Mandelbaum B R, Finerman G A, Reicher M A, Hartzman S, Bassett L W, Gold R H, Rauschning W, Dorey F
Am J Sports Med. 1986 Sep-Oct;14(5):361-70. doi: 10.1177/036354658601400503.
Traumatic injury to the knee remains a diagnostic and therapeutic challenge. Magnetic resonance imaging (MRI) has been applied to musculoskeletal pathoanatomy and has been shown to be an effective tool for definition and characterization of knee pathology. A systematic approach is taken to establish anatomical and pathoanatomical correlations, as well as the role of MRI in the management of knee injuries. Imaging was performed at the UCLA Medical Center using a permanent magnet system and a combination of solenoidal surface coils and thin-section, high-resolution scanning techniques. Images depict structural anatomical and spatial details of the knee that correlate well with corresponding cadaveric cryosections. To determine pathoanatomical correlations and the efficacy of MRI, 105 patients with preoperative diagnoses of meniscal tears, anterior and posterior cruciate ligament tears, tibial plateau fracture, and patella and quadriceps injuries were imaged. Results indicated that for the medial meniscus MRI demonstrated a 95.7% sensitivity, 81.8% specificity, 90% accuracy, 88.2% positive predictive value (PPV), and 93.1% negative predictive value (NPV). Imaging of the lateral meniscus demonstrated a 75% sensitivity, 95% specificity, 91% accuracy, 80% PPV, and 94% NPV. MRI of the ACL revealed 100% sensitivity, specificity, accuracy, positive and negative predictive values. MRI is a noninvasive tool which uses no ionizing radiation and can accurately define and characterize anatomy and pathoanatomy. This study indicates that MRI in conjunction with clinical evaluation can contribute to treatment decision-making processes and assist in preoperative planning. An algorithm demonstrating the potential clinical use of MRI is presented.
膝关节创伤性损伤仍然是一个诊断和治疗难题。磁共振成像（MRI）已应用于肌肉骨骼病理解剖学，并且已被证明是定义和表征膝关节病理的有效工具。我们采用系统方法来建立解剖学和病理解剖学的相关性，以及MRI在膝关节损伤管理中的作用。成像在加州大学洛杉矶分校医学中心使用永磁系统以及螺线管表面线圈和薄层高分辨率扫描技术进行。图像描绘了膝关节的结构解剖和空间细节，与相应的尸体冷冻切片相关性良好。为了确定病理解剖学相关性和MRI的有效性，对105例术前诊断为半月板撕裂、前后交叉韧带撕裂、胫骨平台骨折以及髌骨和股四头肌损伤的患者进行了成像。结果表明，对于内侧半月板，MRI显示出95.7%的敏感性、81.8%的特异性、90%的准确性、88.2%的阳性预测值（PPV）和93.1%的阴性预测值（NPV）。外侧半月板成像显示出75%的敏感性、95%的特异性、91%的准确性、80%的PPV和94%的NPV。ACL的MRI显示出100%的敏感性、特异性、准确性、阳性和阴性预测值。MRI是一种无创工具，不使用电离辐射，能够准确地定义和表征解剖结构和病理解剖结构。本研究表明，MRI结合临床评估有助于治疗决策过程并辅助术前规划。本文还展示了一种说明MRI潜在临床应用的算法。
