De Coninck Tineke, Vanrietvelde Frederik, Seynaeve Patrick, Verdonk Peter, Verstraete Koenraad
1 Department of Radiology, Ghent University Hospital, Ghent, Belgium.
2 Department of Radiology, AZ Groeninge, Kortrijk, Belgium.
Acta Radiol. 2017 Apr;58(4):464-471. doi: 10.1177/0284185116661880. Epub 2016 Sep 30.
Background In cadaveric and arthroscopic studies different insertion locations of the anterior horn of the medial meniscus (AHMM) have been described. Purpose To investigate if the different insertion locations of the AHMM, as described in cadaveric studies, can be determined on magnetic resonance imaging (MRI). Material and Methods MR images of 100 patients without meniscal tears on MRI were retrospectively evaluated. Two observers classified the AHMM insertion based on its position relative to the anterior tibial edge and the medial tibial spine. The association between AHMM insertion and tibial plateau slope, meniscal radial displacement, and anterior intermeniscal ligament (AIL) presence was investigated. Results The AHMM inserted posterior to the anterior tibial edge in 93 knees and anterior to the tibial edge in seven knees (= type III). Of the 93 knees with AHMM insertion posterior to the anterior tibial edge, 63 inserted lateral to the medial tibial spine (= type I) and 30 medial (= type II). The AHMMs inserting anterior to the tibial edge had a significantly ( P < 0.05) steeper anterior tibial plateau slope and a significantly ( P < 0.05) higher presence of the AIL. No significant difference in radial displacement was observed between the three insertion types ( P > 0.05). A strong inter- and intra-observer agreement was observed. Conclusion Three different bony insertion locations of the AHMM, as described in cadaveric studies, could be identified on MRI. All AHMMs inserting anterior to the tibial edge displayed an AIL. Whether there is a clinical correlation with these insertion patterns remains unclear.
在尸体研究和关节镜研究中，已描述了内侧半月板前角（AHMM）的不同插入位置。目的：研究尸体研究中描述的AHMM不同插入位置是否可在磁共振成像（MRI）上确定。材料与方法：回顾性评估100例MRI上无半月板撕裂患者的MR图像。两名观察者根据AHMM相对于胫骨前缘和胫骨内侧棘的位置对其插入情况进行分类。研究AHMM插入与胫骨平台坡度、半月板径向移位和半月板间前韧带（AIL）存在之间的关联。结果：93例膝关节的AHMM插入于胫骨前缘后方，7例膝关节的AHMM插入于胫骨前缘前方（=III型）。在93例AHMM插入于胫骨前缘后方的膝关节中，63例插入于胫骨内侧棘外侧（=I型），30例插入于内侧（=II型）。插入于胫骨前缘前方的AHMM具有显著更陡的胫骨前平台坡度（P < 0.05）和显著更高的AIL存在率（P < 0.05）。三种插入类型之间在径向移位方面未观察到显著差异（P > 0.05）。观察者间和观察者内一致性较强。结论：尸体研究中描述的AHMM的三种不同骨插入位置可在MRI上识别。所有插入于胫骨前缘前方的AHMM均显示有AIL。这些插入模式是否存在临床相关性尚不清楚。
