Department of Orthopaedic Surgery, Japan Community Health Care Organization Gunma Central Hospital, Maebashi, Gunma, Japan.
Department of Orthopaedic Surgery, Japan Community Health Care Organization Gunma Central Hospital, Maebashi, Gunma, Japan.
Arthroscopy. 2018 May;34(5):1631-1637. doi: 10.1016/j.arthro.2017.12.022. Epub 2018 Feb 15.
To prospectively evaluate the sensitivity and specificity of magnetic resonance imaging (MRI) for diagnosing ramp lesions, to compare them between 1.5- and 3-T MRI, and to evaluate whether bone contusion of the posterior lip of the medial tibial plateau was associated with ramp lesions.
For 155 knees that underwent primary ACL reconstruction, we prospectively examined for ramp lesions and medial meniscal body tears on MRI. MRI diagnosis of ramp lesions required high signal irregularity of the capsular margin or separation in the meniscocapsular junction of the medial meniscus posterior horn on sagittal images. Bone contusion of the posterior lip of the medial tibial plateau was verified in 105 knees with MRI performed within 6 weeks after injury. All ramp lesions were identified by transcondylar observation during surgery. The sensitivity and specificity of MRI for ramp lesions and body tears were measured. Furthermore, we evaluated whether bone contusion of the medial tibial plateau was associated with ramp lesions. The χ-square test was used for statistical analysis.
During surgery, ramp lesions were observed in 46 knees and medial meniscal body tears were seen in 35 knees. The sensitivity of MRI for ramp lesions was 71.7% and specificity was 90.5%. The sensitivity for ramp lesions was significantly lower than that for meniscal body tears (94.3%) (P = .01). The sensitivity of 3-T MRI (83.3%) was superior to that of 1.5-T MRI (67.6%), but not significantly different. The incidence of bone contusions was not significantly different among ramp lesions (38.5%), body tears (40.0%), or no tears (30.5%).
The sensitivity of MRI for diagnosing ramp lesions was significantly lower than that for medial meniscal body tears. Bone contusion of the posterior lip of the medial tibial plateau on MRI was not associated with ramp lesions.
Level III, comparative trial.
前瞻性评估磁共振成像（MRI）诊断斜坡病变的敏感性和特异性，比较 1.5-T 和 3-T MRI 之间的差异，并评估内侧胫骨平台后唇骨挫伤是否与斜坡病变有关。
对 155 例接受初次前交叉韧带重建的膝关节进行前瞻性 MRI 检查，以评估斜坡病变和内侧半月板体部撕裂。MRI 诊断斜坡病变需要在矢状图像上显示内侧半月板后角的关节囊缘或半月板关节囊交界处出现高信号不规则或分离。在受伤后 6 周内进行 MRI 检查的 105 例膝关节中验证了内侧胫骨平台后唇的骨挫伤。所有斜坡病变均通过髁间观察在手术中确定。测量 MRI 对斜坡病变和体部撕裂的敏感性和特异性。此外，我们评估了内侧胫骨平台的骨挫伤是否与斜坡病变有关。采用卡方检验进行统计学分析。
手术中发现 46 例膝关节存在斜坡病变，35 例膝关节存在内侧半月板体部撕裂。MRI 诊断斜坡病变的敏感性为 71.7%，特异性为 90.5%。MRI 诊断斜坡病变的敏感性明显低于内侧半月板体部撕裂（94.3%）（P=0.01）。3-T MRI 的敏感性（83.3%）优于 1.5-T MRI（67.6%），但差异无统计学意义。斜坡病变（38.5%）、体部撕裂（40.0%）或无撕裂（30.5%）之间的骨挫伤发生率无显著差异。
MRI 诊断斜坡病变的敏感性明显低于内侧半月板体部撕裂。MRI 上内侧胫骨平台后唇的骨挫伤与斜坡病变无关。
III 级，比较试验。
