Steckel Hanno, Vadala Gianluca, Davis Denise, Fu Freddie H
Department of Orthopaedic Surgery, University of Göttingen, Robert-Koch-Strasse 40, 37075 Göttingen, Germany.
Knee Surg Sports Traumatol Arthrosc. 2006 Nov;14(11):1151-8. doi: 10.1007/s00167-006-0185-8. Epub 2006 Aug 26.
For anterior cruciate ligament (ACL) surgery using the anatomic approach of the double bundle concept it is helpful to describe the anteromedial (AM) and posterolateral (PL) bundle using Magnetic Resonance Imaging (MRI), since this is the most important preoperative parameter next to the physical examination. The aim of this study was to distinguish both bundles in MRI. In a prospective study we evaluated the double bundle structure in ACL anatomy with a 3-T ultra-high-field strength MR imaging of cadaver knees, which allows faster imaging times, increased resolution and increased signal-to-noise ratio. Using oblique sagittal and oblique coronal planes, we were able to distinguish the double bundle structure in each knee. The following arthroscopic evaluation of the knees confirmed our MRI findings. Our study demonstrates the possibility of distinguishing the two bundles in the native ACL with 3T MRI. Following examinations must study the value for clinical application by describing different rupture patterns of the bundles and correlating this to arthroscopy. It would be advantageous to know the rupture pattern in advance. Presurgical planning could be improved by reconstructing only the torn and preserving the intact bundle.
对于采用双束概念解剖入路的前交叉韧带(ACL)手术,利用磁共振成像(MRI)来描述前内侧(AM)束和后外侧(PL)束很有帮助,因为这是仅次于体格检查的最重要术前参数。本研究的目的是在MRI中区分这两个束。在一项前瞻性研究中,我们采用3-T超高场强MR成像对尸体膝关节的ACL解剖结构中的双束结构进行了评估,该成像可实现更快的成像时间、更高的分辨率和更高的信噪比。通过使用斜矢状面和斜冠状面,我们能够在每个膝关节中区分双束结构。随后对膝关节进行的关节镜评估证实了我们的MRI结果。我们的研究证明了利用3T MRI区分天然ACL中两个束的可能性。后续检查必须通过描述束的不同断裂模式并将其与关节镜检查相关联来研究其临床应用价值。提前了解断裂模式将是有益的。通过仅重建撕裂的束并保留完整的束,术前规划可以得到改进。