低场磁共振对筋伤中前交叉韧带损伤的诊断价值研究

Low field MRI diagnosis value of anterior cruciate ligament injury of the tendon injury

目的:分析低场强磁共振成像(Magnetic Resourance Imaging,MRI)对筋断裂伤中前交叉韧带(Anterior Cruciate Ligment,ACL)损伤(完全断裂和部分撕裂)中各征象的诊断敏感性和准确性,提高低场MRI对ACL损伤的诊断准确率。方法:回顾性分析经关节镜检查确诊的ACL损伤病例43例43膝。放射科医生采用单盲法分析、记录低场MRI图像中ACL损伤直接征象和间接征象的出现率,对其在ACL完全断裂及部分撕裂中的诊断价值分别进行评价。结果:ACL断裂时,在评价的直接征象中ACL信号中断、ACL信号全部或部分缺失,ACL走行异常,敏感性及特异性较高;间接征象中PCL角的敏感性及特异性较高,胫骨前移及外侧半月板后角裸露征敏感性虽不高但特异性很高。ACL部分撕裂时,直接征象中ACL信号增高、ACL形态异常(增粗或变细)的敏感性和特异性较高;间接征象中,股骨远端和(或)胫骨近端骨折、骨挫伤敏感性低,但具有较高特异性。结论:低场磁共振对完全断裂和不完全ACL损伤的直接征象可作为诊断依据,间接征象可作为辅助诊断依据,诊断准确性较高,能够满足临床需求。

Objective：To assess the sensitivity and accracy of various signs of anterior cruciate ligament （ACL） injury （ACL complete teared and part injuries）with low strenth magnetic resonance imaging （MRI） ,and improve the accuracy rate to diagnosis ACL injury with the low strengh MRI. Methods： MRI of 43 knee joints followed by arthroscopy were retrospectively evaluated. There were 43 knees with ACL injuries. Unknowing the results of arthroscopy, two radiologists evaluated all images for the presence of 5 primary signs and 5 secondary signs by consensus. Results： Primary signs that the discontinuity of ACL and abnormal contour of ACL, the whole or part signal disappeared were the main clues for diagnosing with high specificity and sensitivity. Most of the secondary signs, however, had relative high specificity but low sensitivity. It is same to ACL complete teared and part injuries. Conclusion： To diagnosis ACL injuries with low strength MRI is valuable. It is can meet the needs of clinicians.