MRI of the knee: value of short echo time fast spin-echo using high performance gradients versus conventional spin-echo imaging for the detection of meniscal tears.

OBJECTIVE: Fast spin-echo (FSE) sequences reduce imaging time compared with conventional spin-echo (CSE) sequences, but may result in blurring. High-performance gradients permit shorter interecho spacing and use of the second echo as the effective TE (20 ms); both improvements reduce blurring. This randomized observer study compared a short TE, second-echo FSE sequence obtained using high-performance gradients and a CSE sequence with similar TR/TE for the detection of meniscal tears in the knee. DESIGN AND PATIENTS: One hundred consecutive MR examinations of the knee using FSE and CSE sequences at 1.5 T were evaluated. The FSE sequence used an effective TE of 20 ms (centered on the second echo at 2 times minimal interecho spacing) and an echo train length of 4. FSE and CSE parameters were otherwise similar. Four independent, masked readers reviewed randomized sagittal FSE and CSE sequences.
RESULTS: Cases were assessed for the presence or absence of meniscal tears and, if present, whether tears were medial or lateral and anterior or posterior. Sequence concordance was 93.5% (1496 of 1600 meniscal segments); the intermethod kappa value was 0.78. Sequence quality was graded from 1 to 5. Average quality of CSE images was slightly but statistically significantly preferred by three of the four readers.
CONCLUSION: There was no statistically significant difference between CSE imaging and FSE imaging centered on the second echo (20 ms) using high-performance gradients for the detection of meniscal tears in the knee. There was a small preference for the quality of CSE images.

RCT Entities:   Population Interventions Outcomes