EVALUATION OF MENISCAL TEARS - FAST SPIN-ECHO VERSUS CONVENTIONAL SPIN-ECHO MAGNETIC-RESONANCE-IMAGING

Rationale and Objectives. We compared the performance of fast spin-ech o (FSE) with conventional spin-echo (CSE) magnetic resonance (MR) imag ing sequences in the detection of meniscal tears. Methods. Seventy-thr ee patients underwent MR examination of the knee for suspected interna l derangement. Each patient was scanned with a CSE sequence and one of two FSE sequences. The primary difference between the two FSE sequenc es consisted of the echo train length (ETL). Thirty-seven patients (gr oup 1) were scanned with the FSE I sequence (ETL = 8), and 36 patients (group 2) were scanned with the FSE II sequence (ETL = 4). Menisci we re graded as torn or not torn on the basis of their MR appearance, The sequences were compared with each other and with the surgical finding s in 31 patients who underwent arthroscopy. Results. In group 1, there was a significant discrepancy between the CSE and FSE I techniques (p = .006). The FSE I sequence detected only 11 of 19 surgically proven torn menisci as opposed to 18 of 19 detected with the CSE sequence. Th e FSE II sequence performed significantly better in group 2, with an a ccuracy equal to that of the CSE sequence. Conclusion. FSE sequences a re extremely technique dependent with regard to detecting meniscal tea rs and should not replace CSE sequences in this setting until further studies are performed to optimize the technique.