MRI多征象分析对前交叉韧带损伤的诊断价值  

The diagnostic value of multiple signs at MR imaging of anterior cruciate ligament injury

作　　者：梁绮玲[1] 韩立新[1] 曹惠霞[1] 杜渭清[1] 崔静[1] 

机构地区：[1]广州军区广州总医院磁共振室,广东广州510010

出　　处：《医学影像学杂志》2010年第9期1351-1354,共4页Journal of Medical Imaging

摘　　要：目的:评价MRI对前交叉韧带(anterior cruciate ligament,ACL)损伤多种征象的诊断价值。方法:回顾分析了128个膝关节的MR图像。全部膝关节均行关节镜检查,其中52个膝关节的ACL损伤,另外76个膝关节的ACL显示完整。在不告知关节镜结果的前提条件下,2名影像科医生共同对ACL损伤的5个直接征象和10个间接征象进行评价,意见不一致时协商解决差异。结果:在评价的5个直接征象中,ACL不连续和ACL走行异常具有相对高的诊断敏感性和特异性;在评价的10个间接征象中,大多数具有相对高的特异性和低的敏感性,其中空髁间窝征、Notch征、外侧半月板后角裸露征、PCL指数、冠状面PCL单层显示等征象特异性较高。结论:ACL损伤的直接征象为诊断的主要依据,以ACL不连续和ACL走行异常具有较高的诊断价值;ACL损伤的间接征象具有辅助诊断意义,其中空髁间窝征、Notch征、外侧半月板后角裸露征、PCL指数、冠状面PCL单层显示等征象最具有诊断价值。Objective：To assess the diagnostic value of multiple signs at magnetic resonance imaging （MRI） of anterior cruciate ligament （ACL） injury. Methods：MR images of 128 knee joints were retrospectively evaluated. There were 52 knees with ACL injuries and 76 knees that were proved to be intact by arthroscopy. Two radiologists,who were unknown to the results of arthroscopy,evaluated all these images for the presence of 5 direct signs and 13 indirect signs. Discordant assessments were resolved by consensus. Results：Among the 5 direct signs,discontinuity of ACL and abnormal contour of ACL had relative higher sensitivity and specificity. Most of the indirect signs,however,had relative high specificity but low sensitivity. The following 5 indirect signs,i.e,bare area at the femoral origin of the ACL,Notch sign,uncovered posterior horn of lateral meniscus sign,PCL curvature ratio,and entire length of the PCL observed on a single coronal image,had relative higher sensitivity. Conclusion：Direct signs were the main clues for diagnosing ACL injuries,and discontinuity and abnormal contour of ACL were the two most valuable signs of a tear. Indirect signs were only for assistant diagnosis and bare area at the femoral origin of the ACL,Notch sign,uncovered posterior horn of lateral meniscus sign,PCL curvature ratio,and entire length of the PCL observed on a single coronal image were the best predictors of an ACL tear.

关 键 词：膝关节 前交叉韧带 磁共振成像 

分 类 号：R686.5[医药卫生—骨科学] R445.2[医药卫生—外科学]