Department of Orthopaedic Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
Department of Orthopaedic Surgery, Kosei Hospital, Okayama, Japan.
Eur J Orthop Surg Traumatol. 2022 Feb;32(2):301-306. doi: 10.1007/s00590-021-02968-4. Epub 2021 Apr 12.
Medial meniscus (MM) posterior root tear (PRT) results in joint overloading and degenerative changes in the knee, and pullout repair is recommended to prevent subsequent osteoarthritis. Diagnosing MMPRT is sometimes difficult, especially in the case of an incomplete tear. A posterior shiny-corner lesion (PSCL) is reported to be useful for diagnosis, although the association between MMPRT and PSCL is unknown. This study aimed to investigate the properties of PSCL, such as the location, volume, and duration from injury to the time of MRI (duration). We hypothesized that PSCL is observed in the early phase after the MMPRT onset.
T2-weighted fat-suppression magnetic resonance imaging (MRI) was obtained from 55 patients with MMPRT preoperatively. The prevalence of the PSCL; giraffe neck, cleft, and ghost signs; severe MM extrusion (> 3 mm); and the PSCL volume were evaluated. The PSCL lesion elliptical volume (mm) was calculated by measuring the anteroposterior, transverse, and craniocaudal dimensions.
PSCL was observed in 34 (62%) cases. The mean volume of the PSCL was 102.0 mm. A significantly shorter duration was observed in the PSCL-positive group (5.6 weeks) than that in the PSCL-negative group (40.9 weeks, P < 0.01), although no significant correlation was observed between the PSCL volume and duration. The sensitivity for the MMPRT was 90.5% when the cut-off duration value was 3 weeks and 81.8% when the cut-off value was 8 weeks.
MRI examination may detect PSCL if it is performed early following MMPRT onset. Detecting PSCL may be useful in diagnosing MMPRT with high sensitivity.
内侧半月板(MM)后根部撕裂(PRT)会导致膝关节过度负荷和退行性改变,建议进行抽出修复以预防后续的骨关节炎。诊断 MMPRT 有时较为困难,尤其是不完全撕裂的情况。据报道,后角亮线征(PSCL)有助于诊断,但 MMPRT 与 PSCL 之间的关联尚不清楚。本研究旨在探讨 PSCL 的特征,如位置、体积和从损伤到 MRI 时间(持续时间)。我们假设 PSCL 是在 MMPRT 发病的早期阶段观察到的。
对 55 例 MMPRT 术前患者进行 T2 加权脂肪抑制磁共振成像(MRI)检查。评估 PSCL 的发生率、长颈鹿颈、裂隙和幽灵征;严重 MM 挤出(>3mm);以及 PSCL 体积。通过测量前后、横径和颅底尺寸计算 PSCL 病变椭圆体积(mm)。
34 例(62%)患者观察到 PSCL。PSCL 的平均体积为 102.0mm。PSCL 阳性组的持续时间明显更短(5.6 周),明显短于 PSCL 阴性组(40.9 周,P<0.01),尽管 PSCL 体积与持续时间之间无显著相关性。当截断时间值为 3 周时,MMPRT 的灵敏度为 90.5%,当截断值为 8 周时,灵敏度为 81.8%。
如果在 MMPRT 发病后早期进行 MRI 检查,可能会检测到 PSCL。检测 PSCL 可能有助于以较高的灵敏度诊断 MMPRT。