Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
Clin Radiol. 2011 Mar;66(3):269-74. doi: 10.1016/j.crad.2010.11.003. Epub 2011 Jan 6.
To evaluate the clinical significance of the intra-substance longitudinal split of the posterior cruciate ligament (LS-PCL) and to evaluate its potential clinical significance on MRI.
The databases of two centres were searched for LS-PCL, 6917 knee magnetic resonance imaging (MRI) examinations undertaken were retrospectively reviewed. LS-PCL was defined as increased signal intensity in a PCL in the longitudinal direction, but with an intact ligament outer surface on MRI. Twelve patients were enrolled in this study. Available arthroscopic results, degree of posterior knee instability, and changes in MRI findings, or the degree of instability during follow-up (FU), were reviewed from the patients medical records and via their MRI images. MRI images were reviewed by two musculoskeletal radiologists in consensus for presence and location of LS-PCL and any combined injuries: menisci lesions, ligament injuries, and bone marrow changes.
Seven of 12 patients (58.3%) had morphological or functional evidence of PCL injury or insufficiency according to the change of posterior instability on FU stress testing (n=3), insufficiency during arthroscopy (n=2), or decreased extent and altered shape of the PCL split on the FU MRI (n=3). One patient revealed both change of posterior instability on FU stress testing and insufficiency during arthroscopy. Combined injuries were revealed in seven patients. Five patients had isolated LS-PCL: two patients underwent arthroscopic PCL reconstructions; and another three patients revealed knee instability on stress testing.
Although LS-PCL has not been described before, it can be a type of partial tear of the PCL, which causes PCL insufficiency.
评估后交叉韧带（PCL）内部分叉的临床意义，并评估其在 MRI 上的潜在临床意义。
在两个中心的数据库中搜索 LS-PCL，回顾性分析了 6917 例膝关节磁共振成像（MRI）检查。LS-PCL 定义为 PCL 在纵向方向上的信号强度增加，但在 MRI 上韧带外表面完整。本研究纳入 12 例患者。从患者的病历和 MRI 图像中查阅了现有的关节镜结果、后膝不稳定程度以及 MRI 发现的变化或随访（FU）期间的不稳定程度。两名肌肉骨骼放射科医生对 MRI 图像进行了共识评估，以确定 LS-PCL 的存在和位置以及任何合并损伤：半月板损伤、韧带损伤和骨髓变化。
根据 FU 应激发试中后不稳定的变化（n=3）、关节镜下不稳定性（n=2）或 FU MRI 上 PCL 分裂程度和形状的改变（n=3），12 例患者中有 7 例（58.3%）存在 PCL 损伤或不稳定性的形态或功能证据。1 例患者同时存在 FU 应激发试中后不稳定的改变和关节镜下不稳定性。在 7 例患者中发现了合并损伤。5 例患者存在孤立性 LS-PCL：2 例患者接受了关节镜下 PCL 重建；另外 3 例患者在应激发试中出现膝关节不稳定。
虽然 LS-PCL 以前没有描述过，但它可能是 PCL 的部分撕裂类型，导致 PCL 不稳定性。
