轴向MRI对部分前交叉韧带损伤的诊断价值

Axial MRI in the diagnosis of partial anterior cruciate ligament injury

目的评估轴向磁共振成像(MRI)对部分前交叉韧带(ACL)损伤的诊断价值。方法 238例在做MRI检查16周内,用关节镜或直接外科手术来评价ACL损伤情况:143例正常,28例部分损伤,67例完全损伤。28例部分损伤中,有8例不稳定性损伤(部分ACL损伤或需要行ACL重建手术)和20例稳定性损伤(部分ACL损伤)。结果ACL轴向MRI图像显示:109例呈椭圆形,3例内部信号增强,45例呈衰减形,6例呈孤立的束条状,56例呈云雾状,19例不显影。轴向MRI检查的敏感性为100%(75/75),特异性为96%(157/163)。结论轴向MRI检查能够分辨稳定的ACL(正常ACL和稳定的部分ACL损伤)与不稳定ACL(不稳定的部分ACL损伤和完全ACL损伤)。在MRI图像上,稳定的ACL呈衰减形或椭圆形,或显示为内部信号增强;不稳定的ACL呈孤立的束条状、云雾状或不显影。应用轴向MRI检查,有助于提高部分ACL损伤的诊断水平。

Objective To evaluate the diagnostic value of axial MRI in partial anterior cruciate ligament（ACL） injury.Methods 238 patients were evaluated for their injuries with arthroscope or surgery within 16 weeks after they had received MRI examination.The results showed that 143 cases were normal,28 partial tears and 67 complete tears.Among the 28 cases with partial tears,8 were unstable partial tears（partial ACL tears or requiring ACL reconstructive surgery） and 20 stable tears（partial ACL tears）.Results Axial MRI images demonstrated that 109 cases appeared elliptical,3 with increased intrasubstance signal intensity,45 attenuated,6 isolated bundle signs,56 cloudlike mass signs,and 19 nonvisualized.The sensitivity and specificity of axial MRI was 100%（75/75） and 96% respectively.Conclusions Axial MRI could distinguish stable ACLs（normal anterior cruciate ligament and stable partial tears） from unstable ACLs（unstable partial tears and complete tears）.On axial MRI images,stable ACL is attenuated,elliptical or appears as areas of increased intrasubstance signal intensity,while unstable ACL appears as isolated bundle,cloudlike mass or are nonvisualized.Axial MRI is helpful in improving the diagnostic accuracy of partial ACL tear.