CAJ | 학술논문

目的:分析膝关节急性前交叉韧带(anterior cruciate ligament,ACL)撕裂的MRI征象,提高对ACL撕裂的术前诊断和评估能力.方法:回顾性分析117例经关节镜或手术证实急性ACL撕裂患者的临床及影像学资料,分析其MRI征象.结果:117例MRI直接征象主要为ACL纤维中断或部分不连续、弥漫性增粗并信号增高、走行异常、胫骨附着处撕脱骨折;间接征象主要为胫、股骨外侧髁的"对吻性"骨挫伤或骨折、后交叉韧带曲率增大、胫骨前移位、内侧副韧带损伤、内侧半月板撕裂. 评估分析5种MRI直接征象得出,ACL走行异常具有相对高的诊断敏感度和特异度;5种MRI间接征象均诊断特异度高而敏感度低. 结论:MRI直接征象能较准确地诊断急性ACL撕裂,并评估其撕裂程度,可作为主要诊断依据;而MRI间接征象特异度较高、敏感度相对较低,不能作为主要诊断依据,但对明确诊断具有较大帮助,可作为辅助诊断依据.
목적:분석슬관절급성전교차인대(anterior cruciate ligament,ACL)시렬적MRI정상,제고대ACL시렬적술전진단화평고능력.방법:회고성분석117례경관절경혹수술증실급성ACL시렬환자적림상급영상학자료,분석기MRI정상.결과:117례MRI직접정상주요위ACL섬유중단혹부분불련속、미만성증조병신호증고、주행이상、경골부착처시탈골절;간접정상주요위경、고골외측과적"대문성"골좌상혹골절、후교차인대곡솔증대、경골전이위、내측부인대손상、내측반월판시렬. 평고분석5충MRI직접정상득출,ACL주행이상구유상대고적진단민감도화특이도;5충MRI간접정상균진단특이도고이민감도저. 결론:MRI직접정상능교준학지진단급성ACL시렬,병평고기시렬정도,가작위주요진단의거;이MRI간접정상특이도교고、민감도상대교저,불능작위주요진단의거,단대명학진단구유교대방조,가작위보조진단의거.
Objective:To analyze the direct or indirect MRI signs in knee joint acute anterior cruciate ligament (ACL) rup-ture,to improve the preoperative diagnosis and the estimation ability of ACL rupture. Methods:Collecting 117 cases (117 knees) of acute anterior cruciate ligament (ACL) rupture proved by arthroscopy and surgery,retrospective analyzing and sum-marizing their MRI signs. Results:117 cases of acute ACL rupture direct signs were mainly the ACL fiber completely or par-tially discontinuous,diffuse enlargement and higher,abnormal contour. Indirect signs were mainly the tibia and the lateral femoral condyle "kissing" bone bruise,PCLS curvature increases,anterior tibial translation,MCL injury,medial meniscus tear, ministry of tibial insertion of ACL avulsion fracture. Among the 5 primary signs,abnormal contour of ACL had relatively higher of diagnostic sensitivity and specificity. The 5 indirect signs had high specificity and low sensitivity. Conclusion:Direct MRI signs can accurately diagnose acute ACL rupture,and can evaluate the degree of tear,can be used as the main diagnostic basis. Indirect MRI signs has higher specificity and lower sensitivity,which cannot serve as main diagnosis basis,but with great help for diagnosis,can be used as auxiliary diagnosis.