Diagnosis of Internal Derangement of the Knee: Volume Isotropic Turbo Spin-Echo Acquisition MRI With Fat Suppression Versus Without Fat Suppression

OBJECTIVE: The purpose of this study was to compare 3D volume isotropic turbo spin-echo acquisition (VISTA) MRI with and without fat suppression for use in evaluating ligaments, menisci, and cartilage. MATERIALS AND METHODS: Two radiologists retrospectively and independently reviewed 71 MRI studies. Each study consisted of 3D intermediate-weighted VISTA images with fat suppression and without fat suppression. The presence of tears of the anterior cruciate and posterior cruciate ligaments, tears of the medial and lateral menisci, and cartilaginous defects was evaluated. Arthroscopic surgical findings were used as the standard of reference. Statistical analysis was performed to calculate the sensitivity, specificity, and accuracy of the two methods. RESULTS: Mean specificity and accuracy for medial meniscal tears were significantly higher with VISTA (specificity, 95.0%; accuracy, 94.4%) than with fat-suppressed VISTA (FS-VISTA) (specificity, 81.3%; accuracy, 85.9%), and the difference was statistically significant (specificity, p = 0.003; accuracy, p = 0.004). Mean specificity for cartilaginous defects was also significantly higher with VISTA than with FS-VISTA (99.1% vs 96.8%, p = 0.039). There were no other significant differences between the two methods. CONCLUSION: Three-dimensional VISTA MRI has higher specificity than FS-VISTA imaging for evaluation of medial meniscal tears and cartilaginous defects.