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MRI Criteria for Meniscal Ramp Lesions of the Knee in Children With Anterior Cruciate Ligament Tears.

前交叉韧带撕裂儿童膝关节半月板斜坡病变的MRI标准。

  • 影响因子:2.91
  • DOI:10.2214/AJR.20.23389
  • 作者列表:"Nguyen JC","Bram JT","Lawrence JTR","Hong S","Leska TM","Ganley TJ","Ho-Fung V
  • 发表时间:2021-03-01
Abstract

:OBJECTIVE. The purpose of this study was to investigate the performance of MRI criteria for identifying meniscal ramp lesions in children with concomitant anterior cruciate ligament (ACL) tear, with arthroscopy used as the reference standard. MATERIALS AND METHODS. This retrospective study included 85 children who underwent a preoperative MRI examination and arthroscopically guided primary ACL reconstruction between June 1, 2017, and December 31, 2019. Blinded to arthroscopic findings, two radiologists reviewed all MRI examinations and reached consensus on the presence or absence of an effusion and various findings within the medial and lateral tibiofemoral joints. Chi-square, Fisher exact, independent t, and Mann-Whitney U tests were used to compare MRI findings between patients with and without arthroscopically confirmed meniscal ramp lesions. RESULTS. At arthroscopy, 35 children (23 boys and 12 girls; mean [± SD] age, 15.7 ± 2.0 years) had ramp lesions and 50 children (22 boys and 28 girls; mean age, 15.1 ± 2.4 years) had intact meniscocapsular junctions. Knees in which a ramp lesion was observed were significantly more likely to have MRI findings of a medial meniscus tear (p = .005), peripheral meniscal irregularity (p = .001), junctional T2-weighted signal (p < .001), and a meniscocapsular ligament tear (p < .001). No significant difference was found between children with and without ramp lesions with regard to the presence of an effusion (p = .65) or a lateral meniscus tear (p = .08) or the extent of medial and lateral tibial plateau marrow edema (p = .67 and p = .83, respectively). CONCLUSION. MRI findings associated with an arthroscopic diagnosis of meniscal ramp lesion include medial meniscus tear, peripheral meniscal irregularity, junctional fluidlike signal, and capsular ligament tear.

摘要

: 客观。本研究的目的是探讨MRI标准在鉴别伴有前交叉韧带 (ACL) 撕裂的儿童半月板斜坡病变中的表现,关节镜检查作为参考标准。材料和方法。这项回顾性研究纳入了2017年6月1日至20 19年12月31日期间接受了术前MRI检查和关节镜引导下初次ACL重建的85名儿童。两名放射科医生对所有MRI检查进行了检查,并对胫骨内侧和外侧关节内是否存在积液以及各种检查结果达成共识。使用卡方检验、Fisher精确检验、独立t检验和Mann-Whitney U检验比较有关节镜证实的半月板斜坡病变和无关节镜证实的半月板斜坡病变患者的MRI表现。结果。在关节镜检查中,35名儿童 (23名男孩和12名女孩; 平均 [± SD] 年龄,15.7 ± 2.0岁) 有斜坡病变,50名儿童 (22名男孩和28名女孩; 平均年龄,15.1 ± 2.4岁) 有完整的脑膜囊连接。在观察到斜坡病变的膝关节中,MRI更可能出现内侧半月板撕裂 (p = .005) 、周围半月板不规则 (p = .001) 、交界T2-weighted信号 (p < .001) 和半月板包膜韧带撕裂 (p <.001)。在存在积液 (p = .65) 或外侧半月板撕裂 (p = .08) 或内侧和外侧胫骨平台骨髓水肿的程度 (分别为p = .67和p = .83) 方面,有和没有斜坡病变的儿童之间没有发现显著差异。结论。与关节镜诊断半月板斜坡病变相关的MRI表现包括内侧半月板撕裂、外周半月板不规则、交界液样信号和囊韧带撕裂。

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