Comparison of oblique coronal images in knee of three-dimensional isotropic T2-weighted turbo spin echo MRI versus two-dimensional fast spin echo T2-weighted sequences for evaluation of posterior cruciate ligament injury

Objective: To compare image quality between three-dimensional volume isotropic turbo spin echo acquisition (3D VISTA) with the posterior cruciate ligament (PCL) view and two-dimensional (2D) fast spin echo (FSE) for evaluation of PCL injury. Methods: This retrospective study included 60 patients with clinical suspicion of PCL injury who underwent both 2D FSE and 3D VISTA of the knee between January 2015 and December 2015, The diagnostic performance of each oblique corona! view and the combined images was evaluated for sensitivity, specificity and accuracy for diagnosing a PCL tear. The arthroscopically confirmed diagnoses were used as the reference standard. Data were analyzed using the McNemar test. Results: The mean contrast-to-noise ratio was significantly higher for 3D VISTA than for 2D FSE. The two imaging modalities did not differ significantly in anatomical identification ability, with the exception of margin sharpness, which was inferior for 3D VISTA with Reader 2 (p = 0.038). When we classified the diagnoses of PCL injury as normal or abnormal, there were no significant differences in sensitivity, specificity or accuracy between the PCL view of 3D VISTA and 2D FSE images (p > 0,05), Conclusion: 3D VISTA had a superior contrast-to-noise ratio than 2D FSE and similar image quality in the evaluation of the PCL. The PCL view of 3D VISTA has the same diagnostic ability as 2D FSE in the diagnosis of PCL injury and can thus replace 2D FSE. Advances in knowledge: The oblique coronal view 3D VISTA MRI has similar diagnostic ability to 2D FSE in the diagnosis of PCL injury, and therefore 3D VISTA image can replace 2D FSE.