MRI Imaging Of Meniscal Bucket-handle Tears

Purpose: Evaluation of MRI diagnosis in meniscal bucket-handle tearsMeterials and methods:1 Case information26 menisci in 26 patients who had MRI imaging examination of the knee during 2006,January and 2008,January and subsequently they had a diagnosis of bucket-handle tear on arthroscopy in our hospital. In same period ,22 menisci were diagnosed to have a non-bucket-handle tear on arthroscopy as a control group. Average time between MR imaging and subsequent arthroscopy was 11.5 days (range2–70 days).2 Scanning technologyThe MR imaging examinations were performed on the 1.5-T General Electric unit in our hospital. Sagittal T1-weighted, T2-weighted, proton- density and T2*-weighted. and coronal T1-weighted and T2-weighted sequences were obtained on MR imaging examinations of the knee in our hospital.3 Image analysisArthroscopy is considered as the gold standard. All the meniscus are confirmed by arthroscopy. Two Radiation physician analyz the MR imaging signs. The MR imaging findings which associate with meniscal bucket- handle tears are also recorded.4 Statistical methodsSPSS11.5 software is used to descripte clinical data of 48 meniscus. Sensitivity, specificity of MR imaging signs on the diagnosis of meniscal bucket-handle tears are Calculated.Results:1 Sensitivity, specificity of MR imaging signs for the diagnosis of meniscal bucket-handle tears.(1) Absent bow tie sign is found in 18 of 26 meniscal bucket-handle tears.This sign is found in 5 of 22 meniscal non-bucket-handle tears. Sensitivity of this sign is 70% in our study, specificity is 77%.(2) Coronal truncation sign is found in 15 of 26 meniscal bucket- handle tears. This sign is found in 1 of 22 meniscal non-bucket-handle tears. Sensitivity of this sign is 58 %in our study, specificity is 95%.(3) Fragment within the intercondylar notch sign is found in 21 of 26 meniscal bucket-handle tears. This sign is found in 2 of 22 meniscal non-bucket-handle tears. Sensitivity of this sign is 81% in our study, specificity is 90%.(4) Disproportional posterior horn sign is found in 10 of 26 meniscal bucket-handle tears, This sign is absent in 22 meniscal non-bucket-handle tears. Sensitivity of this sign is 38% in our study, specificity is 100%.(5) Double-PCL sign is found in 8 of 26 meniscal bucket-handle tears. This sign is found in 1 of 22 meniscal non-bucket-handle tears. Sensitivity of this sign is 31% in our study, specificity is 95%.(6) Double-anterior horn sign is found in 5 of 26 meniscal bucket-handle tears. This sign is absent in 22 meniscal non-bucket-handle tears. Sensitivity of this sign is 19% in our study, specificity is 100%.(7) Flipped meniscus sign is found in 3 of 26 meniscal bucket-handle tears. This sign is absent in 22 meniscal non-bucket-handle tears. Sensitivity of this sign is 12% in our study, specificity is 100%.2 Co-existing signsAn association of bone contusion with medial maniacal bucket handle tears in our study is found in 12 of 19 patients., ACL rupture 6, PCL rupture 1, MCL rupture 2, popliteal tendon injury 1. An association of bone contusion with lateral maniacal bucket handle tears in our study is found in 3 of 7 patients., ACL rupture 3, discoid meniscus 3.Conclusion:1 Sensitivity of the intercondylar notch fragment sign is highest on diagnosis of meniscal bucket-handle tears. Sensitivity of disproportional posterior horn sign, double-anterior horn sign and flipped meniscus sign are highest. 2 Co-existing signs of maniacal bucket handle tears are bone contusion, the anterior cruciate ligament, posterior cruciate ligament and medial collateral ligament injury, discoid meniscus, popliteal tendon injury. Bone contusion , the anterior cruciate ligament rupture and discoid meniscus have higher frequency.