Coquart B, Le Corroller T, Laurent P E, Ollivier M, Pradel V, Champsaur P, Guenoun D
APHM, Hôpital Sainte Marguerite, 270 Boulevard de Sainte Marguerite, Marseille, 13009, France.
ISM, UMR 7287 CNRS et Aix-Marseille Université, CP 910, Avenue de Luminy, Marseille Cedex 09, 13288, France.
Surg Radiol Anat. 2016 Oct;38(8):955-62. doi: 10.1007/s00276-016-1657-2. Epub 2016 Mar 2.
A ligament of the knee has recently drawn the attention: the rediscovered anterolateral ligament (ALL) of the knee. The tibial insertion of the ALL is torn off in the Segond fracture, pathognomonic of the anterior cruciate ligament tear. The ALL originates from the lateral femoral epicondyle and has fibers inserting on the lateral meniscus. It attaches distally to the tibial plateau, midway between the tip of the fibular head and Gerdy's tubercle. The purpose of this study was to evaluate the visibility of the ALL using routine MRI (1.5T) protocol.
In the first part of our study 10 cadaveric knee joints were examined using MR imaging to evaluate the visibility of the ALL. These cadaveric knees have been dissected to assess the presence of the ALL and to evaluate the accordance between MRI and anatomic dissection. In the second part of the study, 61 knee MRI of patients were examined to evaluate the visibility of the ALL using axial and coronal DP-FS weighted sequences.
In all cadaveric knee MRI, the ALL was visualized (full visualization in 75 % and partial visualization in 25 % of the cases), with 100 % accordance between MRI and anatomic dissection. Two cadaveric knees where the ALL was not viewed were excluded of the radio-anatomic analysis. The ALL was visualized in 93.4 % (95 % CI = 84.1-98.2) of the knee MRI studies of the 61 patients included. The whole ligament was visualized in 82 % (95 % CI = 70-90.6) examinations and it was partially visualized in 11.5 % (95 % CI = 4.7-22.2).
Our results show that the ALL of the knee can be identified using routine 1.5T MR imaging, which suggest that better radiological description of this underestimated anatomical structure may be beneficial in the preoperative planning of ACL tears.
膝关节的一条韧带最近引起了关注：重新发现的膝关节前外侧韧带（ALL）。在胫骨髁间棘骨折（前交叉韧带撕裂的特征性表现）中，ALL的胫骨附着点会被撕脱。ALL起自股骨外侧髁，有纤维附着于外侧半月板。其远端附着于胫骨平台，位于腓骨头尖与Gerdy结节之间的中点。本研究的目的是使用常规MRI（1.5T）协议评估ALL的可视性。
在我们研究的第一部分，使用磁共振成像检查了10个尸体膝关节，以评估ALL的可视性。对这些尸体膝关节进行了解剖，以评估ALL的存在情况，并评估MRI与解剖学解剖之间的一致性。在研究的第二部分，对61例患者的膝关节MRI进行了检查，使用轴位和冠状位DP-FS加权序列评估ALL的可视性。
在所有尸体膝关节MRI中，ALL均可见（75%的病例完全可见，25%的病例部分可见），MRI与解剖学解剖之间的一致性为100%。未观察到ALL的两个尸体膝关节被排除在放射解剖学分析之外。在纳入的61例患者的膝关节MRI研究中，93.4%（95%CI=84.1-98.2）的病例可见ALL。82%（95%CI=70-90.6）的检查中可见整个韧带，11.5%（95%CI=4.7-22.2）的检查中可见部分韧带。
我们的结果表明，使用常规1.5T MR成像可以识别膝关节的ALL，这表明对这种被低估的解剖结构进行更好的影像学描述可能有助于前交叉韧带撕裂的术前规划。
