Precision of Magnetic Resonance Imaging in Detection of Anterior Cruciate Ligament and Posterior Cruciate Ligament Ruptures and Subsequent Arthroscopic Correlations: An Investigation

Rev Bras Ortop (Sao Paulo). 2024 Dec 7;59(5):e707-e711. doi: 10.1055/s-0044-1785508. eCollection 2024 Oct.

Abstract

Objective The present study endeavors to scrutinize the precision of magnetic resonance imaging as a diagnostic modality for detecting ligament disruption of the knee, with arthroscopy serving as the gold standard. The study delves into the sensitivity, specificity, positive predictive value, and negative predictive value of magnetic resonance imaging (MRI) results in a cohort of 200 patients against diagnostic arthroscopy. Methods Our institution conducted a comprehensive clinical examination of all patients with knee injuries, and those with affirmative findings suggestive of ligament disruption were subjected to an MRI scan. The study comprised 200 patients with MRI-confirmed anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) tears, who subsequently underwent arthroscopy for both diagnostic and therapeutic purposes. The results were subjected to various statistical tests to compare and analyze the outcomes. Results The study has demonstrated a remarkably high sensitivity and specificity, providing near-optimal accuracy for the diagnosis of ACL and PCL injuries via MRI compared with arthroscopy. Patients with affirmative MRI findings could proceed to undergo diagnostic/therapeutic arthroscopic procedures. Conclusion The study emphasizes the significance of MRI as a noninvasive and highly precise method for assessing ligament injuries in the knee. Although MRI can be used as a first-line investigation, it must be emphasized that arthroscopy remains the gold standard for diagnosing ACL and PCL tears. The current study recommends the use of MRI as a valuable screening tool in patients with suspected knee ligament disruption, with potential to reduce the number of diagnostic arthroscopies in patients with inconclusive clinical findings, thereby minimizing patient discomfort and healthcare costs.

Keywords: anterior cruciate ligament; arthroscopy; knee; magnetic resonance imaging; meniscus.