Ravi Varun, Rehman Mahad, Xia Shuda, Chhabra Avneesh, Silva Flavio Duarte
UT Southwestern Medical School, UT Southwestern Medical Center, Dallas, TX, USA.
Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, USA.
Skeletal Radiol. 2025 Feb;54(2):325-334. doi: 10.1007/s00256-024-04744-x. Epub 2024 Jul 17.
To compare radiographic measurements of lateral tibial slope (LTS), medial TS (MTS), and coronal TS (CTS) in MRI-defined intact, injured, and mucoid-degenerated native ACL knees and determine inter-reader reliability.
Patient records from 2 years at tertiary care hospitals were reviewed for individuals aged 18-100 undergoing 3-Tesla knee MRI and radiographs. Two randomly selected cohorts, control, and pathologic ACLs on MRI with 86 patients each, were age, gender, and BMI-matched. A fellowship-trained musculoskeletal radiologist reevaluated curated images, characterizing ACL status. Two trained medical students independently collected clinical data and measured slopes on blinded radiographs. ICC, Cohen's kappa, and case-control matching were performed using SPSS statistical package, with ICC and ANOVA used for comparisons.
Among 172 patients with 172 MRIs and radiographs, there were 86 controls and 86 ACL lesions. There were 108/172 (62.79%) males and 64/172 (37.21%) females. ICCs were 0.966 for MTS, 0.975 for LTS, and 0.978 for CTS. Mucoid degeneration patients had a higher BMI and were older than control (p < .05) or completely torn (p < .001) ACL patients. There was no difference in TS between normal and pathologic ACLs; however, LTS-MTS differences were larger with partial tears (2.5 ± 4.9) than normal ACLs by 4.5° (± 1.2, p < .001), complete tears by 4.5° (± 1.3, p < .001), and mucoid degeneration by 4.9° (± 1.5, p = .001).
Various TS measurements are reliable. LTS-MTS differences are associated with different ACL lesions compared to normal ACLs.
比较MRI定义的完整、损伤和黏液样变性的天然前交叉韧带（ACL）膝关节的胫骨外侧坡度（LTS）、内侧坡度（MTS）和冠状面坡度（CTS）的影像学测量值，并确定阅片者间的可靠性。
回顾了三级医院2年期间18 - 100岁接受3特斯拉膝关节MRI和X线检查的患者记录。随机选择两个队列，MRI上的对照组和病理性ACL组，每组86例患者，进行年龄、性别和体重指数（BMI）匹配。一名接受过 fellowship培训的肌肉骨骼放射科医生重新评估整理后的图像，确定ACL状态。两名经过培训的医学生独立收集临床数据并在盲法X线片上测量坡度。使用SPSS统计软件包进行组内相关系数（ICC）、科恩kappa系数分析以及病例对照匹配，采用ICC和方差分析进行比较。
在172例有MRI和X线片的患者中，有86例对照组和86例ACL损伤患者。男性108/172（62.79%），女性64/172（37.21%）。MTS的ICC为0.966，LTS为0.975，CTS为0.978。黏液样变性患者的BMI较高，且比对照组（p < 0.05）或完全撕裂（p < 0.001）的ACL患者年龄更大。正常ACL和病理性ACL之间的坡度无差异；然而，部分撕裂时LTS - MTS差异（2.5°±4.9°）比正常ACL大4.5°（±1.2°，p < 0.001），完全撕裂时大4.5°（±1.3°，p < 0.001），黏液样变性时大4.9°（±1.5°，p = 0.001）。
各种坡度测量是可靠的。与正常ACL相比，LTS - MTS差异与不同的ACL损伤相关。
