| BackgroundThe cruciate ligament injury is clinically more common lesion, seriously affect the stability of knee joint motion, early diagnosis and prognosis of choice has important significance for clinical treatment. The MRI has high spatial resolution and good density resolution, can not only of cruciate ligaments injury objectively, clearly show the fracture position, cruciate ligament and the scope of the complications, but also can evaluate the knee meniscus and cartilage injury, especially multiplanar reconstruction(MPR), can be clearly showed the entire anterior cruciate ligament(ACL) and the posterior cruciate ligament(PCL), is the current domestic and foreign inspection image cruciate ligament more commonly used in science and technology.ObjectiveUsing MRI image post-processing multiplanar reconstruction(MPR), the observation of anterior cruciate ligament(ACL) and posterior cruciate ligament(PCL) anatomical structure and signal features of anterior cruciate ligament(ACL) of the anteromedial bundle and posterolateral bundle and posterior cruciate ligament(PCL) of the anterior lateral bundle, rear inner side beam in knee motion effect and change rules, and anterior cruciate ligament(ACL) and posterior cruciate ligament(PCL) injury location, signs and concomitant injury, provide the reference for the diagnosis of disease, cruciate ligament surgery and postoperative evaluation.Materials and methodsCollection of image section steel plant MRI general hospital in Anyang city during the period from 2012 January to 2013 December,100 patients underwent MRI scan, the lower limbs of adults and no significant lesions, including 55 cases of male, female 45 cases, age 20-50 years old; cruciate ligament injury in 66 patients with 70 knee joint, of which 35 were male,19 are left side side, right knee 20, female 31 cases, left knee 20 side, the 11 side of the right knee, aged 23-59 years old. The knee joint MRI image data is transmitted to the 3D-reconstruction workstation, using multiplanar reconstruction(MPR) technique, reconstruction, measurement, analysis of knee joint in MRI image reconstruction on a workstation.Results1. Anterior cruciate ligament(ACL) in multiplanar reconstruction(MPR) technique oblique sagittal zonal slightly low signal or low signal intensity, the front edge of the most intensive signal fiber bundle, the lowest, the anteromedial bundle in the knee flexion tension, posterolateral bundle in knee extension of tension, both in the anterior cruciate ligament(ACL) internal interlaced connected. Anterior cruciate ligament(ACL) length, width, thickness were 30.21±1.53 mm,11.46±2.04 mm and 5.85±1.36 mm, angle and sagittal plane, coronal plane were 20.77°±2.37° and 39.58°±1.80°, and the femoral, tibial attachment point of the area were 47.15±3.44 mm2 and 92.77±2.73 mm2, anterior cruciate ligament(ACL) point area, vertical diameter, horizontal diameter was larger than that of the attached to the tibial attachment point in the femur, and there were significant differences between them(P < 0.05).2. Posterior cruciate ligament(PCL) in multiplanar reconstruction(MPR) technique oblique sagittal showed low signal intensity on the back of the convex strip, above, the bundle is more intensive, signal of anterior cruciate ligament lower ACL, subsequent medial bundle in the extension of knee knees when tension, relaxation, anterolateral bundle in flexion knee extension with tension, relaxation. The posterior cruciate ligament(PCL) length, width, thickness were 38.83±1.70 mm,10.76±1.79 mm and 5.90±1.14 mm, angle and sagittal plane, coronal plane were 51.36°±4.40° and 83.48°±7.56°, and the femoral, tibial attachment point of the area were 93.25± 4.33 mm2 and 66.20±2.17 mm2, posterior cruciate ligament(PCL) point area, longitudinal attached to the femur diameter was larger than that of the attachment point in the tibia, there were significant differences between them(P< 0.05).3. Anterior cruciate ligament(ACL) point area, vertical diameter, horizontal diameter attached to the tibia were larger than the posterior cruciate ligament(PCL) attachment point of the corresponding value in the tibia, there were significant differences between them(P< 0.05). The posterior cruciate ligament(PCL) point of the area, vertical diameter, transverse attached to the femur diameter were larger than the anterior cruciate ligament(ACL) attached to the corresponding value point in the femur, and there were significant differences between them(P< 0.05).4. Acute anterior cruciate ligament(ACL) tear in the form of thickening and swelling, border is not clear, can be in the shape of irregular high signal, stripe like high signal, focal high signal, chronic injury is to low residual root shaped low signal, part of stump after being absorbed in the present intercondylar fossa syndrome. MRI diagnosis accuracy, sensitivity and specificity were 94.29%,90.70% and 100%, ligament tear in patients with positive rate was significantly higher than the proportion of indirect signs of partial laceration patients. Acute anterior cruciate ligament(ACL) laceration, tear of the fibular collateral ligament was low, all patients had joint effusion, chronic laceration is the fibular collateral ligament tear, tibial collateral ligament tear and bone bruise lower incidence of joint effusion is often little or no effusion. But the higher incidence of meniscal tears.5. Acute posterior cruciate ligament(PCL) injury increased signal, the morphology of thickening, swelling, signal and chronic injury is relatively low, mainly for the abnormal morphology. MRI imaging in the diagnosis of posterior cruciate ligament(PCL) tear accuracy, sensitivity, specificity were 98.57%,88.89% and 100%. The posterior cruciate ligament(PCL) of the distal end of laceration torn was low, with collateral ligament tear in the meniscus tear and damage on fibular side of the lower incidence of joint effusion, the incidence of higher. Conclusion1. Anterior cruciate ligament(ACL) and posterior cruciate ligament(PCL) were different in the tibia, fibula at the point of attachment of the area, the carrying capacity and the damage degree is different, can be used as a diagnostic, cruciate ligament disease operation therapy and postoperative evaluation reference.2. Anterior cruciate ligament(ACL) of the posterolateral bundle and posterior cruciate ligament(PCL) of the posterior medial bundle in knee extension position to play a role in anterior cruciate ligament(ACL) of the anteromedial bundle and posterior cruciate ligament(PCL) anterolateral bundle in knee flexion play a role, so the anterior cruciate ligament(ACL) the fracture of the posterior cruciate ligament (PCL) have a certain influence.3. Anterior cruciate ligament(ACL) complete tear more easily cause knee joint instability, is the cause of posterior cruciate ligament(PCL) structure with the important factors of damage. |
