MR imaging of the flexed knee: comparison to the extended knee in delineation of meniscal lesions.

Abstract

The aim of this study was to obtain MR images in the flexed-knee position and to compare the diagnostic value to the extended position in delineation of the menisci. With a mobile knee brace and a flexible surface coil, the knee joint was either fully extended or bent to a semi-flexed position (average 45 degrees of flexion) within a 1.5-T superconducting magnet. Sets of sagittal MR images were obtained for both the extended- and flexed-knee positions. Using the arthroscopic results as gold standards, 97 menisci were evaluated. Two observers interpreted each MR image of the extended and flexed positions independently without knowledge of the arthroscopic results. Flexed-knee MR images revealed 22 of the 27 arthroscopically proven torn menisci and 69 of the 70 intact menisci, for a sensitivity of 81.5%, a specificity of 98.6%, and an accuracy of 93.8%. Extended-knee MR images indicated a sensitivity of 81.5%, a specificity of 92.9%, and an accuracy of 89.7%. No statistically significant difference was found between the two positions. To enhance MR visualization of all the knee components, we recommend examining the knee in a flexed position within the magnet.