Skip to main content
Log in

MRI of the knee: how do field strength and radiologist’s experience influence diagnostic accuracy and interobserver correlation in assessing chondral and meniscal lesions and the integrity of the anterior cruciate ligament?

  • Musculoskeletal
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Accuracy of MRI reports is taken for granted. In this paper the inter-observer reliability in the interpretation of meniscal lesions, degree of chondropathy, and integrity of the ACL was analyzed while taking the radiologist’s experience and field strength into account. Fifty-two MRI studies of knees were interpreted by 11 radiologists independently. Twenty-two were acquired on 1.0-T, 20 on 1.5-T, and 10 on 3.0-T systems. Four of the radiologists had more than 5 years and seven had 3 to 5 years of experience in interpreting MRI studies. The findings were compared with the intra-operative findings. Inter-observer variance, specificity, and sensitivity were evaluated for each field strength. Inter-observer correlation ranged between 0.370 for cartilage lesions and 0.597 for meniscal tears. Correlation values did not increase with experience or field strength. The number of false reports was dependent on the observer, but not on field strength. The rate of false interpretations was significantly higher for most criteria in the less experienced group. In conclusion, inter-observer correlation was low, although the diagnostic criteria were defined. The use of the classification scheme should be standardized by uniform training. Radiologist experience seems to be more important than field strength.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Bridgman S, Richards PJ, Walley G et al (2007) The effect of magnetic resonance imaging scans on knee arthroscopy: randomized controlled trial. Arthroscopy 23:1167–1173

    PubMed  Google Scholar 

  2. Chang CY, Wu HT, Huang TF et al (2004) Imaging evaluation of meniscal injury of the knee joint: a comparative MR imaging and arthroscopic study. Clin Imaging 28:372–376

    Article  PubMed  Google Scholar 

  3. Duchateau F, Vande Berg BC (2002) MR imaging of the articular cartilage of the knee with arthroscopy as gold standard: assessment of methodological quality of clinical studies. Eur Radiol 12:2977–2981

    PubMed  Google Scholar 

  4. Elvenes J, Jerome CP, Reikerås O et al (2000) Magnetic resonance imaging as a screening procedure to avoid arthroscopy for meniscal tears. Arch Orthop Trauma Surg 120:14–16

    PubMed  CAS  Google Scholar 

  5. Jungius KP, Schmid MR, Zanetti M et al (2006) Cartilaginous defects of the femorotibial joint: accuracy of coronal short inversion time inversion-recovery MR sequence. Radiology 240:482–488

    Article  PubMed  Google Scholar 

  6. Tamburrini O, Bianchi D, Capparelli G et al (1997) “Occult” posttraumatic lesions of the knee: can magnetic resonance substitute for diagnostic arthroscopy? Radiol Med 94:433–439

    PubMed  CAS  Google Scholar 

  7. Figueroa D, Calvo R, Vaisman A et al (2007) Knee chondral lesions: incidence and correlation between arthroscopic and magnetic resonance findings. Arthroscopy 23:312–315

    Article  PubMed  Google Scholar 

  8. Vaz CE, Camargo OP, Santana PJ et al (2005) Accuracy of magnetic resonance in identifying traumatic intraarticular knee lesions. Clinics 60:445–450

    Article  PubMed  Google Scholar 

  9. Magee T, Shapiro M, Williams D (2002) MR accuracy and arthroscopic incidence of meniscal radial tears. Skeletal Radiol 31:686–689

    Article  PubMed  Google Scholar 

  10. Cihangiroglu M, Yildirim H, Bozgeyik Z et al (2004) Observer variability based on the strength of MR scanners in the assessment of lumbar degenerative disc disease. Radiol 51:202–208

    Google Scholar 

  11. Endo Y, Schweitzer ME, Bordalo-Rodrigues M et al (2007) MRI quantitative morphologic analysis of patellofemoral region: lack of correlation with chondromalacia patellae at surgery. AJR Am J Roentgenol 189:1165–1168

    Article  PubMed  Google Scholar 

  12. De Smet AA, Graf BK (1994) Meniscal tears missed on MR imaging: relationship to meniscal tear patterns and anterior cruciate ligament tears. AJR Am J Roentgenol 162:905–911

    PubMed  Google Scholar 

  13. De Smet AA, Mukherjee R (2008) Clinical, MRI, and arthroscopic findings associated with failure to diagnose a lateral meniscal tear on knee MRI. AJR Am J Roentgenol 190:22–26

    Article  PubMed  Google Scholar 

  14. Van Dyck P, Gielen J, D’Anvers J et al (2007) MR diagnosis of meniscal tears of the knee: analysis of error patterns. Arch Orthop Trauma Surg 127:849–854

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to W. Krampla.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Krampla, W., Roesel, M., Svoboda, K. et al. MRI of the knee: how do field strength and radiologist’s experience influence diagnostic accuracy and interobserver correlation in assessing chondral and meniscal lesions and the integrity of the anterior cruciate ligament?. Eur Radiol 19, 1519–1528 (2009). https://doi.org/10.1007/s00330-009-1298-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-009-1298-5

Keywords

Navigation