Bellelli A, Mancini P, Polito M, David V, Mariani P P
Dipartimento di Radiologia, Ospedale S. Giovanni Calibita Isola Tiberina, Fatebenefratelli, Roma, Italy.
Radiol Med. 2006 Sep;111(6):828-35. doi: 10.1007/s11547-006-0076-6. Epub 2006 Aug 11.
The aim of our study was to propose a new classification of acute posterior ligament (PCL) injuries based on magnetic resonance imaging (MRI).
Using MRI, we reviewed 220 patients presenting an acute posterior ligament injury. The MRI exam was performed on a 0.2-Tesla (T) magnet and a 1.5-T magnet using T1-weighted spin echo (SE), T2-weighted SE and fat-suppression scans [short-tau inversion recovery (STIR)] in axial, sagittal and coronal planes. In no case was paramagnetic contrast agent injected.
Twenty-five per cent of patients were identified as having type I lesions and another 30% as having type II lesions according to the Gross classification. Out of 77 patients, 35% of the whole sample, 37 had a tear of the posteromedial fascicle (type II lesion), and the remaining 40 had anterolateral fascicle tears (type III). In 10% of cases, the ligaments appeared completely interrupted, and these were classified as type IV lesions.
T1-weighted SE sequences need to be integrated with T2-weighted and STIR sequences to detect the real extent of the remaining fascicle. The MRI exam could thus be able to provide a qualitative evaluation of PCL injuries and establish how the injury compromises joint stability.
我们研究的目的是基于磁共振成像（MRI）提出一种新的急性后交叉韧带（PCL）损伤分类方法。
我们利用MRI对220例急性后交叉韧带损伤患者进行了回顾性研究。MRI检查在0.2特斯拉（T）磁体和1.5T磁体上进行，采用T1加权自旋回波（SE）、T2加权SE和脂肪抑制扫描[短反转时间反转恢复序列（STIR）]，扫描平面包括轴位、矢状位和冠状位。所有病例均未注射顺磁性造影剂。
根据Gross分类，25%的患者被诊断为I型损伤，另有30%为II型损伤。在77例患者中，占整个样本的35%，37例后内侧束撕裂（II型损伤），其余40例为前外侧束撕裂（III型）。10%的病例韧带完全中断，这些被归类为IV型损伤。
T1加权SE序列需要与T2加权和STIR序列相结合，以检测剩余束的实际损伤程度。因此，MRI检查能够对PCL损伤进行定性评估，并确定损伤如何影响关节稳定性。
