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学科主题: 放射科学
题名:
前交叉韧带假体断裂的MRI征象分析
其他题名: MRI findings of anterior cruciate ligament graft tear
作者: 高丽香; 袁慧书; 郑卓肇
关键词: 前交叉韧带 ; 磁共振成像 ; 假体植入 ; Anterior cruciate ligament ; Magnetic resonance imaging ; Prosthesis implantation
刊名: 中华放射学杂志
发表日期: 2015
DOI: 10.3760/cma.j.issn.1005-1201.2015.02.010
期: 2, 页:121-125
收录类别: 中国科技核心期刊 ; 中文核心期刊 ; CSCD
文章类型: Journal Article
摘要: 目的:总结前交叉韧带(ACL)假体断裂的MRI表现、急性断裂和慢性断裂的MRI征象差异,并与其他常用物理检查对ACL假体断裂的诊断能力进行比较。方法回顾性分析43例(44个膝关节)经关节镜检查证实的ACL假体断裂的膝关节MRI图像,包括40个完全断裂和4个部分断裂。其中,急性假体断裂18个、慢性假体断裂26个。依据传统ACL断裂的MRI诊断标准,将ACL假体断裂的MRI表现分为直接征象和间接征象。利用精确概率法比较各种直接征象和间接征象在急性假体断裂和慢性假体断裂中出现率的差异,利用χ2检验比较MRI与物理检查对ACL假体断裂的诊断准确性。结果 ACL假体断裂的MRI直接征象包括ACL假体不连续13个、ACL假体肿胀增粗12个、ACL假体走行异常6个、ACL假体消失5个、ACL假体萎缩细小3个;间接征象包括“对吻性”骨挫伤4个、后交叉韧带松弛3个、胫骨前移2个、股骨外侧髁骨挫伤1个、胫骨平台后部骨挫伤1个。急性ACL假体断裂和慢性ACL假体断裂对比,上述各征象的出现比例差异均无统计学意义(P值均>0.05)。MRI、Lachman试验和前抽屉试验的诊断准确性分别为87.5%(35/40)、95.0%(38/40)和95.0%(38/40),均明显高于轴移试验(42.5%,17/40),且差异有统计学意义(χ2=17.80,P<0.0083)。结论 MRI为ACL假体断裂的敏感检查手段,直接征象为诊断ACL假体断裂的主要证据,但各MRI征象均不能区分急性和慢性断裂;MRI、Lachman试验和前抽屉试验的诊断准确性差异无统计学意义,但三者均高于轴移实验。 Objective To summarize MRI features of anterior cruciate ligament graft tear and to explore the differences of MRI findings between acute tear and chronic tear, and compare the diagnostic ability of MRI and clinical examinations for graft tear. Methods MR images of 43 patients (44 knees) with anterior cruciate ligament graft tear(40 complete tear, 4 partial tear)confirmed by secondary arthroscopy were retrospectively analyzed. There were 18 acute tear and 26 chronic tear. Primary and secondary signs reported with conventional anterior cruciate ligament tear were adopted to evaluate graft tear. The exact probability method was used to compare the prevalence difference between various direct and indirect signs and the χ2 test was used to compare the accuracy between MRI and physical examination. Results The primary signs in MR images of anterior cruciate ligament graft tear included graft discontinuity in 13 kness, graft thickening with edematous high signal intensity in 12 knees, decreased slope of graft fibers in 6 kness, graft disappearing in 5 knees, and distinct graft atrophy in 3 knees. The secondary signs included kissing bone contusion in 4 knees, posteriorcruciate ligament buckling in 3 knees, increased anterior tibial displacement in 2 knees, bone contusion of the lateral condyle of femur, and bone contusion of thetibia condyle in 1 knee, respectively. There were no significant differences regarding the proportion of each sign between acute and chronic graft tear. Accuracy of MRI, Lachman test, and anterior drawer test were 87.5%(35/40), 95.0%(38/40)and 95.0%(38/40), respectively, which were all significantly higher than that of pivot shift test(42.5%,17/40) with significant differences(χ2=17.80, P<0.0083). Conclusions MRI is sensitive for diagnosing anterior cruciate ligament graft tear, the primary signs is the main evidence for the diagnosis of ACL graft tear, but it is hard to distinguish acute and chronic graft tear based on MR findings. The diagnostic accuracy has no statistically significant differences among MRI, Lachman test, and anterior drawer test, but they are all higher than pivot shift test.
语种: 中文
原文出处: 查看原文
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内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/69357
Appears in Collections:北京大学第三临床医学院_放射科_期刊论文

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作者单位: 100191北京大学第三医院放射科

Recommended Citation:
高丽香,袁慧书,郑卓肇. 前交叉韧带假体断裂的MRI征象分析[J]. 中华放射学杂志,2015(2):121-125.
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