Kruger N, McNally E, Al-Ali S, Rout R, Rees JL, Price AJ. Three-dimensional reconstructed magnetic resonance scans: Accuracy in identifying and defining knee meniscal tears. World J Orthop 2016; 7(11): 731-737 [PMID: 27900270 DOI: 10.5312/wjo.v7.i11.731]
Corresponding Author of This Article
Dr. Neil Kruger, Orthopaedic Research Unit, Department of Orthopaedics, University of Cape Town, Groote Schuur Hospital, Cape Town 8001, South Africa. neilkruger6@gmail.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Basic Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Nov 18, 2016; 7(11): 731-737 Published online Nov 18, 2016. doi: 10.5312/wjo.v7.i11.731
Three-dimensional reconstructed magnetic resonance scans: Accuracy in identifying and defining knee meniscal tears
Neil Kruger, Eugene McNally, Sami Al-Ali, Raj Rout, Jonathan L Rees, Andrew J Price
Neil Kruger, Orthopaedic Research Unit, University of Cape Town, Cape Town 7925, South Africa
Eugene McNally, Raj Rout, Jonathan L Rees, Andrew J Price, Nuffield Orthopaedic Centre, University of Oxford, Oxford OX3 7LD, United Kingdom
Sami Al-Ali, the Whittington Hospital, London N19 5NF, United Kingdom
Author contributions: Price AJ and Rees JL contributed to study design and concept, proof reading and editing; McNally E contributed to study design, data input and analysis; Al-Ali S and Rout R contributed to data input, analysis, editing and proofing; Kruger N contributed to data input and analysis, study design and wrote the paper.
Institutional review board statement: All scan data was solely maintained on hospital computers and anonymised prior to segmentation, hence independent IRB board approval was not required.
Conflict-of-interest statement: None of the authors have any conflict of interest or anything to disclose related to the research performed.
Data sharing statement: The technical appendix and dataset is available from the corresponding author at neilkruger6@gmail.com. As per the IRB statement, all patient data was kept on hospital computers and anonymised prior to segmentation. Risk of identification is hence extremely low.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Neil Kruger, Orthopaedic Research Unit, Department of Orthopaedics, University of Cape Town, Groote Schuur Hospital, Cape Town 8001, South Africa. neilkruger6@gmail.com
Telephone: +27-21-4045118
Received: January 11, 2016 Peer-review started: January 14, 2016 First decision: March 7, 2016 Revised: July 6, 2016 Accepted: August 17, 2016 Article in press: August 18, 2016 Published online: November 18, 2016 Processing time: 307 Days and 13.8 Hours
Abstract
AIM
To determine whether three-dimensional (3D) reconstruction from conventional magnetic resonance imaging (MRI) is able to accurately detect a meniscal tear, and define the configuration.
METHODS
Thirty-three patients’ 3T MRI scan data were collected and sagittal uni-planar 3D reconstructions performed from the preoperative MRI. There were 24 meniscal tears in 24 patients, and nine controls. All patients had arthroscopic corroboration of MRI findings. Two independent observers prospectively reported on all 33 reconstructions. Meniscal tear presence or absence was noted, and tear configuration subsequently categorised as either radial, bucket-handle, parrot beak, horizontal or complex.
RESULTS
Identification of control menisci or meniscal tear presence was excellent (Accuracy: observer 1 = 90.9%; observer 2 = 81.8%). Of the tear configurations, bucket handle tears were accurately identified (Accuracy observer 1 and 2 = 80%). The remaining tear configurations were not accurately discernable.
CONCLUSION
Uni-planar 3D reconstruction from 3T MRI knee scan sequences are useful in identifying normal menisci and menisci with bucket-handle tears. Advances in MRI sequencing and reconstruction software are awaited for accurate identification of the remaining meniscal tear configurations.
Core tip: Three-dimensional reconstruction from magnetic resonance imaging (MRI) is an expanding field with potentially great clinical utility, but must be applied with caution when segmenting knee meniscal tears. Tear presence or absence, and the complex configuration of bucket handle tears were accurately distinguishable. The remaining tear configurations could not be correctly identified. Advances in MRI sequencing and reconstruction software need to be made before the remaining meniscal tear configurations will be identifiable.
