Kim Hee Kyung, Laor Tal, Shire Norah J, Bean Judy A, Dardzinski Bernard J
Department of Radiology and Imaging Research Center and Center for Epidemiology and Biostatistics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229-3039, USA.
Radiology. 2008 Jun;247(3):826-35. doi: 10.1148/radiol.2473071097.
To retrospectively compile normative data on the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL) in children and young adults.
This HIPAA-compliant study was approved by the institutional review board. The requirement for informed patient consent was waived. Knee MR imaging examinations (n = 324) were performed in 168 female and 156 male patients (age range, 1-20 years) at 1.5 and 3.0 T, and the image findings were retrospectively evaluated by two blinded radiologists separately. One radiologist reviewed all images twice at two sessions, and the other reviewed a random subset of half the images during one session. Discordant assessments were resolved by consensus. The sagittal and coronal ACL-tibial angles, Blumensaat line-ACL angle, angle of inclination of the intercondylar roof, ACL-tibial insertion site, and PCL angle and horizontal component-to-vertical component ratio were measured. The associations between these values and patient age, patient sex, and physeal patency were assessed. Linear and fractional polynomial regression models were used to evaluate the relationships between measurements.
ACL-tibial angles became significantly larger (P < .001) with increasing age during skeletal growth and approached adult values after physeal fusion. The Blumensaat line-ACL angle was constant after age 2 years. The inclination of intercondylar roof angle became significantly smaller (P < .001) with increasing age. The ACL-tibial insertion site was constant at the junction of the anterior and middle thirds of the tibial anteroposterior diameter and was not age dependent. The PCL angle became significantly larger (P < .001) with advancing age and in children who had fused as opposed to open physes. The horizontal component-to-vertical component PCL ratio became significantly smaller with advancing age (P < .001).
During growth, angulation of the ACL is age dependent. The angle and morphologic changes of the PCL are age dependent throughout skeletal maturation.
回顾性收集儿童和青年前交叉韧带（ACL）及后交叉韧带（PCL）的标准数据。
本符合健康保险流通与责任法案（HIPAA）的研究经机构审查委员会批准。无需患者知情同意。对168名女性和156名男性患者（年龄范围1 - 20岁）在1.5T和3.0T条件下进行膝关节磁共振成像检查（n = 324），影像结果由两名不知情的放射科医生分别进行回顾性评估。一名放射科医生在两个时间段对所有图像各回顾两次，另一名放射科医生在一个时间段内随机回顾一半图像的子集。通过达成共识解决不一致的评估。测量矢状面和冠状面的ACL - 胫骨角、布卢姆萨线 - ACL角、髁间顶倾斜角、ACL - 胫骨附着点以及PCL角和水平分量与垂直分量之比。评估这些值与患者年龄、患者性别以及骨骺通畅情况之间的关联。使用线性和分数多项式回归模型评估测量值之间的关系。
在骨骼生长过程中，ACL - 胫骨角随年龄增长显著增大（P <.001），骨骺融合后接近成人值。2岁以后布卢姆萨线 - ACL角保持恒定。髁间顶倾斜角随年龄增长显著减小（P <.001）。ACL - 胫骨附着点恒定于胫骨前后径前中三分之一交界处，与年龄无关。PCL角随年龄增长显著增大（P <.001），在骨骺已融合的儿童中比骨骺未闭合的儿童更大。PCL水平分量与垂直分量之比随年龄增长显著减小（P <.001）。
在生长过程中，ACL的角度与年龄相关。在整个骨骼成熟过程中，PCL的角度和形态变化与年龄相关。
