Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland.
Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Knee Surg Sports Traumatol Arthrosc. 2023 Sep;31(9):3799-3805. doi: 10.1007/s00167-023-07343-w. Epub 2023 Feb 23.
The anterolateral ligament (ALL) is an important structure for controlling anterolateral rotatory stability of the knee. Its assessment, however, is difficult using standardized MRI images. The goal of this study was to assess the reliability of judging the integrity of the ALL on multi-planar reformatted (MPR) MRI images and on standard coronal reformatted (SCR) MRI images in knees with an anterior cruciate ligament (ACL) rupture.
Forty-eight patients (14 females, 34 males, 30 ± 6 years (mean age ± standard deviation)) with acute ACL ruptures (< 2 weeks) and no additional knee injuries (except segond fractures) were included. Images were assessed by two independent raters twice with at least a 2-week interval in between. The assessment was first performed on SCR images and thereafter on MPR images. Images were judged for assessability of the ALL and then the integrity of the ALL was rated.
Depending on rater and read, the ALL was judged as "torn" in between 5 (10.4%) and 11 (22.9%) patients out of 48 patients on SCR images. On MRP images, the ALL was judged as "torn" in between 5 (10.4%) and 6 (12.5%) patients out of 48 patients, depending on rater and read. Inter- and intra-rater reliability for the assessment of the ALL using MPR images was "substantial" to "almost perfect". Inter- and intra-rater reliability for the assessment using SCR was "fair" to "substantial".
MPR images should be used when assessing the integrity of the ALL. Assessment quality is independent of patient positioning during MRI acquisition and the ALL can be displayed in full length on one image.
Level III.
前外侧韧带（ALL）是控制膝关节前外侧旋转稳定性的重要结构。然而，使用标准化 MRI 图像评估其完整性具有一定难度。本研究旨在评估在 ACL 断裂的膝关节中，使用多平面重建（MPR）MRI 图像和标准冠状面重建（SCR）图像评估 ALL 完整性的可靠性。
本研究纳入 48 例急性 ACL 断裂患者（14 名女性，34 名男性，平均年龄 30±6 岁），且这些患者均无其他膝关节损伤（除 segond 骨折）。由两名独立的评估者在至少 2 周的间隔内对 48 例患者进行两次评估。首先在 SCR 图像上进行评估，然后在 MPR 图像上进行评估。评估 ALL 的可评估性，然后对 ALL 的完整性进行评分。
在 SCR 图像上，48 例患者中，有 5 例（10.4%）和 11 例（22.9%）患者的 ALL 被评估者和观察者分别判断为“撕裂”。在 MPR 图像上，48 例患者中，有 5 例（10.4%）和 6 例（12.5%）患者的 ALL 被评估者和观察者分别判断为“撕裂”。使用 MPR 图像评估 ALL 的组内和组间可靠性为“高度可靠”到“几乎完美”。使用 SCR 进行评估的组内和组间可靠性为“中等”到“高度可靠”。
评估 ALL 完整性时应使用 MPR 图像。评估质量与 MRI 采集过程中的患者体位无关，并且可以在一张图像上完整显示 ALL。
III 级。
