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MRI 评估膝关节后内侧角:后角内侧半月板撕裂与后斜韧带和远端半膜肌腱撕裂的关系。

MR evaluation of the posteromedial corner of the knee: association of posterior horn medial meniscus tear with posterior oblique ligament and distal semi-membranosus tendon tear.

机构信息

Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.

出版信息

Br J Radiol. 2023 Jun 1;96(1146):20220944. doi: 10.1259/bjr.20220944. Epub 2023 Mar 16.

DOI:10.1259/bjr.20220944
PMID:36924261
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10230401/
Abstract

OBJECTIVE

To assess if posterior oblique ligament and distal semi-membranosus tendon tears are associated with posterior horn medial meniscus tears on MRI.

METHODS

From January 1, 2018 to December 31, 2019, 56 patients who met the inclusion criteria were enrolled in this study. Of the 56 patients, 43 patients who had a posterior horn of medial meniscus tear were included in the study group. A control group of 13 individuals was formed for comparison. Two radiologists reviewed the MR images and recorded the presence and grades of posterior oblique ligament and distal semi-membranosus tendon tears. We used the independent -test and one-way ANOVA to compare the tear grades. Interobserver agreement was analyzed using a Cohen's κ coefficient (κ value) for categorical variables.

RESULTS

The mean grades for the posterior oblique ligament and distal semi-membranosus tendon tears were significantly higher in the study group (all, < 0.001). Interobserver agreement between the two readers was substantial in assessing the grade of posterior oblique ligament tear (κ = 0.653±0.087) and almost perfect in assessing the grade of distal semi-membranosus tendon tear (κ = 0.876±0.060).

CONCLUSION

Posterior oblique ligament and distal semi-membranosus tendon tears are significantly associated with posterior horn of medial meniscus tear and medial meniscus posterior root tears, and the peel-back mechanism could be related to this association.

ADVANCES IN KNOWLEDGE

Presenting this paper could adjust radiologist search patterns and potentially help orthopedists with management and pre-surgical planning for the posteromedial corner injury of the knee.

摘要

目的

评估 MRI 上后斜韧带和远端半膜肌腱撕裂与内侧半月板后角撕裂的关系。

方法

本研究纳入了 2018 年 1 月 1 日至 2019 年 12 月 31 日符合纳入标准的 56 名患者。在这 56 名患者中,有 43 名患者的内侧半月板后角撕裂被纳入研究组。为了进行比较,还建立了一个包含 13 名个体的对照组。两名放射科医生对 MRI 图像进行了回顾,并记录了后斜韧带和远端半膜肌腱撕裂的存在和程度。我们使用独立样本 t 检验和单因素方差分析来比较撕裂程度。使用 Cohen's κ 系数(κ 值)对分类变量进行观察者间一致性分析。

结果

研究组后斜韧带和远端半膜肌腱撕裂的平均程度明显更高(均<0.001)。两位观察者在评估后斜韧带撕裂程度方面的观察者间一致性为中等(κ=0.653±0.087),在评估远端半膜肌腱撕裂程度方面的观察者间一致性为几乎完美(κ=0.876±0.060)。

结论

后斜韧带和远端半膜肌腱撕裂与内侧半月板后角撕裂和内侧半月板后根撕裂明显相关,撕脱机制可能与这种相关性有关。

知识进展

本研究结果可能会调整放射科医生的搜索模式,并有助于骨科医生对膝关节后内侧角损伤进行管理和术前规划。

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BMC Musculoskelet Disord. 2020 May 14;21(1):301. doi: 10.1186/s12891-020-03336-9.
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Meniscal Root Tears: Current Concepts Review.半月板根部撕裂:当前概念综述
Arch Bone Jt Surg. 2018 Jul;6(4):250-259.
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Imaging of Muscle Injuries in Sports Medicine: Sports Imaging Series.运动医学中的肌肉损伤影像学:运动影像学系列。
Radiology. 2017 Mar;282(3):646-663. doi: 10.1148/radiol.2017160267.
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A Current Review of the Meniscus Imaging: Proposition of a Useful Tool for Its Radiologic Analysis.半月板成像的当前综述:一种用于其放射学分析的有用工具的提议
Radiol Res Pract. 2016;2016:8329296. doi: 10.1155/2016/8329296. Epub 2016 Feb 11.
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ISAKOS classification of meniscal tears-illustration on 2D and 3D isotropic spin echo MR imaging.国际膝关节外科学会(ISAKOS)半月板撕裂分类——二维和三维各向同性自旋回波磁共振成像示例
Eur J Radiol. 2016 Jan;85(1):15-24. doi: 10.1016/j.ejrad.2015.10.022. Epub 2015 Nov 2.
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Posteromedial Corner of the Knee: The Neglected Corner.膝关节后内侧角:被忽视的角落。
Radiographics. 2015 Jul-Aug;35(4):1123-37. doi: 10.1148/rg.2015140166.
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Medial meniscus posterior root tear: a comprehensive review.内侧半月板后根部撕裂:综述
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Posterolateral and posteromedial corner injuries of the knee.膝关节后外侧和后内侧角损伤
Radiol Clin North Am. 2013 May;51(3):413-32. doi: 10.1016/j.rcl.2012.10.004. Epub 2013 Mar 7.
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An anatomical three-dimensional study of the posteromedial corner of the knee.膝关节后内侧角的解剖三维研究。
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