Duc S R, Zanetti M, Kramer J, Käch K P, Zollikofer C L, Wentz K U
MR Research Group, Institute of Radiology, Cantonal Hospital, Winterthur, Switzerland.
Acta Radiol. 2005 Nov;46(7):729-33. doi: 10.1080/02841850500215907.
To evaluate the three standard orthogonal imaging planes and a paracoronal imaging plane for anterior cruciate ligament (ACL) tears.
Ninety patients (91 knees; 29 F and 61 M) aged between 15 and 84 years (mean 36.9 +/- 16.4 years) underwent magnetic resonance imaging (MRI) of the knee prior to arthroscopy. At surgery, 32 knees had an intact ACL, 4 a partial tear, and 55 a complete ACL tear. In all patients, axial, sagittal, coronal, and paracoronal T2-weighted turbo-SE images were acquired. The ACL was classified as intact, partially, or completely torn. Partial and complete tears were combined for statistical evaluation.
Partial ACL tears (four cases) were not correctly diagnosed at MRI except in one knee by one observer on coronal images. Sensitivity in detecting ACL tears was 95%/63% (reader1/reader2) in the axial, 93%/95% in the sagittal, 93%/86% in the coronal, and 100%/93% in the paracoronal plane. Specificity was 75%/81% in the axial, 72%/81% in the sagittal, 78%/94% in the coronal, and 78%/88% in the paracoronal plane.
ACL tears can be diagnosed accurately with each of the standard orthogonal planes. Based on reader confidence and interobserver agreement paracoronal images may be useful in equivocal cases.
评估用于诊断前交叉韧带（ACL）撕裂的三个标准正交成像平面和一个副冠状成像平面。
90例患者（91个膝关节；29例女性和61例男性），年龄在15至84岁之间（平均36.9±16.4岁），在关节镜检查前接受了膝关节磁共振成像（MRI）检查。手术中，32个膝关节的ACL完整，4个为部分撕裂，55个为完全ACL撕裂。对所有患者均采集了轴位、矢状位、冠状位和副冠状位T2加权快速自旋回波图像。ACL被分类为完整、部分或完全撕裂。将部分和完全撕裂合并进行统计学评估。
除一名观察者在冠状位图像上对一个膝关节做出正确诊断外，MRI未正确诊断出部分ACL撕裂（4例）。检测ACL撕裂的敏感度在轴位为95%/63%（观察者1/观察者2），矢状位为93%/95%，冠状位为93%/86%，副冠状位为100%/93%。特异度在轴位为75%/81%，矢状位为72%/81%，冠状位为78%/94%，副冠状位为78%/88%。
使用每个标准正交平面均可准确诊断ACL撕裂。基于观察者的信心和观察者间的一致性，副冠状位图像在疑难病例中可能有用。
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