Prince Jeffrey S, Laor Tal, Bean Judy A
Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
AJR Am J Roentgenol. 2005 Sep;185(3):756-62. doi: 10.2214/ajr.185.3.01850756.
The objective of our study was to evaluate the MRI characteristics of anterior cruciate ligament (ACL) injuries and associated findings relative to skeletal maturity. We also contrast the frequency of findings in this younger population to adult data.
Eighty-two consecutive knees with an MRI report diagnosis of ACL injury (partial tear, sprain, or complete tear) or tibial spine avulsion fracture imaged over 4 years were retrospectively reviewed. Patients were grouped by degree of skeletal maturity as determined from the MR images. The examinations were reviewed for the type of ACL injury, secondary imaging findings, and associated knee injuries. Findings were correlated to skeletal maturity, and frequencies were compared with adult data.
ACL injuries were more common in boys in the skeletally immature group, but more common in girls in the skeletally mature group (p = 0.03). Tibial spine avulsion fractures were most common in skeletally immature patients (p < 0.01), whereas complete tears of the ACL were most common in skeletally mature patients. Associated injuries were less common in the skeletally immature group, but this trend did not reach statistical significance. Most secondary signs of ACL injuries occurred at similar rates in all groups with frequencies similar to those reported in adults.
ACL injuries in skeletally immature patients are seen more often in boys. Tibial avulsion fractures and partial tears are more common in younger, less rigid skeletons that may absorb the forces of trauma. As children mature, complete ACL tears and associated injuries occur in frequencies approaching those patterns seen in adults. Similarly, skeletally mature girls are affected more often than mature boys.
本研究的目的是评估前交叉韧带（ACL）损伤的MRI特征以及与骨骼成熟度相关的相关发现。我们还将该年轻人群中的发现频率与成人数据进行对比。
回顾性分析连续82例在4年期间进行MRI检查且报告诊断为ACL损伤（部分撕裂、扭伤或完全撕裂）或胫骨棘撕脱骨折的膝关节。根据MR图像确定的骨骼成熟度对患者进行分组。对检查结果进行ACL损伤类型、继发性影像学表现及相关膝关节损伤的评估。将结果与骨骼成熟度进行关联，并将频率与成人数据进行比较。
骨骼未成熟组中，ACL损伤在男孩中更为常见，但在骨骼成熟组中女孩更为常见（p = 0.03）。胫骨棘撕脱骨折在骨骼未成熟患者中最为常见（p < 0.01），而ACL完全撕裂在骨骼成熟患者中最为常见。相关损伤在骨骼未成熟组中较少见，但这一趋势未达到统计学意义。ACL损伤的大多数继发性征象在所有组中的发生率相似，频率与成人报告的相似。
骨骼未成熟患者的ACL损伤在男孩中更常见。胫骨撕脱骨折和部分撕裂在较年轻、较不坚硬的骨骼中更为常见，这些骨骼可能吸收创伤力量。随着儿童成熟，ACL完全撕裂和相关损伤的发生率接近成人所见模式。同样，骨骼成熟的女孩比成熟男孩更容易受到影响。
