前交叉韧带损伤的MRI相关征象分析  

Evaluation of MRI features of anterior cruciate ligament injury

作　　者：郭吉敏[1] 刘春霖[2] 曹满瑞[1] 郭学军[3] 赵艳[3] 刘鹏程[3] 

机构地区：[1]南方医科大学附属深圳市妇幼保健院放射科,广东518028 [2]深圳市第二人民医院放射科,广东518035 [3]北京大学深圳医院影像中心,广东518036

出　　处：《放射学实践》2010年第11期1268-1271,共4页Radiologic Practice

摘　　要：目的:分析膝关节多种MRI征象对诊断前交叉韧带(ACL)损伤的价值。方法:经关节镜证实的194例患者(包括前ACL正常膝97例、ACL损伤膝97例),对ACL损伤的相关MRI直接征象和间接征象进行评价。结果:在评价的4个直接征象(ACL连续性中断、信号缺失、形态异常及走行异常)中,除ACL信号缺失外,其余直接征象对诊断ACL损伤均具有统计学意义,其中韧带连续性中断具有较高的诊断敏感度(83.5%)、特异度(97.9%)及阳性似然比(39.8)。大多数间接征象具有较高的特异性和相对低的敏感性,其中Notch征、骨挫伤、外侧半月板后角裸露征及胫骨前移等征象具有较高的阳性似然比,分别为:+∞、9.0、55.70和8.0。结论:前交叉韧带损伤的MRI直接征象是其诊断的主要依据;由于其间接征象具有较高的特异性和+LR,因此可作为前交叉韧带损伤的辅助诊断依据,尤其是直接征象难以确诊的可疑ACL损伤者。Objective： To analyze the value of various MRI features in the diagnosis of anterior cruciate ligament （ACL） injury. Methods：The clinical materials of 194 patients with knee joint injury confirmed by arthroscopy （including 97 knees with normal ACI. and 97 knees with ACI. injuries respectively） were analyzed, the primary and secondary signs of ACL injury on MR1 were evaluated. Results： Among the four primary signs of ACL injury （discontinuity of ACL,loss of ACL signals,abnormal morphology and course of ACL）,apart from the loss of ACL signals,all of the other three primary signs had statistical significance in diagnosing ACL injury with the discontinuity of ACL had relative higher sensitivity （83.5 % ） , specificity （97.9 %）, and positive likelihood ratio （ ＋ LR, 39. 8）. Most of the secondary signs showed relative higher specificity but lower sensitivity with notch sign, bone contusion, uncovered posterior horn of lateral meniscus and anterior displacement of tibia had higher ＋ LR （＋ ∞, 9.0,55.7,8.0 respectively）. Conclusion：Primary signs were the main basis for the diagnosis of ACL injuries. However, the secondary signs had higher specificity and ＋LR,which could be used for accessory signs for the diagnosis,especially in those patients with suspicious ACL injury but could not be diagnosed with primary signs.

关 键 词：前交叉韧带 膝关节 磁共振成像 诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学] R686.5[医药卫生—诊断学]