前交叉韧带损伤的MRI诊断与关节镜下所见的比较研究

目的：探讨MRI对前交叉韧带(ACL)损伤的诊断准确率极其对临床治疗的指导意义。方法：7l例关节镜手术患者术前行MRI检查，根据MRI诊断分为正常、部分损伤和断裂组，将MRI诊断结果与关节镜下所见进行对比。结果：以关节镜下所见为标准，MRI诊断准确率正常组为87．5％(7／8)，部分损伤组为61．9％(13／21)，断裂组为90．5％(38／42)。本组MRI诊断ACL损伤总诊断准确率为95．8％。ACL与胫骨平台夹角小于450和各序列扫描均未见ACL影像为诊断ACL完全断裂的可靠依据。结论：MRI是诊断ACL损伤的有效无创性检查方法，但部分损伤与完全断裂有时难以鉴别，ACL重建术前应常规行关节镜探查。

The correlation between MRI of the diagnosis of anterior cruciate ligament injuries and arthroscopy

Objective:To verify the accuracy of MRI in the diagnosis of anterior c ruciate ligament(ACL) injuries and its instructional value for clinical manageme nt.Methods:71 cases diagnosed as ACL i njuries clinically were divided into norm al, partial injury and rupture groups according to the MRI examination, the rela tionship between the classification of MRI and the morphological changes under t he arthroscopy was analyzed retrospectively.Results:Depending on the exploratio n in arthroscopy, the accurate rate of diagnosis of MRI for normal group was 87. 5%(7/8); 61.9%(13/21) for partial injury group; 90.5%(38/42) for rupture group. The total accurate rate of MRI for diagnosis of ACL injuries was 95.8%. Abnormal horizontal orientation of ACL and nonvisualization of the ACL were reliable evi dence of an ACL rupture.Conclusion:MRI is an ef fective noninvasive diagnostic technique for the diagnosis of ACL injuries, the differential diagnosis of parti al and complete rupture of ACL is somewhat difficult. Before the reconstruction of ACL, routine diagnostic arthroscopy is necessary.