前交叉韧带重建术后移植物MRI信号表现与二次关节镜结果的一致性

Consistency of postoperative graft magnetic resonance image signal appearance and the secondary arthroscopy result after anterior cruciate ligament reconstruction

目的探讨前交叉韧带(ACL)重建术后各时间段移植物MRI信号特征,并与二次关节镜结果作对照。方法回顾性分析39例行ACL重建术患者的移植物MRI信号特征与二次关节镜结果,分析两者的一致性。结果39例二次关节镜显示移植物连续性均为良好,其中紧张度良好18例,张力轻度松弛21例。术后行90例次MRI检查,按距离第一次关节镜术后时间划分:<3个月Ⅰ类信号11例次、Ⅱ类信号1例次;3~11个月Ⅰ类信号9例次、Ⅱ类信号32例次、Ⅲ类信号9例次;≥12个月Ⅰ类信号13例次、Ⅱ类信号13例次、Ⅲ类信号2例次。术后12~18个月,Ⅰ~Ⅲ类信号的患者移植物张力情况比较差异无统计学意义(P>0.05);但术后18个月以上,Ⅰ、Ⅱ类MRI信号者与关节镜所见的移植物张力情况高度一致。结论术后3个月以内移植物基本表现为均匀低信号,术后3~11个月大部分移植物表现为线状、条纹状高信号或局限性高信号,术后12~18个月移植物MRI信号特征与实际张力情况吻合度差;>18个月移植物MRI信号与实际张力情况高度吻合。

Objective To investigate the postoperative MRI signal characteristics of anterior cruciate ligament(ACL)graft at different stages,and compare with the results of secondary arthroscopic examination.Methods The MRI signal characteristics and secondary arthroscopic results of 39 patients treated with ACL reconstruction were analyzed retrospectively,and their consistency was analyzed.Results There were 39 cases of good integrity with secondary arthroscopy.The tension of ACL graft was taut in 18 cases and the other 21 cases were slightly lax.A total of 90 case-times MRI scans were divided into three classes,according to the duration after the first arthroscopy:there were 11 case-times as classⅠand 1 case-times as classⅡwithin 3 months postoperation.At 3~11 months postoperation,the case-times of classⅠ,ⅡandⅢwere 9,32 and 9,respectively.And 13 case-times as classⅠ,13 case-times as classⅡand 2 case-times as classⅢhad been operated at more than 12 months postoperation.At 12~18 months after operation,there were no significant differences in the tension of grafts among patients with classⅠ~Ⅲsignals(P>0.05),but more than 18 months after operation,the tension of grafts with classⅠ,Ⅱsignals were highly consistent with those seen under arthroscopy.Conclusions Postoperative ACL graft within 3 months show homogeneously low signal intensity,while most of the ACL graft within 3~11 months show localized high signal intensity with line or stripe shape.From 12 months to 18 months after operation,the grafts MRI signal characteristics are not consistent with the actual tension of the graft.Over 18 months,the grafts are basically homogeneous and low signal,which are highly consistent with the actual tension of the graft.