Fitzgerald S W, Remer E M, Friedman H, Rogers L F, Hendrix R W, Schafer M F
Department of Radiology, Northwestern University Medical School, Chicago, IL 60611.
AJR Am J Roentgenol. 1993 Jun;160(6):1233-7. doi: 10.2214/ajr.160.6.8498224.
Most studies evaluating the anterior cruciate ligament have focused on sagittal MR images for the diagnosis of injury. Limitations of sagittal images have been reported, however, including nonvisualization and incomplete visualization of the ligament. This study was undertaken to assess the value of adding coronal and axial MR images to sagittal images in the evaluation of the anterior cruciate ligament.
We reviewed oblique sagittal T1-weighted, coronal T2-weighted, and axial T2-weighted images to determine the status of the anterior cruciate ligament in 325 patients. All patients had arthroscopy. Sagittal images were initially interpreted alone and then in combination with coronal and axial images.
Sagittal T1-weighted images alone had a 94% sensitivity and an 84% specificity for determining the status of the anterior cruciate ligament. A multiplanar evaluation of the anterior cruciate ligament resulted in a change in MR interpretation in 21 patients (6%), which led to an improved sensitivity of 98% and a specificity of 93%. Diagnostic confidence was improved in an additional 14 patients (4%).
Our results show that the efficacy of MR imaging for the detection of anterior cruciate ligament tears is greater when axial and coronal images are used in combination with sagittal images than when sagittal images are used alone.
大多数评估前交叉韧带的研究都集中于矢状面磁共振成像（MR）来诊断损伤。然而，矢状面图像的局限性已被报道，包括韧带无法显示和显示不完全。本研究旨在评估在评估前交叉韧带时，在矢状面图像基础上增加冠状面和横断面MR图像的价值。
我们回顾了325例患者的斜矢状面T1加权、冠状面T2加权和横断面T2加权图像，以确定前交叉韧带的状态。所有患者均接受了关节镜检查。首先单独解读矢状面图像，然后将其与冠状面和横断面图像结合解读。
单独的矢状面T1加权图像在确定前交叉韧带状态时，敏感性为94%，特异性为84%。对前交叉韧带进行多平面评估后，21例患者（6%）的MR解读发生了变化，敏感性提高到98%，特异性提高到93%。另有14例患者（4%）的诊断信心得到改善。
我们的结果表明，在检测前交叉韧带撕裂时，将横断面和冠状面图像与矢状面图像结合使用时，MR成像的效果比单独使用矢状面图像更好。
