Pricca P, Cecchini A, Vecchioni G, Mariani P M, Tansini A, Ferrario A
Servizio di Radiodiagnostica, IRCCS, Policlinico S. Matteo, Pavia.
Radiol Med. 1988 May;75(5):486-96.
The high incidence of cruciate ligament injuries as a result of acute knee trauma with hemarthrosis and abuse of diagnostic arthroscopies call for a suitable radiological imaging of the central pivot. Computed Arthrotomography (CAT) was used to examine the knee joint in 20 cases of clinically suspected chronic cruciate ligament injury. The images were correlated with arthroscopic and/or arthrotomic findings. Thirteen lesions of the anterior cruciate ligament (ACL) (65%) were found, plus 1 lesion of the posterior cruciate ligament (PCL) (5%), 2 associated lesions of ACL + PCL (10%), and 4 normal cases. Confirmation of pathology was available in all cases but one by arthroscopy and/or surgery. The central pivot diseases were classified as follows: absence, detachment, partial or complete tear. CAT findings of cruciate ligament injuries are emphasized and the role of the technique as compared to arthroscopy is discussed. CAT is useful in 3-D evaluation of central pivot and detection of different cruciate ligament injuries, with high sensitivity-specificity for ACL and high specificity-moderate sensitivity for PCL. In the evaluation of the chronic unstable knee, CAT is highly accurate and gives the surgeon useful information towards the planning of therapeutic procedures. CAT is almost non-invasive, well tolerated and easy to perform in out-patients, which make it a first-choice procedure in the screening of chronic ligament injuries.
急性膝关节创伤伴关节积血导致的交叉韧带损伤高发，以及诊断性关节镜检查的滥用，都需要对中心枢轴进行合适的放射学成像检查。对20例临床怀疑为慢性交叉韧带损伤的患者，采用计算机关节断层扫描（CAT）检查膝关节。将图像与关节镜检查和/或关节切开术的结果进行对比。共发现13例前交叉韧带（ACL）损伤（65%），1例后交叉韧带（PCL）损伤（5%），2例ACL + PCL联合损伤（10%），4例正常病例。除1例外，所有病例均通过关节镜检查和/或手术确诊病理情况。中心枢轴疾病分类如下：缺如、分离、部分或完全撕裂。强调了交叉韧带损伤的CAT检查结果，并讨论了该技术与关节镜检查相比的作用。CAT对中心枢轴的三维评估及不同交叉韧带损伤的检测很有用，对ACL具有高敏感性 - 特异性，对PCL具有高特异性 - 中等敏感性。在评估慢性不稳定膝关节时，CAT高度准确，能为外科医生制定治疗方案提供有用信息。CAT几乎无创，耐受性好，便于门诊操作，这使其成为慢性韧带损伤筛查的首选检查方法。
