Zhao Mengou, Zhou Ying, Chang Junru, Hu Jie, Liu Huixia, Wang Shuhang, Si Donglei, Yuan Yaqin, Li Haiyan
Department of Computed Tomography and Magnetic Resonance, Shijiazhuang Third Hospital, Shijiazhuang, China.
Department of Gynaecology, Shijiazhuang Third Hospital, Shijiazhuang, China.
Ann Transl Med. 2020 Dec;8(24):1657. doi: 10.21037/atm-20-7391.
Anterior cruciate ligament (ACL) injury can cause damage to the meniscus and articular cartilage, and may even lead to osteoarthritis. This study aimed to analyze the accuracy and feasibility of magnetic resonance imaging (MRI) imaging signs in the diagnosis of knee joint ACL injury.
A total of 78 patients admitted to our hospital from June 2018 to October 2019 with highly suspected ACL injury were selected for this prospective study. We used MRI and arthroscopy to diagnose the ACL injuries, and the results of MRI and arthroscopy, as well as the value of MRI in diagnosing ACL injury, were compared.
Among the 78 participants, 66 cases were diagnosed with ACL injury (28 with complete tear, 38 with partial tear), and 12 were normal according to arthroscopy. Among the 66 cases with ACL injury, 63 (95.45%) were confirmed by MRI detection. The sensitivity, specificity, and accuracy of MRI in the diagnosis of ACL injury were 95.45% (63/66), 91.67%, and 94.87%, respectively. The accuracy of MRI in the diagnosis of complete and partial tears were 92.86% and 94.74%, respectively. Among the four direct MRI signs of ACL injury, the differences in interruption of ACL continuity, thickening and edema, and abnormal walking were statistically significant (P<0.05). Among the 8 indirect MRI signs, all showed high specificity and low sensitivity, and which the specificity of posterior cruciate ligament index, Notch sign, meniscus exposure sign of posterior ankle, and lateral collateral ligament monolayer display showed higher specificity (P<0.05).
Examination with MRI offers high accuracy in the diagnosis of ACL injury, and has good consistency with arthroscopic diagnosis, which can provide reliable guidance for the selection and formulation of clinical surgery plans, and might be used as the first choice for the non-traumatic diagnosis of ACL injury.
前交叉韧带（ACL）损伤可导致半月板和关节软骨损伤，甚至可能引发骨关节炎。本研究旨在分析磁共振成像（MRI）影像征象在膝关节ACL损伤诊断中的准确性和可行性。
选取2018年6月至2019年10月我院收治的78例高度怀疑ACL损伤的患者进行这项前瞻性研究。我们采用MRI和关节镜检查来诊断ACL损伤，并比较MRI与关节镜检查的结果以及MRI在诊断ACL损伤中的价值。
78例参与者中，关节镜检查显示66例诊断为ACL损伤（28例完全撕裂，38例部分撕裂），12例正常。在66例ACL损伤病例中，MRI检测确诊63例（95.45%）。MRI诊断ACL损伤的敏感性、特异性和准确性分别为95.45%（63/66）、91.67%和94.87%。MRI诊断完全撕裂和部分撕裂的准确性分别为92.86%和94.74%。在ACL损伤的四个直接MRI征象中，ACL连续性中断、增厚和水肿以及走行异常的差异具有统计学意义（P<0.05）。在8个间接MRI征象中，均显示出高特异性和低敏感性，其中后交叉韧带指数、Notch征、后踝半月板暴露征和外侧副韧带单层显示的特异性较高（P<0.05）。
MRI检查在ACL损伤诊断中具有较高的准确性，与关节镜诊断具有良好的一致性，可为临床手术方案的选择和制定提供可靠指导，可能作为ACL损伤无创诊断的首选方法。
