Chung Hye Won, Ahn Jin Hwan, Ahn Joong Mo, Yoon Young Cheol, Hong Hyun Pyo, Yoo So Young, Kim Seonwoo
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Korean J Radiol. 2007 May-Jun;8(3):236-41. doi: 10.3348/kjr.2007.8.3.236.
The aim of this study is to evaluate the reliability of MR imaging to predict the stability of the torn anterior cruciate ligament (ACL) after complete recovery of the ligament's continuity.
Twenty patients with 20 knee injuries (13 males and 7 females; age range, 20-54) were enrolled in the study. The inclusion criteria were a positive history of acute trauma, diagnosis of the ACL tear by both the physical examination and the MR imaging at the initial presentation, conservative treatment, complete recovery of the continuity of the ligament on the follow up (FU) MR images and availability of the KT-2000 measurements. Two radiologists, who worked in consensus, graded the MR findings with using a 3-point system for the signal intensity, sharpness, straightness and the thickness of the healed ligament. The insufficiency of ACL was categorized into three groups according to the KT-2000 measurements. The statistic correlations between the grades of the MR findings and the degrees of ACL insufficiency were analyzed using the Cochran-Mantel-Haenszel test (p < 0.05).
The p-values for each category of the MR findings according to the different groups of the KT-2000 measurements were 0.9180 for the MR signal intensity, 1.0000 for sharpness, 0.5038 for straightness and 0.2950 for thickness of the ACL. The MR findings were not significantly different between the different KT-2000 groups.
MR imaging itself is not a reliable examination to predict stability of the ACL rupture outcome, even when the MR images show an intact appearance of the ACL.
本研究旨在评估磁共振成像(MR)在预测前交叉韧带(ACL)撕裂后韧带连续性完全恢复时其稳定性的可靠性。
本研究纳入了20例膝关节损伤患者(13例男性,7例女性;年龄范围20 - 54岁)。纳入标准为有急性创伤史、初次就诊时体格检查及MR成像均诊断为ACL撕裂、接受保守治疗、随访(FU)MR图像显示韧带连续性完全恢复以及可获得KT - 2000测量值。两名放射科医生共同工作,使用三分制对MR表现的信号强度、清晰度、笔直度和愈合韧带厚度进行分级。根据KT - 2000测量值将ACL功能不全分为三组。采用Cochran - Mantel - Haenszel检验分析MR表现分级与ACL功能不全程度之间的统计学相关性(p < 0.05)。
根据KT - 2000测量的不同组,MR表现各分类的p值分别为:ACL的MR信号强度为0.9180,清晰度为1.0000,笔直度为0.5038,厚度为0.2950。不同KT - 2000组之间的MR表现无显著差异。
即使MR图像显示ACL外观完整,MR成像本身也不是预测ACL断裂预后稳定性的可靠检查。