膝关节后交叉韧带撕裂的MRI表现及诊断价值  

MRI Findings and Diagnostic Value of Posterior Cruciate Ligament Tear

作　　者：郑雷[1] 刘禄明[1] 孙百胜[1] 姜辉[1] 都基权[1] 杜海峰[1] 

机构地区：[1]武警山东省总队医院医学影像科武警部队医学影像诊断中心,山东济南250014

出　　处：《临床放射学杂志》2011年第3期384-388,共5页Journal of Clinical Radiology

摘　　要：目的探讨膝关节后交叉韧带(PCL)撕裂的MRI表现及其诊断价值。资料与方法回顾性分析31例经临床证实PCL撕裂患者的MRI资料。31例均行常规MRI矢状位T1WI、T2WI、脂肪抑制FSE双回波矢状位和冠状位扫描。结果 PCL完全撕裂18例,部分性撕裂13例,其中实质部撕裂20例,近端撕裂7例,远端撕裂4例,完全撕裂中,实质部撕裂13例,近端撕裂3例,远端撕裂2例,部分性撕裂中,实质部撕裂7例,近端撕裂4例,远端撕裂2例。PCL撕裂的MRI直接征象表现为PCL消失、不连续、PCL肿大增粗或不规则变细、韧带信号异常;PCL撕裂的MRI间接征象及其伴随损伤包括内侧副韧带(MCL)损伤、骨挫伤、交叉韧带三角间隙积液、半月板损伤及软骨损伤等。MRI诊断PCL完全撕裂的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为88.9%、100%、100%、86.7%和93.5%,MRI诊断PCL部分性撕裂的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为76.9%、88.9%、83.3%、84.2%和83.9%。结论 MRI能较好地显示PCL撕裂的直接征象、间接征象及其伴随损伤,具有较高的临床应用价值。Objective To evaluate MRI findings and diagnostic value of posterior cruciate ligament（PCL） tear.Materials and Methods MR images of 31 patients with PCL tear proved by clinical data were reviewed.Routine MR Scanning was performed in sagittal and coronal planes,including T1WI,T2WI and fat suppression sequence.Results Among 31 patients,complete PCL tear was showed in 18 cases and partial PCL tear in 13 cases.Twenty cases were substantial tear,7 cases were roximal tear and 4 cases distal tear.Among the patients with complete PCL tear,there was a substantial tear in 13 cases,proximal tear in 3 cases and distal tear in 2 cases.Among the patients with partial PCL tear,7 cases were substantial tear,4 cases proximal tear and 2 cases distal tear.The primary signs of PCL tear were disappearance,discontinuity,swelling or irregularly thinning and abnormal signal of PCL.The associated signs of PCL tear were medial collateral ligament（MCL） injury,bone bruises,cruciate ligament space fluid,meniscus injury,cartilage injury and so on.The sensitivity,specificity,positive and negative predictive values,and accuracy of MR diagnosis for complete PCL tear were 88.9%,100%,100%,86.7% and 93.5% respectively;The sensitivity,specificity,positive and negative predictive values,and accuracy of MR diagnosis for partial PCL tear were 76.9%,88.9%,83.3%,84.2% and 83.9% respectively.Conclusion MRI can show PCL tear clearly as well as adjunctive structure of knee,and MRI has important value in clinical application.

关 键 词：膝关节 后交叉韧带撕裂 磁共振成像 

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