外伤性膝关节前外侧韧带损伤的MR影像特征及相关性分析

MRI appearances of the injured anterolateral ligament of the knee on MRI and associations among the appearances

目的探讨外伤所致膝关节前外侧韧带损伤病人的MR影像特征,并分析其与前交叉韧带撕裂、外侧半月板撕裂及骨挫伤的相关性,为深入研究前外侧韧带对膝关节稳定性的作用提供可靠依据。方法回顾性分析2016年1月—2017年2月间因外伤进行膝关节MRI检查的320例病人(共321膝)的影像资料。采用美国GE公司生产的Signa HDe 1.5 T MR扫描设备,分别行膝关节斜矢状面T1WI、质子密度加权成像(PDWI)和冠状面、横断面PDWI扫描。根据前外侧韧带的完整性和损伤部位对所有病人进行分类统计。采用独立性卡方检验对前外侧韧带撕裂与前交叉韧带撕裂、外侧半月板撕裂及骨挫伤的相关性进行分析。结果全部病人膝关节MR影像均可显示前外侧韧带,显示率为100%。151/321膝(47.0%;95%CI为41.6%~52.5%)存在前外侧韧带损伤,其中累及胫骨部、股骨部及半月板部的分别为97膝、96膝及65膝。前交叉韧带撕裂158膝,外侧半月板撕裂98膝,股骨外侧髁挫伤58膝,外侧胫骨平台挫伤71膝,分别与前外侧韧带撕裂具有相关性(均P<0.001)。结论 MRI检查可以很好地显示前外侧韧带解剖及其损伤情况。膝关节前外侧韧带损伤与前交叉韧带撕裂、外侧半月板撕裂及膝外侧骨挫伤具有相关性。

Objective To investigate the MR imaging features of patients with anterolateral ligament injury caused by trauma, and to analyze its associations with anterior cruciate ligament （ACL） tear, lateral meniscus tear, and lat-eral bone contusion, so as to provide reliable information of knee stability supported by anterolateral ligament. Methods We retrospectively analyzed the MR imaging of 320 patients with 321 knees trauma from January 2016 to February 2017. The MRI examinations were all performed on GE Company Signa HDe 1.5 T MR. Imaging protocol included oblique sagit-tal T1-weighted sequence, and coronal, axial, and sagittal proton density weighted sequences. All injuries were categorized according to the integrity and site of the injured anterolateral ligament. The correlation among the anterolateral ligament tear, anterior cruciate ligament tear, lateral meniscus tear, and bone contusion was analyzed with chi-square test. Results All anterior cruciate ligament can be demonstrated in examinations （100%）. There were 151 of 321 （47%, 95%CI：41.6%-52.5%） knees showed signs of anterolateral ligament injury. Among the cases with injury, ninty-seven knees showed femoral portion lesions, ninty-six knees showed tibial lesions, and 65 knees showed meniscal portion lesions. Abnormality was detected in ACL in 158 knees, in the lateral meniscus in 98 knees, in lateral femoral condyle in 58 knees, and in later-al tibial plateau contusion in 71 knees, which were statistically associated with anteriorlateral ligament injury （P〈0.001）. Conclusions MRI examination can be a good choice for displaying anteriorlateral ligament tears. Anteriorlateral ligament injury significantly associates with ACL tear, lateral meniscus tear, and lateral bone contusion.