半月板周缘垂直撕裂及前交叉韧带损伤相关性MRI探究.docVIP

半月板周缘垂直撕裂及前交叉韧带损伤相关性MRI探究 　【摘要】 目的：探讨半月板周缘垂直撕裂与前交叉韧带损伤(ACL)的相关性。方法：对178 例经关节镜证实，诊断为半月板撕裂的膝关MRI进行回顾性研究，对半月板撕裂的部位和裂口方向及ACL的情况进行诊断分析。并比较半月板周缘垂直撕裂患者和其他类型半月板撕裂患者ACL的发生率。结果：178 例患者中有22 例被证实为半月板周缘垂直撕裂，其中18 例合并急性或慢性ACL，占81.8％，另4 例前交叉韧带完整。在156 例其他类型半月板撕裂患者中，13 例合并急性或慢性ACL，占8.3％。两者比较具有统计学意义(P＜0.001)。结论：半月板周缘垂直撕裂与急性或慢性前ACL密切相关。膝关节MRI图像上，半月板周缘垂直撕裂可作为ACL的辅助诊断依据之一，可以提高诊断ACL的准确率。 【关键词】 核磁共振 前交叉韧带损伤 半月板撕裂 周缘垂直撕裂 Abstract Objective：The purpose of this article is to determine the prevalence of anterior cruciate ligament(ACL) tears in knees with the peripheral vertical meniscal tears seen on MRI imaging compared to knees with other types of meniscal tears.Methods：A retrospective review of 178 knee MRI examinations with imaging diagnoses of meniscal tear was performed to assess the location and morpholpgy of the meniscal tear，and to assess the status of the ACL.Results：In all patients，twentytwo peripheral vertical meniscal tears were identined，18 of whom had acute ACL tears or chronic ACL defiencg.Four peripheral vertical tears were seen in the setting of anormal ACL.Of the 156 examination with other types of meniscal tears，there were 13 cases with hacute ACL tears or chronic ACL deficiency.The difference in the prevalence of ACI tear or deficoency in knees with meniscal tears or the peripheral vertical type(81.8％) compared with the prevalence of ACL tear or defiiency in knees with other types of meniscal tears(8.3％) was statintically significant(P＜0.001).Conclusion：Perpheral vertical meniscal tears are highly associated with ACL lesion.The finding of this type of tear on knee MRI imaging should prompt close inspection of the ACL for evidence of acute or chronic injury，and its presence may help make the diagnosis of ACL tear in equivocal cases. Key words magnetic resonance imaging；anterior cruciate ligament；meniscal tears；peripheral vertical tears 根据MR表现可将半月板撕裂分为水平撕裂、斜形撕裂、放射状撕裂、垂直撕裂、周缘撕裂、桶柄样撕裂、复合撕裂、半月板移位等［1～3］。半月板撕裂，特别是周缘撕裂，通常合并前交叉韧带损伤(ACL)［3，4］。尽管ACL断裂可以合并所有类型的半月板撕裂，但是，在ACL断裂患者中半