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前交叉韧带损伤时外侧半月板后根撕裂可以通过 MRI 特定征象的联合而非单独检测到。

Lateral meniscus posterior root tear in anterior cruciate ligament injury can be detected using MRI-specific signs in combination but not individually.

机构信息

Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2020 Oct;28(10):3094-3100. doi: 10.1007/s00167-019-05599-9. Epub 2019 Jun 28.

Abstract

PURPOSE

The purpose of this study was to evaluate (1) the diagnostic value of using single and multiple magnetic resonance imaging (MRI) findings for lateral meniscus posterior root tear (LMPRT) detection in anterior cruciate ligament (ACL) injury and (2) the influence of time from ACL injury to MRI assessment on LMPRT detection. Finally, we investigated the relationship between LMPRT and bone bruising.

METHODS

In all, 231 knees with ACL injury, 32 with LMPRT, were retrospectively assessed. Cases were evaluated for LMPRT based on the cleft, ghost, and truncated triangle signs, used individually or in combination. To assess the influence of the timing of the MRI assessment on LMPRT detection, we also evaluated the overall sensitivity, specificity, and accuracy in cases in which MRI was performed within 2 weeks of injury. The number of condyles with bone bruising was assessed and then compared between patients with and without LMPRT.

RESULTS

Although the sensitivity and specificity of the three signs individually were 34.4-65.6% and 94.0-97.0%, when at least one of these signs was positive, the sensitivity and specificity were 84.4% and 90.5%, respectively. However, the diagnostic value of each sign when MRI was performed within 2 weeks of injury was lower than the overall value. There was a significant difference in the number of condyles with bone bruising between the LMPRT (3 ± 1) and non-LMPRT (2 ± 2) groups.

CONCLUSIONS

Although the sensitivity of each sign for LMPRT was low, LMPRT could be detected adequately if these signs were used in combination. Therefore, surgeons should detect LMPRT using these three signs in combination, not individually.

LEVEL OF EVIDENCE

IV.

摘要

目的

本研究旨在评估:(1) 在 ACL 损伤中,使用单一和多种磁共振成像 (MRI) 发现检测外侧半月板后根撕裂 (LMPRT) 的诊断价值;(2) MRI 评估与 ACL 损伤之间的时间间隔对 LMPRT 检测的影响。最后,我们还研究了 LMPRT 与骨挫伤之间的关系。

方法

共回顾性评估了 231 例 ACL 损伤患者,其中 32 例伴 LMPRT。根据裂隙、幽灵和截断三角形征象单独或联合评估 LMPRT。为了评估 MRI 评估时间对 LMPRT 检测的影响,我们还评估了 MRI 检查在损伤后 2 周内进行时的整体敏感性、特异性和准确性。评估有和无 LMPRT 的患者的骨挫伤的髁骨数量,并进行比较。

结果

虽然三个征象单独的敏感性和特异性分别为 34.4-65.6%和 94.0-97.0%,但当至少有一个征象阳性时,敏感性和特异性分别为 84.4%和 90.5%。然而,MRI 检查在损伤后 2 周内进行时,每个征象的诊断价值均低于整体价值。LMPRT(3 ± 1)组和非 LMPRT(2 ± 2)组的骨挫伤髁骨数量存在显著差异。

结论

尽管每个征象对 LMPRT 的敏感性均较低,但如果联合使用这些征象,则可以充分检测到 LMPRT。因此,外科医生应使用这三个征象联合而不是单独来检测 LMPRT。

证据等级

IV。

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