The Role of Coronal Oblique Magnetic Resonance Imaging in Detection of Anterior Cruciate Ligament Tears

Background: the anterior cruciate ligament (ACL) is the knee joint ligament that is the most frequently injured and necessitate knee joint MRI secondary to trauma. Aim of the study: to assess the benefit of adding T2W-coronal oblique sequence to the standard MRI knee protocol in detecting and grading the ACL tears. Patients and methods: Seventy patients participated in this cross-sectional study between July 2021 to December 2021, 54 were males and 16 were females with an age ranged from 18-45 years (mean age 33.4±8.6). Three well-trained general radiologists interpreted the results; each radiologist assessed all the patients in the standard sequences alone (method A), then randomly re-assessed them using the standard and oblique sequences together (method B). Results: the results showed a considerable degree of variability in interpretation between the 3 radiologists in method A, while there was a relative decrease in the degree of variability in interpretation between the 3 radiologists in method B. There was a statically significant difference between the results for each radiologist in both methods (P-value 0.0001). The results showed an overall increment in Cohen's Kappa score for radiologists no. 2 and 3 in method B compared to method A, Cohen Kappa for (Radiologist 2: in method A 0.800 became 0.808 in method B) and (Radiologist 3: in method A 0.801 became 0.936 in method B), while for radiologist 1, there was substantial agreement in both methods. Conclusion: addition of oblique coronal sequence in assessing ACL injury revealed an improved detection and appropriate grading of the ACL tears.