Background The posteromedial meniscal region is gaining interest among orthopedic surgeons, as lesions of this area has been reported to be signifcantly associated with anterior cruciate ligament tears. The current imaging literature is unclear. Purpose To evaluate the diagnostic performance of MR in the detection of meniscal ramp lesions having arthroscopy as reference standard. Materials and methods We retrospectively included 56 patients (mean age of 25±7 years; 14 females) from January to November 2017 with a arthroscopically proved ACL tear and posterior meniscocapsular separation. On preoperative MRI, two radiologists with 13 and 2 years’ experience in musculoskeletal imaging assessed the presence/absence of ramp lesion, meniscotibial ligament lesion, peripheral meniscal lesion, or their combination, bone bruise. Having arthroscopy as reference standard, diagnostic performance of MRI in the evaluation of ramp area lesions was calculated. Cohen’s kappa (k) and Fisher’s Exact Test statistics were used. Results Agreement between radiologists ranged from κ=0.784 (meniscotibial ligament lesions) to κ=0.918 red–red meniscal lesion. Sensitivities were 97.4% for ramp lesions, 95.8% for meniscotibial ligament lesion, 94.4% for peripheral meniscal lesions; specifcities were 88.9%, 81.3%, and 97.4%, respectively; accuracies were 94.6%, 87.5%, and 96.4%, respectively. Agreement between MR and arthroscopy was almost perfect in identifcation of ramp lesions (κ=0.871) and red–red zone meniscal lesions (κ=0.908). The agreement between the two methods was substantial (κ=0.751) for meniscotibial lesion. No signifcant association between tibial plateau bone bruise and the diferent type of lesions was found (κ≥0.004 and p≥0.08). Conclusion MR has high diagnostic performance in meniscal ramp area lesion assessment, with substantial to almost perfect inter-reader agreement.

Meniscal ramp lesions: diagnostic performance of MRI with arthroscopy as reference standard / M. Zappia, L.M. Sconfienza, S. Guarino, M. Tumminello, G. Iannella, P.P. Mariani. - In: LA RADIOLOGIA MEDICA. - ISSN 0033-8362. - 126:8(2021 Aug), pp. 1106-1116. [10.1007/s11547-021-01375-3]

Meniscal ramp lesions: diagnostic performance of MRI with arthroscopy as reference standard

L.M. Sconfienza
;
2021-08

Abstract

Background The posteromedial meniscal region is gaining interest among orthopedic surgeons, as lesions of this area has been reported to be signifcantly associated with anterior cruciate ligament tears. The current imaging literature is unclear. Purpose To evaluate the diagnostic performance of MR in the detection of meniscal ramp lesions having arthroscopy as reference standard. Materials and methods We retrospectively included 56 patients (mean age of 25±7 years; 14 females) from January to November 2017 with a arthroscopically proved ACL tear and posterior meniscocapsular separation. On preoperative MRI, two radiologists with 13 and 2 years’ experience in musculoskeletal imaging assessed the presence/absence of ramp lesion, meniscotibial ligament lesion, peripheral meniscal lesion, or their combination, bone bruise. Having arthroscopy as reference standard, diagnostic performance of MRI in the evaluation of ramp area lesions was calculated. Cohen’s kappa (k) and Fisher’s Exact Test statistics were used. Results Agreement between radiologists ranged from κ=0.784 (meniscotibial ligament lesions) to κ=0.918 red–red meniscal lesion. Sensitivities were 97.4% for ramp lesions, 95.8% for meniscotibial ligament lesion, 94.4% for peripheral meniscal lesions; specifcities were 88.9%, 81.3%, and 97.4%, respectively; accuracies were 94.6%, 87.5%, and 96.4%, respectively. Agreement between MR and arthroscopy was almost perfect in identifcation of ramp lesions (κ=0.871) and red–red zone meniscal lesions (κ=0.908). The agreement between the two methods was substantial (κ=0.751) for meniscotibial lesion. No signifcant association between tibial plateau bone bruise and the diferent type of lesions was found (κ≥0.004 and p≥0.08). Conclusion MR has high diagnostic performance in meniscal ramp area lesion assessment, with substantial to almost perfect inter-reader agreement.
MRI; Arthroscopy; ACL injuries; Meniscus; Anatomy
Settore MED/36 - Diagnostica per Immagini e Radioterapia
3-giu-2021
Article (author)
File in questo prodotto:
File Dimensione Formato  
Zappia2021_Article_MeniscalRampLesionsDiagnosticP.pdf

accesso aperto

Descrizione: online first
Tipologia: Publisher's version/PDF
Dimensione 1.68 MB
Formato Adobe PDF
1.68 MB Adobe PDF Visualizza/Apri
Zappia2021_Article_MeniscalRampLesionsDiagnosticP.pdf

accesso aperto

Tipologia: Publisher's version/PDF
Dimensione 1.67 MB
Formato Adobe PDF
1.67 MB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/848577
Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus 3
  • ???jsp.display-item.citation.isi??? 2
social impact