Diagnostic Accuracy of Magnetic Resonance Imaging in Anterior Cruciate Ligament Injury

Abstract

Objective: This research set out to evaluate the diagnostic performance of magnetic resonance imaging (MRI) in identifying injuries of the anterior cruciate ligament (ACL), using arthroscopic assessment as the reference
comparator.

Study Design: A cross-sectional analysis with a retrospective review
Place and Duration of Study: This study was conducted at the Department of Radiology, Services Institute of Medical Sciences/Services Hospital, Lahore covered a two-year period, extending from April 2024 to March 2025.

Methods: A cross-sectional analysis with a retrospective review of patient records was carried out. A total of 267 people were included, ages 16 to 60, who had a history of knee trauma and a clinical suspicion of an ACL injury.
After undergoing an MRI, each patient had an arthroscopy done. A 1.5 Tesla MRI scanner was used for imaging, and standardized knee imaging sequences were used. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy were then calculated by comparing the MRI observations with the arthroscopy findings. SPSS version 22 was used to process and analyze the data, and findings were considered statistically significant if the p-value was less than 0.05.

Results: MRI demonstrated a sensitivity of 97%, specificity of 95.12%, PPV of 98.5%, NPV of 90%, and overall diagnostic accuracy of 95% for ACL tears. Thickening or edema and discontinuity of ACL fibers were the most
sensitive MRI findings, while posterior cruciate ligament angle and index showed the highest specificity. The diagnostic accuracy for both complete and partial tears was 93%.

Conclusion: MRI demonstrates strong diagnostic capability for identifying ACL injuries, assisting orthopedic surgeons in early management and reducing unnecessary arthroscopies.