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ACCURACY OF MAGNETIC RESONANCE IN IDENTIFYING TRAUMATIC INTRAARTICULAR KNEE LESIONS

To evaluate the diagnostic accuracy of magnetic resonance imaging of the knee in identifying traumatic intraarticular knee lesions.. 300 patients with a clinical diagnosis of traumatic intraarticular knee lesions underwent prearthoscopic magnetic resonance imaging. The sensitivity, specificity, posi...

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Published in:Clinics (São Paulo, Brazil) Brazil), 2005-12, Vol.60 (6), p.445-450
Main Authors: Vaz, Carlos Eduardo Sanches, de Camargo, Olavo Pires, de Santana, Paulo José, Valezi, Antonio Carlos
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description To evaluate the diagnostic accuracy of magnetic resonance imaging of the knee in identifying traumatic intraarticular knee lesions.. 300 patients with a clinical diagnosis of traumatic intraarticular knee lesions underwent prearthoscopic magnetic resonance imaging. The sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio for a positive test, likelihood ratio for a negative test, and accuracy of magnetic resonance imaging were calculated relative to the findings during arthroscopy in the studied structures of the knee (medial meniscus, lateral meniscus, anterior cruciate ligament, posterior cruciate ligament, and articular cartilage). Magnetic resonance imaging produced the following results regarding detection of lesions: medial meniscus: sensitivity 97.5%, specificity 92.9%, positive predictive value 93.9%, positive negative value 97%, likelihood positive ratio 13.7, likelihood negative ratio 0.02, and accuracy 95.3%; lateral meniscus: sensitivity 91.9%, specificity 93.6%, positive predictive value 92.7%, positive negative value 92.9%, likelihood positive ratio 14.3, likelihood negative ratio 0.08, and accuracy 93.6%; anterior cruciate ligament: sensitivity 99.0%, specificity 95.9%, positive predictive value 91.9%, positive negative value 99.5%, likelihood positive ratio 21.5, likelihood negative ratio 0.01, and accuracy 96.6%; posterior cruciate ligament: sensitivity 100%, specificity 99%, positive predictive value 80.0%, positive negative value 100%, likelihood positive ratio 100, likelihood negative ratio 0.01, and accuracy 99.6%; articular cartilage: sensitivity 76.1%, specificity 94.9%, positive predictive value 94.7%, positive negative value 76.9%, likelihood positive ratio 14.9, likelihood negative ratio 0.25, and accuracy 84.6%. Magnetic resonance imaging is a satisfactory diagnostic tool for evaluating meniscal and ligamentous lesions of the knee, but it is unable to clearly identify articular cartilage lesions. Avaliar a validade da ressonância magnética do joelho no diagnóstico das lesões intra-articulares traumáticas do joelho. População de 300 pacientes, com quadro clínico sugestivo de lesões intra-articulares traumáticas do joelho, que tiveram seus laudos de ressonância magnética comparados com os resultados obtidos nas artroscopias realizadas posteriormente. Foram calculados a sensibilidade, especificidade, valor preditivo positivo, valor preditivo negativo, razão de verossimilhança positiva, razã
doi_str_mv 10.1590/S1807-59322005000600003
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The sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio for a positive test, likelihood ratio for a negative test, and accuracy of magnetic resonance imaging were calculated relative to the findings during arthroscopy in the studied structures of the knee (medial meniscus, lateral meniscus, anterior cruciate ligament, posterior cruciate ligament, and articular cartilage). Magnetic resonance imaging produced the following results regarding detection of lesions: medial meniscus: sensitivity 97.5%, specificity 92.9%, positive predictive value 93.9%, positive negative value 97%, likelihood positive ratio 13.7, likelihood negative ratio 0.02, and accuracy 95.3%; lateral meniscus: sensitivity 91.9%, specificity 93.6%, positive predictive value 92.7%, positive negative value 92.9%, likelihood positive ratio 14.3, likelihood negative ratio 0.08, and accuracy 93.6%; anterior cruciate ligament: sensitivity 99.0%, specificity 95.9%, positive predictive value 91.9%, positive negative value 99.5%, likelihood positive ratio 21.5, likelihood negative ratio 0.01, and accuracy 96.6%; posterior cruciate ligament: sensitivity 100%, specificity 99%, positive predictive value 80.0%, positive negative value 100%, likelihood positive ratio 100, likelihood negative ratio 0.01, and accuracy 99.6%; articular cartilage: sensitivity 76.1%, specificity 94.9%, positive predictive value 94.7%, positive negative value 76.9%, likelihood positive ratio 14.9, likelihood negative ratio 0.25, and accuracy 84.6%. Magnetic resonance imaging is a satisfactory diagnostic tool for evaluating meniscal and ligamentous lesions of the knee, but it is unable to clearly identify articular cartilage lesions. Avaliar a validade da ressonância magnética do joelho no diagnóstico das lesões intra-articulares traumáticas do joelho. População de 300 pacientes, com quadro clínico sugestivo de lesões intra-articulares traumáticas do joelho, que tiveram seus laudos de ressonância magnética comparados com os resultados obtidos nas artroscopias realizadas posteriormente. Foram calculados a sensibilidade, especificidade, valor preditivo positivo, valor preditivo negativo, razão de verossimilhança positiva, razão de verossimilhança negativa e acurácia da ressonância magnética do joelho para o diagnóstico de lesões em cada estrutura intra-articular estudada do joelho (menisco medial, menisco lateral, ligamento cruzado anterior, ligamento cruzado posterior e cartilagem articular). Em relação às lesões do menisco medial, a sensibilidade da ressonância magnética foi de 97.5%, a especificidade de 92.9% o valor preditivo positivo de 93.9%, o valor preditivo negativo de 97%, a razão de verossimilhança positiva de 13.7, a razão de verossimilhança negativa de 0.02 e a acurácia de 95.3%. Para o menisco lateral, a sensibilidade da ressonância magnética foi de 91.9%, a especificidade de 93.6%, o valor preditivo positivo de 92.7%, o valor preditivo negativo de 92.9%, a razão de verossimilhança positiva de 14.3, a razão de verossimilhança negativa de 0.08 e a acurácia de 93.6%. Para o ligamento cruzado anterior, a sensibilidade da ressonância magnética foi de 99.0%, a especificidade de 95.4%, o valor preditivo positivo de 91.9%, o valor preditivo negativo de 99.5%, a razão de verossimilhança positiva de 21.5, a razão de verossimilhança negativa de 0.01 e a acurácia de 96.6%. Para o ligamento cruzado posterior, a sensibilidade da ressonância magnética foi de 100%, a especificidade de 99%, o valor preditivo positivo de 80%, o valor preditivo negativo de 100%, a razão de verossimilhança positiva de 100, a razão de verossimilhança negativa de 0.01 e a acurácia de 99.6%. Para as lesões condrais a sensibilidade da ressonância magnética foi de 76.1%, a especificidade de 94.9%, o valor preditivo positivo de 94.7%, o valor preditivo negativo de 76.9%, a razão de verossimilhança positiva de 14.9, a razão de verossimilhança negativa de 0.25 e a acurácia de 84.6%. 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The sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio for a positive test, likelihood ratio for a negative test, and accuracy of magnetic resonance imaging were calculated relative to the findings during arthroscopy in the studied structures of the knee (medial meniscus, lateral meniscus, anterior cruciate ligament, posterior cruciate ligament, and articular cartilage). Magnetic resonance imaging produced the following results regarding detection of lesions: medial meniscus: sensitivity 97.5%, specificity 92.9%, positive predictive value 93.9%, positive negative value 97%, likelihood positive ratio 13.7, likelihood negative ratio 0.02, and accuracy 95.3%; lateral meniscus: sensitivity 91.9%, specificity 93.6%, positive predictive value 92.7%, positive negative value 92.9%, likelihood positive ratio 14.3, likelihood negative ratio 0.08, and accuracy 93.6%; anterior cruciate ligament: sensitivity 99.0%, specificity 95.9%, positive predictive value 91.9%, positive negative value 99.5%, likelihood positive ratio 21.5, likelihood negative ratio 0.01, and accuracy 96.6%; posterior cruciate ligament: sensitivity 100%, specificity 99%, positive predictive value 80.0%, positive negative value 100%, likelihood positive ratio 100, likelihood negative ratio 0.01, and accuracy 99.6%; articular cartilage: sensitivity 76.1%, specificity 94.9%, positive predictive value 94.7%, positive negative value 76.9%, likelihood positive ratio 14.9, likelihood negative ratio 0.25, and accuracy 84.6%. Magnetic resonance imaging is a satisfactory diagnostic tool for evaluating meniscal and ligamentous lesions of the knee, but it is unable to clearly identify articular cartilage lesions. Avaliar a validade da ressonância magnética do joelho no diagnóstico das lesões intra-articulares traumáticas do joelho. População de 300 pacientes, com quadro clínico sugestivo de lesões intra-articulares traumáticas do joelho, que tiveram seus laudos de ressonância magnética comparados com os resultados obtidos nas artroscopias realizadas posteriormente. Foram calculados a sensibilidade, especificidade, valor preditivo positivo, valor preditivo negativo, razão de verossimilhança positiva, razão de verossimilhança negativa e acurácia da ressonância magnética do joelho para o diagnóstico de lesões em cada estrutura intra-articular estudada do joelho (menisco medial, menisco lateral, ligamento cruzado anterior, ligamento cruzado posterior e cartilagem articular). Em relação às lesões do menisco medial, a sensibilidade da ressonância magnética foi de 97.5%, a especificidade de 92.9% o valor preditivo positivo de 93.9%, o valor preditivo negativo de 97%, a razão de verossimilhança positiva de 13.7, a razão de verossimilhança negativa de 0.02 e a acurácia de 95.3%. Para o menisco lateral, a sensibilidade da ressonância magnética foi de 91.9%, a especificidade de 93.6%, o valor preditivo positivo de 92.7%, o valor preditivo negativo de 92.9%, a razão de verossimilhança positiva de 14.3, a razão de verossimilhança negativa de 0.08 e a acurácia de 93.6%. Para o ligamento cruzado anterior, a sensibilidade da ressonância magnética foi de 99.0%, a especificidade de 95.4%, o valor preditivo positivo de 91.9%, o valor preditivo negativo de 99.5%, a razão de verossimilhança positiva de 21.5, a razão de verossimilhança negativa de 0.01 e a acurácia de 96.6%. Para o ligamento cruzado posterior, a sensibilidade da ressonância magnética foi de 100%, a especificidade de 99%, o valor preditivo positivo de 80%, o valor preditivo negativo de 100%, a razão de verossimilhança positiva de 100, a razão de verossimilhança negativa de 0.01 e a acurácia de 99.6%. Para as lesões condrais a sensibilidade da ressonância magnética foi de 76.1%, a especificidade de 94.9%, o valor preditivo positivo de 94.7%, o valor preditivo negativo de 76.9%, a razão de verossimilhança positiva de 14.9, a razão de verossimilhança negativa de 0.25 e a acurácia de 84.6%. A ressonância magnética apresenta alta acurácia para identificar as lesões meniscais e ligamentares do joelho, mas é insatisfatória para diagnosticar as lesões da cartilagem articular.</description><subject>Anterior Cruciate Ligament Injuries</subject><subject>Arthroscopy</subject><subject>Artroscopia</subject><subject>False Negative Reactions</subject><subject>False Positive Reactions</subject><subject>Humans</subject><subject>Joelho</subject><subject>Knee</subject><subject>Knee Injuries - diagnosis</subject><subject>Magnetic resonance</subject><subject>Magnetic Resonance Imaging - standards</subject><subject>MEDICINE, GENERAL &amp; INTERNAL</subject><subject>Posterior Cruciate Ligament - injuries</subject><subject>Predictive Value of Tests</subject><subject>Ressonância magnética</subject><subject>Tibial Meniscus Injuries</subject><subject>Traumatologia</subject><subject>Traumatology</subject><issn>1807-5932</issn><issn>1980-5322</issn><issn>1980-5322</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNqFUU1v0zAYjhCIjcFfgJy4ZfgjjuOjFdJi0blS0h52shzHRqnSZtjtJP497lLYYRIcLL969XzpeZPkEwS3kDDwpYUloBlhGCEACACgiA_gV8k1ZCXISNy_jvMf0FXyLoRdBDCck7fJFSwwKSFG10nLq2rb8Oo-XS_SO76U9UZUaVO3a8llVadCpuJrLTdicS_kMt00fHvHzxAh48ybOG5XvEm_y7pOV3Ur1rJ9n7xxegz2w-W_SbaLelN9y1brpaj4KjOElDhzIGal2uTMlZR2PeoMg4AC19He4q63SFOCjCXOMY0B0sQZZ3NNaY-xIRDfJGLW7Se9Uw9-2Gv_S016UE-Lyf9Q2h8HM1qFXIEM6FhuO5AXHdZAQ421M0QzpBGLWrezVjCDHSe1m07-EMOrp6bVi6Yj4fNMePDTz5MNR7UfgrHjqA92OgVVlCVjJTunpDPQ-CkEb93fpBCo8zH_YfHxYnHq9rZ_5l2uFwF8BtjY8uNgvTqnPxjbD96aY6xh-K_Jb9T2o6E</recordid><startdate>20051201</startdate><enddate>20051201</enddate><creator>Vaz, Carlos Eduardo Sanches</creator><creator>de Camargo, Olavo Pires</creator><creator>de Santana, Paulo José</creator><creator>Valezi, Antonio Carlos</creator><general>Elsevier España, S.L.U</general><general>Faculdade de Medicina / USP</general><general>Elsevier España</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>GPN</scope><scope>DOA</scope></search><sort><creationdate>20051201</creationdate><title>ACCURACY OF MAGNETIC RESONANCE IN IDENTIFYING TRAUMATIC INTRAARTICULAR KNEE LESIONS</title><author>Vaz, Carlos Eduardo Sanches ; de Camargo, Olavo Pires ; de Santana, Paulo José ; Valezi, Antonio Carlos</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5583-f01987ac49f877bd2bc91070fb7de3bde2a752ce5ff9a302a5fcfe4a77d33c513</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Anterior Cruciate Ligament Injuries</topic><topic>Arthroscopy</topic><topic>Artroscopia</topic><topic>False Negative Reactions</topic><topic>False Positive Reactions</topic><topic>Humans</topic><topic>Joelho</topic><topic>Knee</topic><topic>Knee Injuries - diagnosis</topic><topic>Magnetic resonance</topic><topic>Magnetic Resonance Imaging - standards</topic><topic>MEDICINE, GENERAL &amp; INTERNAL</topic><topic>Posterior Cruciate Ligament - injuries</topic><topic>Predictive Value of Tests</topic><topic>Ressonância magnética</topic><topic>Tibial Meniscus Injuries</topic><topic>Traumatologia</topic><topic>Traumatology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vaz, Carlos Eduardo Sanches</creatorcontrib><creatorcontrib>de Camargo, Olavo Pires</creatorcontrib><creatorcontrib>de Santana, Paulo José</creatorcontrib><creatorcontrib>Valezi, Antonio Carlos</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>SciELO</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Clinics (São Paulo, Brazil)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vaz, Carlos Eduardo Sanches</au><au>de Camargo, Olavo Pires</au><au>de Santana, Paulo José</au><au>Valezi, Antonio Carlos</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>ACCURACY OF MAGNETIC RESONANCE IN IDENTIFYING TRAUMATIC INTRAARTICULAR KNEE LESIONS</atitle><jtitle>Clinics (São Paulo, Brazil)</jtitle><addtitle>Clinics (Sao Paulo)</addtitle><date>2005-12-01</date><risdate>2005</risdate><volume>60</volume><issue>6</issue><spage>445</spage><epage>450</epage><pages>445-450</pages><issn>1807-5932</issn><issn>1980-5322</issn><eissn>1980-5322</eissn><abstract>To evaluate the diagnostic accuracy of magnetic resonance imaging of the knee in identifying traumatic intraarticular knee lesions.. 300 patients with a clinical diagnosis of traumatic intraarticular knee lesions underwent prearthoscopic magnetic resonance imaging. The sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio for a positive test, likelihood ratio for a negative test, and accuracy of magnetic resonance imaging were calculated relative to the findings during arthroscopy in the studied structures of the knee (medial meniscus, lateral meniscus, anterior cruciate ligament, posterior cruciate ligament, and articular cartilage). Magnetic resonance imaging produced the following results regarding detection of lesions: medial meniscus: sensitivity 97.5%, specificity 92.9%, positive predictive value 93.9%, positive negative value 97%, likelihood positive ratio 13.7, likelihood negative ratio 0.02, and accuracy 95.3%; lateral meniscus: sensitivity 91.9%, specificity 93.6%, positive predictive value 92.7%, positive negative value 92.9%, likelihood positive ratio 14.3, likelihood negative ratio 0.08, and accuracy 93.6%; anterior cruciate ligament: sensitivity 99.0%, specificity 95.9%, positive predictive value 91.9%, positive negative value 99.5%, likelihood positive ratio 21.5, likelihood negative ratio 0.01, and accuracy 96.6%; posterior cruciate ligament: sensitivity 100%, specificity 99%, positive predictive value 80.0%, positive negative value 100%, likelihood positive ratio 100, likelihood negative ratio 0.01, and accuracy 99.6%; articular cartilage: sensitivity 76.1%, specificity 94.9%, positive predictive value 94.7%, positive negative value 76.9%, likelihood positive ratio 14.9, likelihood negative ratio 0.25, and accuracy 84.6%. Magnetic resonance imaging is a satisfactory diagnostic tool for evaluating meniscal and ligamentous lesions of the knee, but it is unable to clearly identify articular cartilage lesions. Avaliar a validade da ressonância magnética do joelho no diagnóstico das lesões intra-articulares traumáticas do joelho. População de 300 pacientes, com quadro clínico sugestivo de lesões intra-articulares traumáticas do joelho, que tiveram seus laudos de ressonância magnética comparados com os resultados obtidos nas artroscopias realizadas posteriormente. Foram calculados a sensibilidade, especificidade, valor preditivo positivo, valor preditivo negativo, razão de verossimilhança positiva, razão de verossimilhança negativa e acurácia da ressonância magnética do joelho para o diagnóstico de lesões em cada estrutura intra-articular estudada do joelho (menisco medial, menisco lateral, ligamento cruzado anterior, ligamento cruzado posterior e cartilagem articular). Em relação às lesões do menisco medial, a sensibilidade da ressonância magnética foi de 97.5%, a especificidade de 92.9% o valor preditivo positivo de 93.9%, o valor preditivo negativo de 97%, a razão de verossimilhança positiva de 13.7, a razão de verossimilhança negativa de 0.02 e a acurácia de 95.3%. Para o menisco lateral, a sensibilidade da ressonância magnética foi de 91.9%, a especificidade de 93.6%, o valor preditivo positivo de 92.7%, o valor preditivo negativo de 92.9%, a razão de verossimilhança positiva de 14.3, a razão de verossimilhança negativa de 0.08 e a acurácia de 93.6%. Para o ligamento cruzado anterior, a sensibilidade da ressonância magnética foi de 99.0%, a especificidade de 95.4%, o valor preditivo positivo de 91.9%, o valor preditivo negativo de 99.5%, a razão de verossimilhança positiva de 21.5, a razão de verossimilhança negativa de 0.01 e a acurácia de 96.6%. Para o ligamento cruzado posterior, a sensibilidade da ressonância magnética foi de 100%, a especificidade de 99%, o valor preditivo positivo de 80%, o valor preditivo negativo de 100%, a razão de verossimilhança positiva de 100, a razão de verossimilhança negativa de 0.01 e a acurácia de 99.6%. Para as lesões condrais a sensibilidade da ressonância magnética foi de 76.1%, a especificidade de 94.9%, o valor preditivo positivo de 94.7%, o valor preditivo negativo de 76.9%, a razão de verossimilhança positiva de 14.9, a razão de verossimilhança negativa de 0.25 e a acurácia de 84.6%. A ressonância magnética apresenta alta acurácia para identificar as lesões meniscais e ligamentares do joelho, mas é insatisfatória para diagnosticar as lesões da cartilagem articular.</abstract><cop>Brazil</cop><pub>Elsevier España, S.L.U</pub><pmid>16358132</pmid><doi>10.1590/S1807-59322005000600003</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
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identifier ISSN: 1807-5932
ispartof Clinics (São Paulo, Brazil), 2005-12, Vol.60 (6), p.445-450
issn 1807-5932
1980-5322
1980-5322
language eng
recordid cdi_doaj_primary_oai_doaj_org_article_2f62c0b94eb046b3a0a1a3afc5a92a29
source SciELO Brazil; ScienceDirect Journals
subjects Anterior Cruciate Ligament Injuries
Arthroscopy
Artroscopia
False Negative Reactions
False Positive Reactions
Humans
Joelho
Knee
Knee Injuries - diagnosis
Magnetic resonance
Magnetic Resonance Imaging - standards
MEDICINE, GENERAL & INTERNAL
Posterior Cruciate Ligament - injuries
Predictive Value of Tests
Ressonância magnética
Tibial Meniscus Injuries
Traumatologia
Traumatology
title ACCURACY OF MAGNETIC RESONANCE IN IDENTIFYING TRAUMATIC INTRAARTICULAR KNEE LESIONS
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