基于MRI评估非接触性ACL损伤的骨挫伤模式

Evaluation of Bone Bruising Patterns Associated with Noncontact ACL Ruptures Based on MRI

摘要: 目的：基于磁共振成像技术(MRI)，本文采用一种新的标测技术，来可靠的描述非接触性前交叉韧带(ACL)损伤的骨挫伤模式，并进一步验证文献中最常见的ACL损伤的机制，包括外翻应力、胫骨前平移和胫骨内旋转。方法：根据相同的标准纳入100名在2021~2023年期间进行ACL重建手术的患者，在脂肪抑制T2加权冠状位和矢状位图像上标测出骨挫伤的位置。结果：股骨外侧髁(LFC)的骨挫伤与股骨内侧髁(MFC)相比更多(72.7% vs 27.3%; P < 0.001)，胫骨外侧平台(LTP)的骨挫伤与胫骨内侧平台(MTP)相比更多(72.4% vs 27.6%; P < 0.001)。股骨的骨挫伤几乎完全位于股骨髁的前部/中央部区域(94.1%)，而不是后部区域(5.9%) (P < 0.001)。胫骨的骨挫伤局限于两个平台的后部区域(74.9%)，而不是前部/中央区域(25.1%) (P < 0.001)。结论：新的标测技术为描述非接触性ACL损伤中的骨挫伤模式提供了一种标准化且可靠的方法，使用该技术确定的骨挫伤模式表明了非接触性ACL损伤最常见的机制。

Abstract: Objective: Based on magnetic resonance imaging (MRI), a new mapping technique was used to de-scribe the bone bruising patterns of noncontact anterior cruciate ligament (ACL) injury, and verify the most commonly reported mechanisms for ACL injury in the literature, including valgus stress, anterior tibial translation and internal tibial rotation. Methods: According to the same criteria, 100 patients who underwent ACL reconstruction from 2021 to 2023 were enrolled. The location of bone bruising was mapped on fat suppression T2-weighted coronal and sagittal images. Results: There were more bone bruising in the lateral femoral condyle than in the medial femoral condyle (72.7% vs 27.3%, P < 0.001), and there were more bone bruising in the lateral tibial plateau than in the medial tibial plateau (72.4% vs 27.6%, P < 0.001). The bone bruising of the femur is almost entirely located in the anterior/central area of the femoral condyle (94.1%), rather than in the posterior area of the femoral condyle (5.9%) (P < 0.001). The bone bruising of the tibia is limited to the posterior area of the both plateaus (74.9%), as opposed to the anterior/central area (25.1%) (P < 0.001). Conclusion: The new mapping system provides a standardized and reliable method for describing the pattern of bone bruising in noncontact anterior cruciate ligament injury. The bone bruising pattern determined by this technique indicates the most common mechanism of noncon-tact ACL injury.