前交叉韧带撕裂伴相关损伤患者中前外侧韧带撕裂和斜坡病变的频率：一项回顾性 MRI 分析。
Frequency of anterolateral ligament tears and ramp lesions in patients with anterior cruciate ligament tears and associated injuries indicative for these lesions-a retrospective MRI analysis.
机构信息
Division of General Radiology, Department of Radiology, Medical University of Graz, Graz, Austria.
Department of Trauma Surgery, Klinik Diakonissen Schladming, Schladming, Austria.
出版信息
Eur Radiol. 2023 Jul;33(7):4833-4841. doi: 10.1007/s00330-023-09444-z. Epub 2023 Feb 18.
OBJECTIVES
To assess the frequency of anterolateral ligament (ALL) tears and ramp lesions (RL) detected with MRI in patients with anterior cruciate ligament (ACL) tears and to describe associated injuries indicative for these lesions.
METHODS
In this retrospective study, 164 patients with surgically verified ACL tears were included. Preoperative MRI scans were reviewed for ALL tears and different types of RL. All coexisting meniscal tears, tears of the medial (MCL) and lateral collateral band (LCL), and posterior-medial tibial bone marrow edema (BME) were recorded. The frequency of ALL tears and RL was assessed and coexisting injuries were correlated using Pearson's chi-square test. A p < 0.05 was defined as statistically significant. In cases of multiple testing, Bonferroni's correction was applied.
RESULTS
ALL tears and RL combined were detected in 28 patients (17.1%), ALL tears in 48 patients (29.3%), and RL in 54 patients (32.9%) which were significantly associated to each other. ALL tears were significantly associated with tears of the posterior horn of the lateral meniscus (PHLM), BME, and with tears of the LCL and MCL. RL were significantly associated with tears of the posterior horn of the medial (PHMM) and PHLM, with BME, and with tears of the LCL.
CONCLUSIONS
ACL tears are associated with RL or ALL tears in about one-third of cases and with both lesions combined in about one-fifth of cases. ALL tears and RL are significantly associated with additional posttraumatic injuries, which can thus be indicative of these lesions.
KEY POINTS
• ACL tears were associated with ramp lesions or ALL tears in about one-third of the cases. • Ramp lesions and ALL tears were significantly associated with each other, tear in the PHLM, tear in the LCL, and BME. • ALL tears were more frequently associated with instable classified ramp lesion type 4b and type 5.
目的
评估 MRI 检测到的前交叉韧带（ACL）撕裂患者前外侧韧带（ALL）撕裂和斜坡病变（RL）的频率，并描述提示这些病变的相关损伤。
方法
在这项回顾性研究中，纳入了 164 例经手术证实的 ACL 撕裂患者。对所有患者的术前 MRI 扫描进行了检查，以评估 ALL 撕裂和不同类型的 RL。记录所有并发的半月板撕裂、内侧（MCL）和外侧副韧带（LCL）撕裂以及后内侧胫骨骨髓水肿（BME）。评估 ALL 撕裂和 RL 的频率，并使用 Pearson 卡方检验对相关损伤进行相关性分析。p<0.05 定义为具有统计学意义。在多次检验的情况下，应用 Bonferroni 校正。
结果
28 例（17.1%）患者同时存在 ALL 撕裂和 RL，48 例（29.3%）患者存在 ALL 撕裂，54 例（32.9%）患者存在 RL，这些均显著相关。ALL 撕裂与外侧半月板后角撕裂（PHLM）、BME 以及 LCL 和 MCL 撕裂显著相关。RL 与内侧半月板后角撕裂（PHMM）和 PHLM、BME 以及 LCL 撕裂显著相关。
结论
ACL 撕裂与 RL 或 ALL 撕裂相关的病例约占三分之一，与两种病变同时存在的病例约占五分之一。ALL 撕裂和 RL 与其他创伤后损伤显著相关，因此可以提示这些病变的存在。
关键点
• ACL 撕裂与 RL 或 ALL 撕裂相关的病例约占三分之一。• RL 和 ALL 撕裂显著相关，与 PHLM 撕裂、LCL 撕裂和 BME 相关。• ALL 撕裂与不稳定分级的 RL 类型 4b 和 5 更相关。
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