Clinical utility of fat-suppressed 3-dimensional controlled aliasing in parallel imaging results in higher acceleration sampling perfection with application optimized contrast using different flip angle evolutions MRI of the knee in adults

Abstract

Objective: To compare htree-dimensional CAIPIRINHA SPACE and two-dimensional turbo spin echo (2D TSE) MRI in the diagnosis of knee pathology in symptomatic adult patients. Methods: From February to September in 2018, 120 patients who underwent a knee MRI using both 3D CAIPIRINHA SPACE and 2D TSE MRI were enrolled. The signal-to-noise ratios (SNRs) and contrast-to-noise ratio (CNR) of the 2D and 3D MRI were compared using a paired t-test. Two radiologists independently evaluated both 2D and 3D MRI images using scoring systems for the menisci, ligaments, and cartilage. Intermethod, inter- and intrareader agreements were determined using an intraclass correlation coefficient (ICC). The diagnostic performance of both methods was measured in 44 patients with arthroscopy. Results: The mean scan time of 3D CAIPIRINHA SPACE MRI (4’ 43”) was shorter than that of 2D TSE MRI (17’ 27”). The mean SNR and CNR of 3D CAIPIRINHA SPACE was higher than those of 2D TSE MRI (mean difference, 3.97 of SNR and 1.58 of CNR; p < 0.001 and p = .038, respectively). Intermethod (ICC, 0.84–1.0) and inter-reader (ICC, 0.75–0.97), and intra-reader agreements (ICC, 0.87–1.0) were good or excellent. The diagnostic accuracy of 3D CAIPIRINHA SPACE sequence was equal for ligament (95.5%) and better for meniscal and cartilage evaluation (84.1% each), compared to 2D TSE MRI (79.5% each). Conclusion: The fat-suppressed 3D CAIPIRINHA SPACE MRI maybe useful in clinical practice for the evaluation of the knee in place of the 2D conventional MRI protocol. Advances in knowledge: 1. The 3D CAIPIRINHA SPACE MRI of the knee joint may be acceptable to be used in clinical practice showing comparable imaging quality compared to conventional 2D TSE MRI. 2. Compared with arthroscopic findings as the gold-standard, the diagnostic performance of 3D CAIPIRINHA SPACE MRI was equal or better for knee joint evaluation than that of 2D TSE MRI, as well as with shorter scan time.