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Suspected ACL rupture and meniscal tear

Case Study
Walser, René, M.D. Radiology Center Speyer (RZS) • Germany

Patient history

A 26-year-old athlete was referred to MRI for assessment of a clinically suspected rupture of the anterior cruciate ligament (ACL), and potential further injuries, especially of the menisci. Patient had anterior drawer instability. No prior surgery. The MRI exam was performed on day 3 after the accident.

MR examination

Achieva 1.5T was used with the 16-channel SENSE Knee coil. It’s more difficult to comfortably position a patient in pain for an MR exam. However, this wide coil and the ramped insert allowed this patient to undergo the exam well and to avoid motion artifacts. The larger field of view also helps in this situation as it makes positioning less critical.

ExamCard used:

Images

 PD TSE SPIR COR
PD TSE SPIR COR
 PDW TSE SAG PDW TSE SAG
PDW TSE SAG
PDW TSE SAG


The diagnostic images were from:

PD TSE SPIR COR: voxels 0.55 x 0.75 x 3.0 mm, 25 slices, TR/TE 2129/20 ms, scan time 2:30 min.

PDW TSE SAG:  voxels 0.37 x 0.5 x 3.0 mm, 28 slices, TR/TE 2500/30 ms, scan time 3:45 min.


The coronal PDW TSE SPIR image shows post‐traumatic bone bruise of the lateral malleolus of the left knee and rupture of the anterior cruciate ligament. The PDW TSE SAG image helps for exclusion of a significant partial tear of the medial meniscus posterior horn (left image) and demonstrates rupture of the ACL (right image).

Diagnosis

Rupture of the anterior cruciate ligament, joint effusion, no cartilage damage, no meniscal tear.

Impact of using the 16-channel SENSE Knee coil

The coil’s wide aperture, ramped insert and large FOV helped to make positioning easier for this patient with pain and helped to avoid motion artifacts. In addition, the stable fat suppression and the high spatial resolution make the PD TSE SPIR and the PDW TSE SAG clinically practical to help detection of bone bruise and rule out meniscal tears. Exclusion of meniscal tears and cartilage damage is crucial for surgical planning.


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Oct 18, 2011

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Case Study
Achieva 1.5T
Release 2.6
16-channel SENSE Knee coil, ACL, Knee, meniscus, Musculoskeletal
 

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