Kosaka Masahiro, Nakase Junsuke, Toratani Tatsuhiro, Ohashi Yoshinori, Kitaoka Katsuhiko, Yamada Hiroshi, Komura Koji, Nakamura Shinji, Tsuchiya Hiroyuki
Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
Knee. 2014 Jan;21(1):54-7. doi: 10.1016/j.knee.2013.04.016. Epub 2013 May 23.
The purpose of this study was to investigate the efficacy of additional oblique magnetic resonance imaging (MRI) for the diagnosis of anterior cruciate ligament (ACL) tear and evaluation of ACL remnant tissue.
We retrospectively reviewed the records of 54 knees. Three independent readers evaluated the MR images by the use of three methods: orthogonal sagittal images only (method A); orthogonal sagittal and additional oblique sagittal images (method B); and orthogonal sagittal and oblique coronal images (method C). The sensitivity, specificity, and accuracy for the diagnosis of an ACL tear and the detection of the condition of the ACL remnant tissue by the use of each method were calculated in comparison with arthroscopic findings as the reference standard.
The arthroscopic records revealed 27 knees with intact ACLs and 27 with torn ACLs. Among the 27 knees with torn ACLs, 9 did not have continuous remnant tissue and 18 had certain remnant tissue attached to the femur or the posterior cruciate ligament. The specificities and accuracies of methods B and C for diagnosing an ACL tear were higher than those for method A. The sensitivity, specificity, and accuracy of method C for the detection of ACL remnant tissue were higher than those for method A and B.
Additional use of oblique MRI improved the accuracy of diagnosis of ACL tear and showed a reasonable level of efficacy in detecting ACL remnant tissue.
Level IV (case series).
本研究的目的是探讨额外的斜位磁共振成像（MRI）在诊断前交叉韧带（ACL）撕裂及评估ACL残余组织方面的有效性。
我们回顾性分析了54例膝关节的记录。三位独立阅片者采用三种方法评估MR图像：仅使用正交矢状位图像（方法A）；正交矢状位图像及额外的斜矢状位图像（方法B）；正交矢状位图像及斜冠状位图像（方法C）。以关节镜检查结果作为参考标准，计算每种方法诊断ACL撕裂及检测ACL残余组织状况的敏感性、特异性和准确性。
关节镜检查记录显示，27例膝关节的ACL完整，27例ACL撕裂。在27例ACL撕裂的膝关节中，9例没有连续的残余组织，18例有附着于股骨或后交叉韧带的一定残余组织。方法B和C诊断ACL撕裂的特异性和准确性高于方法A。方法C检测ACL残余组织的敏感性、特异性和准确性高于方法A和B。
额外使用斜位MRI提高了ACL撕裂诊断的准确性，并在检测ACL残余组织方面显示出合理的有效性水平。
IV级（病例系列）。
