Comparison of Knee SPECT and ARRI in Evaluating Meniscus Injuries in Soldiers

作者：Wertman Maya; Milgrom Charles^*; Agar Gabriel; Milgrom Yael; Yalom Newton; Finestone Aharon S

来源：Israel Medical Association Journal, 2014, 16(11): 703-706.

• meniscal tear
• antetinr cruciate ligament (ACL) tear
• knee magnetic resonance imaging (MRI)
• knee TMDP bone single photon emisSlion computed tomography (SPECT)
• knee arthfoscopy

Background: Medical evaluation of a suspected meniscus injury begins with a history-taking and physical examination. Suspected meniscus injuries not responding to treatment are usually sent for imaging to tonfirm the diagnosis before arthrostopy. Tc-MDP bone single photon emission computed tomography (SPECT) scan has been suggested as an alternative to magnetic resonance imaging (MRI) in evaluating suspected knee meniscus tears.
Objectives: To examine the accuracy of knee SPECT as a tool to identify meniscus tears versus that of MRI as compared to the gold standard of arthroscopy.
Methods: The Israel Defense Forces database for 2005 through 2009 was searched using the key words: knee MRI, knee SPECT and knee arthroscopy. We identified 330 subjects who had undergone both a single knee SPECT and a single knee MRI prior to knee surgery. The medical files of 193 of the 330 subjects were randomly selected for review. A comparison was Made between the preoperative SPEC T and MRI studies and the arthroscoOit finding. The sensitivity, specificity and accuracy were calculated.
Results: The subjetts' age was 21.3 3.9. The agreement betweerrSPECT and arthroscopywaS 0.14 forthe medial meniscus and 0.29 fOr the lateral meniscus. The agreement between MRI and arthroscopy was 0.59 for the medial meniscus and 0.69 for the lateral meniscus. SPECT scan was found to be 61% sensitive, 54% specific and 58% acturate in detecting common knee pathology, whereas MRI was found to be 95% sensitive, 67% spetific and 85% accurate.
Conclusions: Knee SPECT has a lower senSitivity, specificity and accuracy than MRI in evaluating meniscal injuries and its use can result in increased unnecessary surgery.

• 出版日期2014-11