Dimond P M, Fadale P D, Hulstyn M J, Tung G A, Greisberg J
Department of Orthopaedic Surgery, Brown University School of Medicine, Providence, Rhode Island, USA.
Am J Knee Surg. 1998 Summer;11(3):153-9.
This retrospective study compared the magnetic resonance imaging (MRI) findings in 87 patients with acute and chronic anterior cruciate ligament (ACL) tears. Sixty patients had acute tears and 27 had chronic tears. The appearance of the torn ligament was examined on MRI, and associated meniscal and osteochondral injuries were described. All findings were verified at arthroscopy. Acute ACL tears (MRI examination was performed within 6 weeks of injury) were typified by the presence of diffuse (58%) or focal (42%) increased signal within the ligament, whereas chronic ACL tears (MRI examination was performed more than 6 months after injury) usually appeared as either a fragmented ligament (44%) or an intact band of low signal with abnormal orientation (30%). Patients with chronic ACL tears had a higher prevalence of medial meniscal tears (78% versus 40%), articular chondromalacia, and an increased posterior cruciate bow ratio (0.47 versus 0.37) in association with chronic ACL tears. A bone bruise was seen in 68% of acute ACL tears but in no case of chronic ACL tear. On MRI, there are salient differences between acute and chronic ACL tears. Chronic ACL tears are associated with a greater prevalence of meniscal and osteochondral injuries. These findings may have implications for future treatment recommendations.
这项回顾性研究比较了87例急性和慢性前交叉韧带（ACL）撕裂患者的磁共振成像（MRI）表现。其中60例为急性撕裂，27例为慢性撕裂。在MRI上检查撕裂韧带的表现，并描述相关的半月板和骨软骨损伤情况。所有结果均在关节镜检查时得到证实。急性ACL撕裂（在损伤后6周内进行MRI检查）的典型表现为韧带内弥漫性（58%）或局灶性（42%）信号增高，而慢性ACL撕裂（在损伤后6个月以上进行MRI检查）通常表现为韧带断裂（44%）或低信号完整带伴异常走行（30%）。慢性ACL撕裂患者内侧半月板撕裂的患病率更高（78%对40%），伴有慢性ACL撕裂的患者还存在关节软骨软化以及后交叉韧带弓比率增加（0.47对0.37）。68%的急性ACL撕裂患者可见骨挫伤，而慢性ACL撕裂患者无一例出现骨挫伤。在MRI上，急性和慢性ACL撕裂存在明显差异。慢性ACL撕裂与半月板和骨软骨损伤的更高患病率相关。这些发现可能对未来的治疗建议有影响。
