前交叉韧带损伤MRI与关节镜诊断的比较

目的：探讨MRI诊断前交叉韧带（ACL）损伤的临床价值。方法：21例临床诊断为ACL损伤的患者关节镜术前均行MRI扫描，并将MRI征象与关节镜下所见进行对比。结果：本组21例中术前MRI扫描显示ACL正常6例，与关节镜检查结果一致；MRI扫描显示ACL2级损伤10例，关节镜检查有明显挫伤或部分撕裂8例，但无断裂，其余2例正常；MRI扫描显示ACL损伤3级5例，关节镜检查完全撕裂2例，部分撕裂3例。两种方法检查结果Kappa值为0．615，P〈0．0001。结论：MRI显示ACL正常时，可靠性很高；MRI提示部分撕裂时可靠性较高，但要警惕假阳性；MRI提示完全撕裂时，可靠性相对较差，部分病例为部分撕裂。

Assessment of MRI and arthroscopy in the diagnosis of anterior cruciate ligament injury

Objective:To evaluate MRI in the diagnosis of anterior cruciate ligament(ACL) injury.Methods:Twenty-one patients with ACL injury underwent preoperative MRI before they underwent treatment through arthroscopy,and the findings were compared.Results:Six patients with suspected ACL injury revealed normal by MRI were confirmed normal by arthroscopy;of 10 cases suggested grade 2 ACL injury by MRI,8 cases were confirmed having contusion or partial tear injury without discontinuity,and 2 cases were normal;of 5 cases suggested grade 3 ACL injury by MRI,2 cases were confirmed having complete discontinuity and 3 cases having partial tear.Compared the results between MRI and arthroscopy,the difference was significant(Kappa value,0.615;P<0.0001).Conclusion:MRI has high value in the diagnosis of ACL,which may reveal normal ACL with very high reliability,partial tear of ACL with higher reliability and complete discontinuity with relatively poor reliability