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Insights Imaging. 2012 Dec;3(6):603-10. doi: 10.1007/s13244-012-0197-5. Epub 2012 Oct 26.

Diagnostic performance of 3D SPACE for comprehensive knee joint assessment at 3 T.

Author information

1
Department of Radiology, University Hospital Antwerp, Wilrijkstraat 10, 2650, Edegem, Belgium, pieter.van.dyck@uza.be.

Abstract

OBJECTIVE:

To assess the diagnostic performance of 3D sampling perfection with application-optimised contrasts using variable flip-angle evolution (SPACE) turbo spin-echo (TSE) sequences compared to 2D TSE for comprehensive knee assessment at 3 T.

METHODS:

From January to July 2011, isotropic 3D SPACE was added to a 2D knee protocol at 3 T. Forty patients underwent subsequent arthroscopy. Three readers independently assessed MR images for meniscus, anterior cruciate ligament (ACL) and cartilage lesions. Readers 1 and 2 evaluated 3D and 2D data at separate sittings; reader 3 interpreted the complete exam including 3D and 2D sequences. Accuracies were calculated using arthroscopy as reference standard. McNemar's test (p < 0.05) was used to compare 3D and 2D techniques.

RESULTS:

The highest diagnostic yield was obtained by reader 3 (accuracies ≥88 %). For the medial meniscus, readers performed better with the 2D technique than with 3D SPACE (accuracies 85-88 % vs. 78-80 %, respectively) (p > 0.05). For the lateral meniscus and ACL, 3D and 2D techniques had similar performance (accuracies ≥93 %). For cartilage lesions, 3D SPACE had significantly lower specificity (p = 0.0156) than the 2D protocol for one reader.

CONCLUSION:

The conventional 2D TSE acquisition is more reliable than 3D SPACE for comprehensive assessment of the knee at 3.0 T.

MAIN MESSAGES:

• 3D SPACE is a valuable component of a knee MR protocol at 3 T. • 3D SPACE cannot be used as a single sequence in the MR evaluation of the knee at 3 T. • Knee MR protocols at 3 T should include both 2D and 3D TSE sequences.

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