The aim of thisstudy was to test the hypothesis that magnetic resonance imaging (MRI) of theknee with 10-minute 3-dimensional (3D) controlled aliasing in parallel imagingresults in higher acceleration (CAIPIRINHA) sampling perfection with applicationoptimized contrast using different flip angle evolutions (SPACE) turbo spinecho (TSE) protocols can replace 20-minute 2-dimensional (2D) TSEstandard-of-reference protocols for the diagnosis of internal derangement.
After internalreview board approval and prospective informed consent, 100 symptomaticsubjects underwent MRI of the knee at 3 T and 50 symptomatic subjects at 1.5 T,consisting of 10-minute 3D CAIPIRINHA SPACE TSE and 20-minutestandard-of-reference 2D TSE protocols. Two fellowship-trained musculoskeletalradiologists assessed the studies in an anonymized and randomized fashion forstructural abnormalities. Descriptive statistics, interreader reliability,intermethod concordance, diagnostic definitiveness, and interchangeabilitytests were applied. P values equal to or smaller than 0.01 were consideredsignificant.
Theinterchangeability analysis showed that the 3D MRI can replace the 2D MRIprotocols, whereas a superiority of 3D MRI was suggested statistically for thedetection of medial and lateral meniscal tears, cartilage defects, and bonemarrow edema by significantly higher common pair exact match proportions ofreaders (P < 0.01, respectively).The overall interreader reliabilities were89% of exact matches for 2D TSE (κ, 0.842) and 96% of exact matches for 3D TSE(κ, 0.941) (P < 0.01). There was good intermethod concordance (κ, 0.736;range, 0.579-1.000). The interreader reliability (2D TSE: κ, 0.748[0.603-1.000]; 3D TSE: κ, 0.901 [0.797-1.000]) and diagnostic definitivenesswere significantly higher for the 3D than 2D MRI (P < 0.01).
10-minute 3DCAIPIRINHA SPACE TSE MRI protocols can replace 20-minute 2D TSEstandard-of-reference MRI protocols for the evaluation of internal derangementof the knee by producing similar results in individual patient diagnoses,whereas interpretations of 3D CAIPIRINHA SPACE TSE MRI examinations resulted inan overall higher interreader reliability, intermethod concordance, and readerdefinitiveness.