胫骨髁间后区积液对交叉韧带损伤的诊断价值

Diagnostic value of hydrops in posterior intercondylar area to the lesion of cruciate ligaments

目的:通过MRI研究膝关节胫骨髁间后区积液作为一种间接征象诊断交叉韧带损伤的价值。方法:抽取136个有关节镜结果的膝关节MRI图像进行回顾性分析。列表计算胫骨髁间后区积液诊断交叉韧带损伤的灵敏度、特异度、阳性预测值、阴性预测值。结果:全部136个膝关节有交叉韧带损伤41个,其中发现胫骨髁间后区积液39个(39/41),未发现胫骨髁间后区积液2个(2/41)。无交叉韧带损伤95个,发现胫骨髁间后区积液的53个(53/95),未发现胫骨髁间后区积液的42个(42/95)。胫骨髁间后区积液诊断交叉韧带损伤的敏感度95.1%,特异度44.2%,阳性预测值42.4%,阴性预测值95.5%。结论:在包裹交叉韧带的滑膜完整的前提下,交叉韧带损伤所致的少量出血和渗出是导致胫骨髁间后区积液的可能原因。在同一前提下,当胫骨髁间后区没有发现积液时,交叉韧带损伤的可能性较小。

Objective ：To assess the diagnostic value of hydrops on MRI presentation in the posterior inercondylar space to the lesion of cruciate ligaments. Methods：Retrospective analysis of the MRI imaging was petformed in 136 cases with cruciate ligament lesion confirmed by arthroscopy through statistical summary of the sensibility, specificity, positive predictive value and negative predictive value between the hydrops in posterior intercondylar area and the lesion of cruciate ligaments. Results ： Of the total 136 knee MRI images,cruciate ligament lesion was found in 41 cases,in which hydrops in the posterior intercondylar space were seen in 39 and free in another 2. In addition, the hydrops in posterior intercondylar area were observed in 53 of the 95 cases with no cruciate ligament lesion, yet 42 revealed no hydrops in the posterior intercondylar space. Estimation of the cruciate ligament lesion on hydorps in posterior intercndylar area basis led to a sensibility of 95.1% ,specificity of 44.2% ,positive predictive value of 42.4% and negative predictive value of 95.5%. Conclusion ： If the synovium covering the cruciate ligaments remains intact, presence of the hydrops in posterior intercondylar area shall be associated with the minor hemorrhage and exudate due to the cruciate ligament injury. Similarly,absence of the hydrops in posterior intercondylar space may indicate less possible lesion of the cruciate ligaments.