THE USE OF NONCONTRAST MAGNETIC-RESONANCE-IMAGING IN EVALUATING MENISCAL REPAIR - COMPARISON WITH CONVENTIONAL ARTHROGRAPHY

The objective of this study was to investigate whether new and differe nt specialized fast spin-echo techniques could be used to accentuate s ignal within the site of meniscal repair, obviating the need far intra -articular contrast. With the use of the frequency-selective fat suppr ession technique, we were able to accentuate fluid in the repair site because of the inherent extended dynamic contrast range of the techniq ue. We performed a blinded study to correlate specialized magnetic res onance imaging (MRI) sequences with standard contrast arthrography, wh ich was used as a standard of reference. Thirty-six patients (36 menis cal repairs) agreed to have MRI followed by contrast arthrography of t he affected knee, irrespective of their clinical symptoms. We found th at MRI had a very high correlation with arthrography in assessing meni scal repair, with statistical significance. In eight cases that had a second-look arthroscopy, we were able to see that MRI proved to be mor e accurate than arthrography in discriminating partial or complete hea ling. This is the first report to show that specialized noncontrast MR T sequences are more effective in evaluating the physiological state o f the repaired meniscus, without artifactual distention of the joint r ecesses by contrast and air. Noncontrast MRI can obviate the need for arthrography in assessment of meniscal repair.