斜冠状位磁共振成像对膝关节前交叉韧带损伤的诊断作用

目的：评价磁共振（MR）高分辨率斜冠状位成像在膝关节前交叉韧带（ACL）损伤诊断中的作用。方法：24例膝关节成像,男15例,女9例,年龄18～67岁。常规膝关节MR成像技术包括斜矢状位T1W、T2W脂肪抑制成像、冠状位T2W脂肪抑制成像、横断位PD脂肪抑制成像,所有病例均行平行于ACL的高分辨率斜冠状位质子加权成像,成像结果与关节镜检查结果进行对比。结果：24例病例中的13例关节镜证实ACL部分损伤,其MR常规成像3例正确评价为部分撕裂（3/13,23.1%）,3例过度评价为完全撕裂（3/13,23.1%）,阴性评价漏诊7例（7/13,53.8%）;MR高分辨率斜冠状位正确评价为部分撕裂6例（6/13,46.2%）,过度评价为完全撕裂3例（3/13,23.1%）,阴性评价漏诊4例（4/13,30.8%）;24例病例中的11例关节镜证实为完全撕裂的MR评价完全正确,诊断符合率100%（11/11）。结论：平行于ACL的高分辨率斜冠状位质子加权成像是一种有效评价ACL部分损伤的方法。

Anterior cruciate ligament tear: value of high resolution proton density weighted sequences with coronal oblique plane in 3.0T MRI of knee

Objective：To evaluate the role of the high resolution proton density weighted MR sequences with coro-nal oblique plane in patients with acute ACL injury.Method：The medical records of 24patients（male 15,female 9, aged 18to 67years old）who underwent arthroscopic ACL reconstruction after MRI in 3 0Twere retrospectively reviewed.The conventional MR planes included the axial plane,the standard coronal plane,the sagittal oblique plane along the lateral femoral epicondyle at the level of the lateral collateral ligament origin.High resolution proton density weighted fast spin echo sequences were obtained in the coronal oblique plane along the long axis of the ACL.Result： The ACL partial tears was detected and reconstructed in 13knees with arthroscopy,in which the right diagnoses of partial ACL tears were described in 3cases（3/13,23.1%）and the false-positive diagnoses of completely ACL tears in 3cases（3/13,23.1%）on the conventional MR planes.False negative diagnoses on the conventional MR planes were in 7（7/13,53.8%）cases with partial ACL tears detected with arthroscopy.On the high resolution proton density-weighted sequences with coronal oblique plane,the right diagnoses of partial ACL tears were described in 6cases （6/13,46.2%）,the false-positive diagnoses of completely ACL tears in 3cases（3/13,23.1%）and the false-negative diagnoses of normal ACL in 4（4/13,30.8%）cases.Complete torn of ACL was detected in 11knees with arthroscopy.The coincidence rate of MRI and arthroscopy was 100% （11/11）.Conclusion：High resolution proton den-sity weighted fast spin echo sequences obtained in the coronal oblique plane along the long axis of the ACL could provide efficient information of diagnosis for ACL partial tears.