiagnosis, Sree Uthradom Thirunal Academy of Medical Sciences, Vattapara, Thiruvanathapuram, Kerala, India.