The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) are important stabilizers of the knee. Des séquences additionnelles suivant l'orientation spatiale théorique du LCA ont été proposées : plan coronal oblique en densité protonique, ... La distinction entre une rupture partielle et une rupture totale est importante à établir puisque elle modifie la prise en charge thérapeutique : la rupture partielle peut cicatriser avec un traitement fonctionnel, ce qui n'est pas le cas des ruptures complètes [1,42]. With the right ankle in the normal anatomic position stabilized in a splint, coronal T2-weighted spin-echo sequences (TSE) were obtained. The radiography technicians performed additional ACL sequences in 63 patients (27%); of these, 10 patients had a partial and 12 patients had a complete ACL tear. The anatomical and clinical aspects are also discussed so that the contribution of MRI to the diagnosis and therapeutic management of an ACL tear can be better understood. In the evaluation of partial ACL injury, four partial tears were correctly diagnosed on nonorthogonal MRI, with one false-positive diagnosis. One oblique was prescribed from a coronal localizing sequence, while the other was prescribed off an axial series. The contralateral ACL may be an appropriate surrogate for measuring, Access scientific knowledge from anywhere. Many imagers can perform oblique sagittal imaging, but the operator must set the proper degree of obliquity for the examination. The C-shaped fibrocartilaginous menisci aid in joint stabilization and load transmission. Objectives This study was undertaken to evaluate the diagnostic efficacy of additional oblique coronal magnetic resonance (MR) imaging of the knee for the grading of anterior cruciate ligament (ACL) injury. Interobserver agreements for routine knee MR imaging and additional coronal imaging were considered to be "very good" (kappaw = 0.851, 0.868, respectively). In the MRI evaluation of patients with suspected ACL injury the following results were obtained for both acute and chronic complete disruption on orthogonal (sagittal) and nonorthogonal (oblique sagittal) imaging, respectively: sensitivity, 61 (16/26) versus 100%; specificity, 70 (21/34) versus 100%; positive predictive value, 61 (16/26) versus 100%; negative predictive value 70 (24/34) versus 100%; and accuracy, 66 (40/60) versus 100%. We believe that we have demonstrated the superiority of T2-weighted nonorthogonal sagittal over conventional orthogonal sagittal ACL MRI in the evaluation of ACL injury. T2 and T2⁎ values were measured in full-thickness as well as superficial and deep layers of each cartilage compartment. The limited oblique T1 sequence had sensitivities and negative predictive value of over 90%, but low specificity and positive predictive values and slight interobserver reliability (Kappa 0.42, 95% CI 0.2–0.6).Conclusions ACL-ruptured patients showed higher T2 and T2⁎ values in full-thickness and superficial layers of medial and lateral tibiofemoral joint. To determine the three-dimensional orientation of the lateral ankle ligaments with MRI. Examination of anterior cruciate ligament (ACL) anatomy is of great interest both in studying injury mechanisms and surgical reconstruction. After routine orthogonal sequences, if general MRI radiographers, with over four years experience, were not able to identify the presence of the ACL, then two 3D volume sequences and 2D limited sagittal oblique T1 sequences were performed. The purpose of this study was to determine whether oblique sagittal T2-weighted images of the anterior cruciate ligament (ACL) are better prescribed off axial or coronal localizing images. The radiographers did perform additional ACL sequences in 63 patients (27%). Diagnostic efficacy of oblique coronal magnetic resonance imaging of the knee, Magnetic resonance imaging of anterior cruciate ligament tears: Reevaluation of quantitative parameters and imaging findings including a simplified method for measuring the anterior cruciate ligament angle, Cruciate and Posterolateral Corner Injuries in the Athlete: Clinical and Magnetic Resonance Imaging Features, Side-to-side differences in anterior cruciate ligament volume in healthy subjects. Meanwhile, patients exhibited higher T2⁎ values in deep layers of lateral tibiofemoral joint. A normal ACL was found in 16.6% (5/30) of patients. Additional use of oblique coronal MR imaging of the knee improves diagnostic accuracy in the grading of ACL injury. The extent and severity of such injuries may have important implications with regard to potential return to athletic pursuits as well as impacting upon activities of daily life. A focus is put on distinct diseases including intra-articular and intraosseous ganglion cysts, iliotibial band friction syndrome, transient osteoporosis, osteonecrosis, osteochondritis dissecans, and imaging of the articular cartilage. Oblique sagittal images parallel to the ACL were obtained at various flexed angles of the knee joint. Twenty-five healthy volunteers were examined. An additional volume sequence was beneficial when filmed. There were no posterior cruciate, medial, or lateral collateral ligament tears at arthroscopy, used as the gold standard. The knee cartilage was segmented into six compartments, including lateral femur (LF), lateral tibia (LT), medial femur (MF), medial tibia (MT), trochlea (Tr), and patella (Pa). Elles sont rares et souvent traumatiques pour ne pas dire qu'elles font suite à un accident de la circulation comme le tibia du motard qui bute contre un pare choc...anecdotiquement une chute sur les genoux pliés qui va faire fortement reculer le tibia sous le femur. Beyond the basic principles of imaging knee injuries great impact was made on the understanding of indirect or collateral findings, even in rare diseases. Background: Full-length visualization of the ACL was demonstrated by 1.4 slices using the sagittal oblique plane prescribed for RFL-1, 2.4 slices using the sagittal oblique plane prescribed for RFL-2, and 1.4 slices using the coronal oblique plane prescribed for RFL-3. In 12 of the 18 normal controls the ACL appeared convex toward the posterior side when the knee was extended and gradually became straight when the knee was flexed. The purpose of this study was to evaluate, using MRI, the morphology of normal anterior cruciate ligament (ACL) and ACL grafts when the knee was extended compared with when the knee was flexed. Conclusion In 15 of the 22 ACL graft patients the grafts appeared straight when the knee was extended and became convex toward the anterior side when the knee was flexed. The coronally prescribed sagittal oblique was subjectively preferred in 18 patients, the axially prescribed oblique was preferred in one patient, and both sequences were felt to be equivalent in 12 patients. Further investigations are required to identify the intrinsic and extrinsic factors responsible for these discrepancies. Eur This pictorial essay reviews the MRI appearance of normal and injured cruciate ligaments. MRI’s high spatial resolution, excellent soft tissue contrast and multiplanar capabilities make it ideal for evaluating suspected injuries of the m… If they identified no ACL, then two 3D volume sequences (Dual Echo Steady State and Fast Low Angle Shot) and 2D limited sagittal oblique T1 sequences were also performed. With adjustments for body weight, the size of the anterior cruciate ligament in girls was found to be statistically smaller than in boys. ACL cross‐sectional area‐to‐length ratio increased by age only in males (R² = 0.06; P = 0.003). The early degeneration could occur in various knee cartilage compartments after acute ACL rupture, especially in the superficial layer of LT. T2⁎-mapping might be more sensitive in detecting deep layer of cartilage than T2-mapping. Women's participation in intercollegiate athletics has increased dramatically in recent years. Dans cette vidéo, nous abordons le test de Muller, également appelé "Quadriceps active test", dans le cadre des atteintes du ligament croisé postérieur. Secondly, either volume sequence (DESS or FLASH) could be used as the supplementary sequence, to evaluate the ACL, but a limited oblique T1 sequence of the intercondylar notch cannot be recommended. Greater participation has increased awareness of health and medical issues specific to the female athlete. The study had ethical approval and two hundred and thirty one consecutive prospective MRI patients with mechanical knee symptoms (77 females, 154 males, of mean age 43.5, range 18–82 years) gave written informed consent. Magnetic resonance images of 269 unique knees (3‐18 years old; 51% female) were used to measure ACL length, cross‐sectional area, length‐to‐cross‐sectional area ratio, and elevation angles. While the knee may normally assume this amount of obliquity in the relaxed position, the orientation of the imaging plane is not guaranteed. We performed a prospective study based on the hypothesis that physiologic differences exist between men and women in strength after adjustments for body weight; that the size of the anterior cruciate ligament is proportionate to the strength of its antagonists, the quadriceps muscles; and that women have a relatively small anterior cruciate ligament, thus predisposing them to a disproportionate number of anterior cruciate ligament injuries. Angles between these tangents and reference lines RFL-1 (the line connecting the posterior edges of the femoral condyles), RFL-2 (the line through the intercondylar joint space), and RFL-3 (the line connecting the anterior and posterior edge of the medial tibial condyle) were measured. The MR examinations included routine sequences and oblique coronal T2-weighted images, which oriented in parallel to the course of the femoral intercondylar roof. It is concluded that the morphological changes seen on MR images of ACL grafts from when the knee is extended to when the knee is flexed are different from those in the normal ACL. This includes considerations about how to achieve a high-standard MR imaging study of the knee, and principles of imaging anterior cruciate ligament and meniscal tears. Noncontact mechanisms were the primary cause of anterior cruciate ligament injury in both female sports. Orthogonal imaging failed to correctly identify any of the partial ACL injuries. Of the secondary findings anterior tibial displacement was the best predictor of ligamentous injury. There was no statistically significant difference in the notch width index between the sexes. However, ACL abnormalities and secondary findings, alone or combined, failed to surpass the diagnostic value of the ACL angle for predicting ACL tears. The objective of this review is to present the various direct and indirect MRI signs of tearing of the anterior cruciate ligament (ACL) and then describe the lesions associated with it. Weighted kappa statistics were used to analyze the diagnostic accuracy of routine knee MR imaging with and without additional oblique coronal imaging. Oblique sagittal images prescribed off a coronal localizer are both subjectively and objectively more effective than axially prescribed sagittal obliques in evaluating the ACL. To ascertain whether radiographers could identify patients requiring supplementary MRI sequences of anterior cruciate ligament (ACL) tears, without a supervising radiologist.Methods To quantitatively assess changes in cartilage matrix after acute anterior cruciate ligament (ACL) rupture using T2- and T2⁎-mapping and analyze the correlation between the results of both methods. All rights reserved. Volume sequences had specificities and accuracies over 95%, with good intraobserver reliability (Kappa 0.859, 95% CI 0.705-1.0). Results: With an increasing number of people participating in recreational and competitive sporting activities, sports-related injuries of the knee and knee ligaments have increased in incidence. Volume sequences including partial tears, had specificities and accuracies over 94%, with substantial interobserver agreement (Kappa 0.86, 95% CI 0.71–1.0). Two independent readers evaluated the status of the ACL by routine knee MR imaging and then by additional oblique coronal imaging. We describe a simple technique that consistently produces excellent MR imaging of the entire length of the anterior cruciate ligament in its oblique sagittal plane. These angles were used for oblique T2-weighted (T2w) MRI of the knees of the remaining five volunteers, and the number of slices that depicted the entire ACL was calculated. Orienting the imaging planes according to the calculated angular deviation allows the full-length visualization of the ligaments and is the basis for optimal imaging of the lateral ankle ligaments. They then had a knee arthroscopy within seven days of the MRI. Of these, 10 patients had a partial and 12 complete ACL tears. Axial proton density-weighted (PDw) images of the knees of 20 volunteers were obtained. Ce ligament agit essentiellement entre 70 et 90° de flexion du genou. We retrospectively reviewed MR images of the knee in 169 patients. The MRI sequences were independently evaluated in a blinded fashion by two consultant radiologists and a specialist radiology registrar and compared to the subsequent knee arthroscopy, as the gold standard, to determine the diagnostic performance statistics.ResultsThe cohort was on the knee arthroscopy weighting list and comprised 205 patients with chronic, 20 acute and 6 acute on chronic mechanical knee symptoms. During the past 15 years knowledge of pathologic conditions of the knee had evolved significantly. The ACL evaluation for complete tears and a normal ACL on the volume sequences had a sensitivity of 100%, specificity of 97% and accuracy of 97%, excluding partial tears. Patients requiring extra sequences, missed by the radiography technicians, were recalled. Les entorses du Ligament Croisé Postérieur. We hypothesized that ACL size and orientation will change by age during skeletal growth and maturation with different trends in males versus females. l. Stabler A, Glaser C, Reiser M. Musculoskeletal MR: lmee. AimsTo compare different supplementary MRI sequences of the ACL to arthroscopy and determine the diagnostic performance of each sequence. White LM, Miniaci A. Cmciate and posterolateral corner injuries ln Use of the monitor can offer some benefits. Firstly, we have shown pragmatically that experienced radiographers identified almost all cases requiring supplementary MRI ACL sequences, without over scanning or needing supervision. The study data support our hypothesis that sex differences in anterior cruciate ligament tear rates are caused primarily by several interrelated intrinsic factors. Son rôle est de maintenir le tibia sous le fémur : - il contrôle le "TIROIR POSTERIEUR" Ses attaches sont derrière le tibia et sur le condyle interne du fémur. A controlled, prospective study of 30 patients with suspected acute internal derangement of the knee was undertaken to evaluate the sensitivity, specificity, predictive value, and accuracy of nonorthogonal (oblique) sagittal magnetic resonance imaging (MRI) in the assessment of anterior cruciate ligament (ACL) injuries. The mean ACL volume was not significantly different (p=0.2331) between the two sides in this population. Two hundred and thirty-one consecutive patients (77 females; 154 males; average age 43.5, range 18 to 82 years; 205 with chronic, 20 acute, and 6 acute on chronic symptoms) underwent knee arthroscopy for mechanical symptoms within a week of MRI. Spin-echo (SE) T1-weighted images (TR 330 ms/TE 15 ms, NEX 1) were obtained with a slice thickness of 3 mm. These ligaments are commonly injured in sports and motor vehicle accidents. Objective (average number of images to demonstrate ACL) and subjective (radiologist's confidence level) evaluations of both sequences were performed independently of the other and then comparatively by two radiologists. Apport de l’IRM dans le diagnostic des ruptures traumatiques du ligament croisé antérieur, The contribution of MRI to the diagnosis of traumatic tears of the anterior cruciate ligament, Quantitative T2-Mapping and T2 ⁎ -Mapping Evaluation of Changes in Cartilage Matrix after Acute Anterior Cruciate Ligament Rupture and the Correlation between the Results of Both Methods, Diagnostic performance of volume and limited oblique MRI of the anterior cruciate ligament compared to knee arthroscopy, Age‐Related Changes in ACL Morphology During Skeletal Growth and Maturation Are Different Between Females and Males, Radiographer led supplementary anterior cruciate ligament MRI sequences: Technical report, Magnetic Resonance Imaging of Cruciate Ligament Injuries of the Knee, MRI of the lateral ankle ligaments: Value of three-dimensional orientation, Anterior cruciate ligament: Oblique sagittal MR imaging, Accuracy of nonorthogonal magnetic resonance imaging in acute disruption of the anterior cruciate ligament, Oblique Sagittal MRI of Anterior Cruciate Ligament, Knee Injury Patterns Among Men and Women in Collegiate Basketball and Soccer: NCAA Data and Review of Literature, MRI of normal anterior cruciate ligament (ACL) and reconstructed ACL: Comparison of when the knee is extended with when the knee is flexed, Correlation of Anthropometric Measurements, Strength, Anterior Cruciate Ligament Size, and Intercondylar Notch Characteristics to Sex Differences in Anterior Cruciate Ligament Tear Rates, Oblique sagittal view of the anterior cruciate ligament: Comparison of coronal vs. axial planes as localizing sequences, Grading of anterior cruciate ligament injury. © 2008-2020 ResearchGate GmbH. We evaluated multiple MRI features to compare their sensitivity and specificity for detecting ACL tears. Semin Musculoskel Radiol 2OO4;8: I I l-131. Between 10 degrees and 20 degrees of external rotation of the knee is considered ideal. Twenty-three patients and 23 healthy controls were enrolled and underwent quantitative MRI examination. Despite similar ACL size between males and females at early ages, adolescent males had significantly longer and thicker ACLs compared to the age‐matched females (P<0.05). Some reports have noted a higher susceptibility to knee injury, specifically injuries to the anterior cruciate ligament, in female athletes as compared with their male counterparts. Most importantly, stiffness and muscular strength increase stress on the anterior cruciate ligament in female athletes. Differences of T2 and T2⁎ values between patients and controls were compared using unpaired Student's t-test, and the correlation between their reciprocals was analyzed using Pearson's correlation coefficient. The imaging diagnosis should be based on primary signs, although the secondary signs are sometimes useful, particularly in chronic cases. However, after a typical acute ACL rupture it is not possible to measure the dimensions of the ACL itself due to concomitant or subsequent degeneration of the remaining ligamentous tissue. The arthroscopy was normal and the radiographers correctly did not scan the extra sequence in 140 patients (72%) who then had normal arthroscopies. Radiol 2OOO; Cmciate and posterolateral corner injuries ln tl'e athlete: clinical and magnetic resonance irnaging features. This article discusses the MR imaging and clinical features of sports-related injuries of the cruciate ligaments and posterolateral corner of the knee, highlighting the implications of such injuries on joint function. This was a pragmatic study to see if the six general MRI radiographers, each with over four years experience, could evaluate the ACL on routine orthogonal sequences (sagittal T1, Gradient Echo T2, Coronal STIR and axial fat suppressed dual echo). In 13 intact ligaments, the average number of images clearly demonstrating the entire length of the ACL was 1.77 on the coronally prescribed sequence and 1.31 on the axially prescribed images. To investigate the three-dimensional (3D) course of the anterior cruciate ligament (ACL) and determine the optimum planes for oblique full-length MRI of the ligament. The severity of the ACL injury was graded using a 4-point system from MR images, namely, intact, low-grade partial tear, high-grade partial tear, and complete tear, and results were compared with arthroscopic findings. Magnetic resonance imaging (MRI) has proven to be an excellent tool in the evaluation of meniscal tears and associated pathology. The elevated percentages of T2 and T2⁎ value in superficial LT were most significant (20.738%, 17.525%). A simple template was devised to facilitate this process, resulting in more consistently oriented imaging planes. Methods: This non-invasive, in vivo technique for measuring ACL volume may prove useful in future large-scale comprehensive studies of potential risk factors for ACL rupture, in quantifying potential loading effects on ACL size as a prophylactic measure against ACL rupture, and in the use of ACL volume as a screening tool for assessing risk of injury. Mechanisms of injury, primary and secondary MRI signs, and associated abnormalities are discussed. Thirty patients with acute hemarthroses underwent MRI within 12 days of injury, followed by arthroscopy within 24 h of the MRI. L'amélioration de la qualité des images IRM (1,5 et 3 Tesla, antenne genou ... excellent MR imaging of the entire length of the anterior cruciate ligament in its oblique sagittal plane. Magnetic resonance imaging (MRI) can diagnose cruciate ligament injuries with high accuracy. Discontinuity was found to be the most useful of the ACL abnormalities. Le LIGAMENT CROISE POSTERIEUR (LCP) est un des ligaments croisés du genou. Il est oblique du haut vers le bas, de dedans en dehors. II-Biomécanique du compartiment interne On distingue, sur la face interne du genou, un plan superficiel, le ligament collatéral médial proprement dit, et un plan profond capsulaire avec trois chefs : § Le chef moyen : renforcement profond du ligament collatéral médial § Le chef postérieur : le ligament postérieur oblique du Hughston. Il est mis sous tension maximale lors de la flexion de 90-120° du genou et se trouve plus relâché en … Nevertheless, the ACL may not always be visualised. The usual MRI sequences for the knee are sagittal T1 , and proton density-weighting with fat saturation (PD fat-sat) in the three axial, coronal and sagittal planes. Observed changes in ACL cross‐sectional area‐to‐length ratio indicate that age‐ and sex‐dependent changes in ACL size are not homogenous. Auteur : Docteur Philippe LORIAUT - Chirurgien Orthopédiste Paris Lilas Male players had statistically greater quadriceps and hamstring muscle strength than female players, even when adjustments were made for body weight.
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