Hong Sung Hwan, Choi Ja-Young, Lee Gyung Kyu, Choi Jung-Ah, Chung Hye Won, Kang Heung Sik
Department of Radiology, Seoul National University College of Medicine, Korea.
J Comput Assist Tomogr. 2003 Sep-Oct;27(5):814-9. doi: 10.1097/00004728-200309000-00022.
This study was undertaken to evaluate the diagnostic efficacy of additional oblique coronal magnetic resonance (MR) imaging of the knee for the grading of anterior cruciate ligament (ACL) injury.
We retrospectively reviewed MR images of the knee in 169 patients. The MR examinations included routine sequences and oblique coronal T2-weighted images, which oriented in parallel to the course of the femoral intercondylar roof. Two independent readers evaluated the status of the ACL by routine knee MR imaging and then by additional oblique coronal imaging. The severity of the ACL injury was graded using a 4-point system from MR images, namely, intact, low-grade partial tear, high-grade partial tear, and complete tear, and results were compared with arthroscopic findings. Weighted kappa statistics were used to analyze the diagnostic accuracy of routine knee MR imaging with and without additional oblique coronal imaging.
The weighted kappa scores (kappaws) were 0.752 (reader 1) and 0.784 (reader 2) by routine knee MR imaging only; with additional oblique coronal imaging, the kappaws increased to 0.809 (reader 1) and 0.843 (reader 2). Interobserver agreements for routine knee MR imaging and additional coronal imaging were considered to be "very good" (kappaw = 0.851, 0.868, respectively).
Additional use of oblique coronal MR imaging of the knee improves diagnostic accuracy in the grading of ACL injury.
本研究旨在评估膝关节额外的斜冠状面磁共振（MR）成像在前交叉韧带（ACL）损伤分级中的诊断效能。
我们回顾性分析了169例患者的膝关节MR图像。MR检查包括常规序列和斜冠状面T2加权图像，其与股骨髁间顶的走行平行。两名独立阅片者先通过常规膝关节MR成像评估ACL的状态，然后再通过额外的斜冠状面成像进行评估。根据MR图像，使用4分制对ACL损伤的严重程度进行分级，即完整、低度部分撕裂、高度部分撕裂和完全撕裂，并将结果与关节镜检查结果进行比较。采用加权kappa统计分析常规膝关节MR成像在有无额外斜冠状面成像时的诊断准确性。
仅通过常规膝关节MR成像时，加权kappa评分（kappaws）分别为0.752（阅片者1）和0.784（阅片者2）；增加斜冠状面成像后，kappaws分别提高到0.809（阅片者1）和0.843（阅片者2）。常规膝关节MR成像和额外冠状面成像的观察者间一致性被认为“非常好”（kappaw分别为0.851、0.868）。
膝关节额外使用斜冠状面MR成像可提高ACL损伤分级的诊断准确性。
