前交叉韧带部分撕裂最大屈曲侧卧位MR成像效果  

Diagnosis of anterior cruciate ligament partial tear by imaging the knee in side-lying and buckling to maximum position in 3.0T

作　　者：徐子军[1] 汤光宇[1] 邵泓达 张长宝[1] 华婷[1] 徐彧[1] 汤欢 

机构地区：[1]同济大学附属第十人民医院放射科,上海200072 [2]复旦大学附属华东医院放射科,上海200040

出　　处：《武警医学》2017年第9期912-916,共5页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的探讨前交叉韧带部分撕裂最大屈曲侧卧位MR成像效果。方法将临床诊断为前交叉韧带部分撕裂的324例患者按照患者受伤到接受磁共振检查间期长短分成亚急性组、中间组、慢性组;所选患者都在接受常规体位及特殊体位膝关节MR检查后进行了关节镜检查。三位放射科医师对常规膝关节MR检查图像进行盲评,所得诊断结果列为A组,3个月后给相同的3位放射科医师提供膝关节常规体位检查图像和侧卧并最大屈曲位图像进行盲评,所得诊断结果列为B组。以关节镜结果为金标准,比较诊断符合率的差异。结果 B组对前交叉韧带部分撕裂的诊断率和关节镜结果更接近(Z=-0.732,P=0.47),阳性检出率明显高于MR常规体位组(P<0.001),尤其对处于中间期部分撕裂患者敏感度及特异度更高(敏感度25.64%,特异度94.73%)。结论前交叉韧带部分撕裂最大屈曲侧卧位MR成像可提高诊断符合率。Objective To investigate whether MR imaging of knees in a side-lying and buckling to maximum position can improve the diagnostic rate of anterior cruciate ligament（ACL） partial tear. Methods Three hundred and twenty-four patients who were diagnosed with ACL partial tear were included in this study. According to the difference of intervals between the time of injury and the time for MR imaging,these patients were divided into three groups： the subacute,intermediate and chronic groups. All the patients underwent MR imaging in both the routine,side-lying and buckling to maximum position,and knee arthroscopy was performed after the MR scan. Three radiologists were invited to make a diagnosis through blind evaluation of the MR images acquired in the routine knee position. The diagnostic results were saved as group A. The MR images of the routine and side-lying and buckling to maximum position of knees were subjected to blind evaluation by another three radiologists after three months,and the diagnostic results were saved as group B,with the results of knee arthroscopy as reference. The difference between these two groups was analyzed statistically.Results The diagnostic rate of group B was comparable to the result of knee arthroscopy. The positive diagnostic rate of group B was much higher than that of group A. Conclusions MR imaging in the side-lying and buckling position of the knee can improve the diagnostic rate of patients with anterior cruciate ligament partial tear,and this MR imaging method is more sensitive for diagnosing patients with ACL partial tear more than 3 months after injury.

关 键 词：前交叉韧带撕裂 膝关节损伤 磁共振成像 特殊体位 

分 类 号：R445.2[医药卫生—影像医学与核医学]