Xu Bin, Zhang Hanyuan, Li Bo, Wang Weichao
Department of Sports Medicine and Arthroscopic Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
Medicine (Baltimore). 2018 Mar;97(10):e0001. doi: 10.1097/MD.0000000000010001.
To compare the direct and indirect signs on magnetic resonance imaging (MRI) for patients with acute and chronic anterior cruciate ligament (ACL) tears.Two independent reviewers retrospectively evaluated the MRI images of 377 patients with ACL tear confirmed by arthroscopy. There were 160 cases with acute ACL tear and 217 cases with chronic ACL tear. Direct signs in T1- and T2-wighted images and indirect signs including meniscus injury, the collateral ligament injury, cartilage damage or osteoarthritis, kissing contusion, Notch syndrome and abnormal posterior cruciate ligament (PCL) and other indirect signs were evaluated.For direct signs on MRI, no significant differences were found between the acute and chronic ACL tear in prevalence of focal high signal in substance of T2-wighted images and in that of abnormal orientation, discontinuity, thickening, or focal masses in substance of T1-weighted images. However, higher incidence of diffuse high signal of T2-weighted images for acute ACL tear was found compared to that for chronic ACL tear (55.0% vs 3.2%). For indirect signs on MRI, the collateral ligament tear (20.6% vs 2.3%), cartilage damage or osteoarthritis (14.4% vs 25.8%), kissing contusion (57.4% vs 0%), Notch syndrome (28.1% vs 3.2%), and bowing type of PCL (33.1% vs 47.0%) can differentiate the acute from chronic ACL tear.Some direct and indirect signs on MRI are closely related to the acute and chronic ACL tear.
比较急性和慢性前交叉韧带（ACL）撕裂患者磁共振成像（MRI）的直接和间接征象。两位独立的评估者回顾性评估了377例经关节镜证实为ACL撕裂患者的MRI图像。其中急性ACL撕裂160例，慢性ACL撕裂217例。评估了T1加权和T2加权图像中的直接征象以及包括半月板损伤、侧副韧带损伤、软骨损伤或骨关节炎、撞击伤、Notch综合征以及后交叉韧带（PCL）异常等间接征象。对于MRI上的直接征象，急性和慢性ACL撕裂在T2加权图像实质内局灶性高信号的发生率以及T1加权图像实质内异常走行、连续性中断、增厚或局灶性肿块的发生率方面未发现显著差异。然而，与慢性ACL撕裂相比，急性ACL撕裂的T2加权图像弥漫性高信号发生率更高（55.0%对3.2%）。对于MRI上的间接征象，侧副韧带撕裂（20.6%对2.3%）、软骨损伤或骨关节炎（14.4%对25.8%）、撞击伤（57.4%对0%）、Notch综合征（28.1%对3.2%）以及PCL的弓状改变（33.1%对47.0%）可区分急性和慢性ACL撕裂。MRI上的一些直接和间接征象与急性和慢性ACL撕裂密切相关。
